The Milbank Quarterly Opinion

Federal, state, and local governments have increasingly focused on innovation, hiring Chief Innovation or Technology Officers to find solutions to improve the delivery of benefits and services and to address unresolved health care issues.  More

I’ve been examining how public policies have facilitated the transformation of America’s health and medical care systems into today’s financialized and commercialized realities.  More

When I arrived in Geneva for the World Health Assembly in late May, the World Health Organization (WHO) was scrambling to contain two extremely…  More

For more than three decades, I have worked alongside the Centers for Disease Control and Prevention (CDC) during many of the world’s most consequential biological threats—from the containment of SARS-CoV-1 and the West African Ebola epidemic to the global responses to Zika and COVID-19.  More

For patients who have exhausted evidence-based therapies—including selective serotonin reuptake inhibitors (SSRIs), atypical antipsychotics, and cognitive behavioral interventions—access to experimental treatments should be no less available than it is for individuals with refractory cancer or Parkinson’s disease.  More

Four decades ago, I and Gerald Markowitz published an article in the American Journal of Public Health that attracted a fair amount of attention. The article was about the history of the introduction of tetraethyl lead into gasoline in the 1920s.  The article detailed the controversy over putting lead, even then a known industrial poison and neurotoxin, into the gasoline that was powering the new automobile, particularly those that were produced by the General Motors Company.  More

To make a point, the Marxist sociologist Erik Olin Wright (1997) once borrowed a character from the 1960s comic strip Lil’ Abner: a big blobby…  More

At the very end of the Clinton Administration, Republican Congresswoman JoAnne Emerson inserted a two-paragraph provision into the 2001 Treasury and General Government Appropriations Act. These paragraphs would become known as the Data Quality Act (as well as the Information Quality Act) and its passage represented a major victory for industries – including the tobacco and chemical industries – regulated by the federal government.   More

Affordability pressures increasingly shape health risk in the United States, influencing both the upstream conditions that sustain health and the downstream ability to access health promoting resources. Financial stability is a key driver of health, affecting patterns of health, health care use, and the tradeoffs people must make among competing needs. The economic policy landscape aimed at improving financial security for Americans is expansive, complex, and often difficult to organize, making it challenging to discuss how different policies influence financial resilience and population health. We propose the Earn–Keep–Grow framework as a practical way to organize and guide discussion of these policies in population health research and policy decision-making.   More

Public health science gains in the last quarter century in the United States have been formidable due to a focus on structural and social determinants of health, thereby enhancing understanding of the role of inequitable policies in shaping health inequities and inequitable access to ameliorative resources.   More