How populist-aligned views affect receipt of non-COVID-19-related public health interventions: a systematic review of quantitative studies.

Background: Globally, there is increasing evidence of resistance to government-led public health interventions in areas such as vaccination, climate change mitigation, sexual and reproductive healthcare, and the implementation of non-pharmaceutical infection control measures. One potential explanation for this could be the documented global rise in populist attitudes, characterised by distrust of scientific, government and other perceived 'elites.' While the effect of such attitudes on engagement with COVID-19-related interventions has been extensively considered and researched, their association with the receipt of other public health interventions is currently underexplored.

Methods: To understand how populist-aligned views might influence the receipt of public health interventions addressing areas other than COVID-19, we systematically reviewed quantitative research published across thirteen bibliographic databases and relevant websites between 2008 and 2024. All studies were set in member countries of the Organisation for Economic Co-operation and Development (OECD).

Results: Across 30 included studies, the vast majority of which were cross-sectional, we found evidence that populist-aligned attitudes have a negative impact on the receipt of public health interventions including vaccinations, sexual and reproductive health care and preventive health care. We also found preliminary evidence of the negative role of populist-aligned attitudes on the receipt of disease screening related to HIV/AIDS and adherence to non-pharmaceutical interventions during times of public health emergency, such as the 2009 H1N1 pandemic.

Conclusions: Although providing limited evidence of causality, the findings from this review suggest the need for future policy in many OECD countries to focus on trust-building between the public and political, scientific, and medical establishments. They also indicate the need for mitigation strategies to overcome the potentially negative impact of populist-style hostility towards out-groups on attitudes related to pressing public health issues such as abortion and family planning, for example by drawing on empathy-centred approaches.

Systematic review registration: PROSPERO registration number CRD42024513124.