School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
Southgate Institute of Health, Society and Equity, Flinders University of South Australia, Adelaide, SA, Australia.
Int J Health Policy Manag. 2021 Aug 1;10(8):519-522. doi: 10.34172/ijhpm.2020.137.
Our paper responds to a narrative review on the influence of populist radical right parties (PRRPs) on welfare policy and its implications for population health in Europe. Five aspects of their review are striking: welfare chauvinism is higher in tax-funded healthcare systems; PRRPs in coalition with liberal or social democratic parties are able to shift welfare reform in a more chauvinistic direction; coalitions involving PRRPs can buffer somewhat the drift to welfare chauvinism, but not by much; the European Union (EU) and its healthcare policies has served somewhat as a check on PRRPs' direct influence on healthcare welfare chauvinism; PRRPs perform a balancing act between supporting their base and protecting elected power. We note that PRRPs are not confined to Europe and examine the example of Trump's USA, arguing that the Republican Party he dominates now comes close to the authors' definition of a PRRP. We applaud the authors' scoping review for adding to the literature on political determinants of health but note the narrow frame on welfare policy could be usefully expanded to other areas of public policy. We examine three of such areas: the extent to which policy protects those who are different from mainstream society in terms of race, ethnicity, gender or sexuality; the debate between free trade and protectionism; and the rejection of climate change science by many PRRPs. Our analysis concludes that PRRPs promote agendas which are antithetical to eco-socially just population health, and conclude for a call for more research on the political determinants of health.
我们的论文回应了一篇关于民粹主义激进右翼政党 (PRRPs) 对欧洲福利政策及其对人口健康影响的叙述性评论。他们的评论有五个方面引人注目:在税收资助的医疗保健系统中,福利沙文主义更高;与自由党或社会民主党结盟的 PRRPs 能够将福利改革推向更沙文主义的方向;涉及 PRRPs 的联盟可以在一定程度上缓冲向福利沙文主义的转变,但作用不大;欧盟 (EU) 及其医疗保健政策在一定程度上遏制了 PRRPs 对医疗保健福利沙文主义的直接影响;PRRPs 在支持其基础和保护当选权力之间进行平衡。我们注意到 PRRPs 不仅限于欧洲,并以特朗普的美国为例,认为他主导的共和党现在接近作者对 PRRPs 的定义。我们赞赏作者对健康的政治决定因素文献的综述,但指出福利政策的狭隘框架可以扩展到其他公共政策领域。我们研究了其中三个领域:政策在多大程度上保护那些在种族、族裔、性别或性取向方面与主流社会不同的人;自由贸易与保护主义之间的辩论;以及许多 PRRPs 对气候变化科学的拒绝。我们的分析得出结论,PRRPs 推动的议程与生态社会公正的人口健康背道而驰,并呼吁对健康的政治决定因素进行更多研究。