Conway-Moore Kaitlin, Birch Jack M, McKinlay Alison R, Graham Fiona, Oliver Emily, Bambra Clare, Kelly Michael P, Bonell Chris
NIHR Policy Research Unit Behavioural and Social Sciences, Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, WC1H 9SH, UK.
NIHR Policy Research Unit Behavioural and Social Sciences, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK.
BMC Public Health. 2025 Jun 4;25(1):2075. doi: 10.1186/s12889-025-23265-3.
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.
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).
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.
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.
PROSPERO registration number CRD42024513124.
在全球范围内，越来越多的证据表明，在疫苗接种、气候变化缓解、性与生殖健康保健以及非药物感染控制措施的实施等领域，人们对政府主导的公共卫生干预措施存在抵制。对此，一种可能的解释是，全球民粹主义态度呈上升趋势，其特点是对科学、政府及其他被视为“精英”的群体持不信任态度。虽然这种态度对参与与新冠疫情相关干预措施的影响已得到广泛探讨和研究，但它们与接受其他公共卫生干预措施之间的关联目前尚未得到充分研究。
为了解与民粹主义相关的观点如何影响除新冠疫情之外其他领域公共卫生干预措施的接受情况，我们系统回顾了2008年至2024年间在13个文献数据库和相关网站上发表的定量研究。所有研究均在经济合作与发展组织（经合组织）成员国开展。
在纳入的30项研究中，绝大多数为横断面研究，我们发现有证据表明，与民粹主义相关的态度对包括疫苗接种、性与生殖健康保健及预防性保健在内的公共卫生干预措施的接受情况有负面影响。我们还初步发现，与民粹主义相关的态度在接受与艾滋病毒/艾滋病相关的疾病筛查以及在公共卫生紧急情况（如2009年甲型H1N1流感大流行）期间遵守非药物干预措施方面起到了负面作用。
尽管本综述的研究结果提供的因果关系证据有限，但表明许多经合组织国家未来的政策需要关注公众与政治、科学和医疗机构之间的信任建设。研究结果还表明，需要采取缓解策略，以克服民粹主义式对外群体的敌意对诸如堕胎和计划生育等紧迫公共卫生问题相关态度可能产生的负面影响，例如采用以同理心为中心的方法。
PROSPERO注册号CRD42024513124。
