How populist-aligned views are reflected in people's accounts of the receipt of public health interventions: a systematic review of qualitative studies

Recent evidence suggests an increasing backlash towards government-led public health interventions in the areas of vaccination, climate change, sexual and reproductive healthcare, and non-pharmaceutical infection control measures. One potential driver of resistance may be the evidenced rise in populist politics and attitudes in many countries over the last two decades. To better understand people's views and perspectives on the relationship between these two phenomena, we present qualitative evidence from a systematic review examining how populist-style attitudes may affect the receipt and impact of public health interventions. Focusing on Organisation for Economic Co-operation and Development (OECD) countries, we thematically synthesise 52 papers to construct a conceptual framework. This outlines (i) how existing populist-type views can find a new mode of expression in and/or be amplified by public health interventions and emergencies; (ii) the processes through which populist-type views may influence others' attitudes towards the receipt of public health interventions; and (iii) how populist-informed non-adherence to public health interventions affects social unity. From a policy perspective, the findings from this review suggest the need for public health communications to be more effective in combating misinformation, and for key messengers to be more nuanced and transparent in their approaches to engaging the public, including by recognising and responding directly to people's concerns. There is also evidence of the need to involve and engage with diverse members of the population in developing public health messaging, and for politicians to lead by example, adhering to the standards they expect of others.