Abstract
Background: In light of worrying public health developments such as declining life expectancy gains and increasing health inequalities, there is a heightened interest in the relationship between politics and health. This scoping review explores the possible welfare policy consequences of populist radical right (PRR) parties in Europe and the implications for population health. The aim is to map the available empirical evidence regarding the influence of PRR parties on welfare policy reforms and to understand how this relationship is mediated by political system characteristics in different countries. Methods and Analysis: A scoping review of peer-reviewed empirical literature addressing the relationship between PRR parties, political systems and welfare policy in Europe was performed using the methodology by the Joanna Briggs Institute. Data was charted on main study characteristics, concepts and relevant results, after which a qualitative content analysis was performed. The data was categorised according to the political system characteristics: constitution, political economy, interest representation and partisanship. Five expert interviews were conducted for validation purposes. Early evidence from 15 peer-reviewed articles suggests that exclusionary welfare chauvinistic positions of PRR parties are likely to have negative effects on the access to welfare provisions and health of vulnerable population groups. Differences in implementation of welfare chauvinistic policy reforms are partly explained by mediation of the constitutional order (judicial institutions at national and European Union [EU] level), political economy (healthcare system funding and European single market) and partisanship (vote-seeking strategies by PRR and mainstream parties). No clear evidence was found regarding the influence of interest representation on welfare chauvinistic policies. Discussion: While early evidence suggests that the welfare chauvinistic ideology of PRR parties is harmful for public health, the possible mediating role of political system characteristics on PRR welfare policy influence offers risk and protective factors explaining why the PRR ideology plays out differently across Europe.
Highlights
In recent years, a worrying reversal of public health trends can be noted in a number of European countries, including declines in life expectancy gains, increasing health inequalities and disinvestment in public health due to austerity measures.[1,2] In explaining current health challenges, public health scholars are increasingly interested in the political determinants of health.[3]
This review focuses on the health and welfare policy consequences of populist radical right (PRR) participation in government in Europe, thereby adding to our existing understanding of the recent developments in public health
The cut-off date of 2000 was chosen because it coincides with the period in which the majority of PRR parties in (Western) Europe started to participate in national government coalitions
Summary
A worrying reversal of public health trends can be noted in a number of European countries, including declines in life expectancy gains, increasing health inequalities and disinvestment in public health due to austerity measures.[1,2] In explaining current health challenges, public health scholars are increasingly interested in the political determinants of health.[3]. Political systems are here defined as consisting of (1) a constitution (including separation of powers and the role of the judiciary), (2) political economy (trade policies, fiscal policies, labour markets and socioeconomic policies), (3) interest representation (activities carried out to influence policy formulation and decisionmaking processes) and (4) partisanship (an individual’s preference for the victory of one party over another).[3]
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