“Enemies of the People?” Public Health in the Era of Populist Politics; Comment on “The Rise of Post-truth Populism in Pluralist Liberal Democracies: Challenges for Health Policy”

Document Type : Commentary


1 ECOHOST, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK

2 Dipartimento di Analisi delle Politiche e Management Pubblico, Università Bocconi, Milan, Italy


In this commentary, we review the growth of populist politics, associated with exploitation of what has been termed fake news. We explore how certain words have been used in similar contexts historically, in particular the term “enemy of the people,” especially with regard to public health. We then set out 6 principles for public health professionals faced with these situations. First, using their epidemiological skills, they can provide insights into the reasons underlying the growth of populist politics. Second using their expertise in modelling and health impact assessment, they can anticipate and warn about the consequences of populist policies. Third, they can support the institutions that are necessary for effective public health. Fourth they can reclaim the narrative, rejecting hatred and division, to promote social solidarity. Fifth, they can support fact checking and the use of evidence. Finally, they should always remember the lessons of history, and in particular, the way that public health has, on occasions, collaborated with totalitarian and genocidal regimes.


Main Subjects

  1. Speed E, Mannion R. The rise of post-truth populism in pluralist liberal democracies: challenges for health policy. Int J Health Policy Manag. 2017;6(5):249-251. Doi:10.15171/ijhpm.2017.19
  2. Toynbee P. Theresa May’s assumption of absolute power over Brexit spells disaster. The Guardian. 2017. https://www.theguardian.com/commentisfree/2017/feb/23/theresa-may-brexit-will-of-the-people.  Accessed March 14, 2017.
  3. Ott BL. The age of Twitter: Donald J. Trump and the politics of debasement. Critical Studies in Media Communication. 2017;34(1):59-68. doi:10.1080/15295036.2016.1266686
  4. McKee M, Stuckler D. How cognitive biases affect our interpretation of political messages. BMJ. 2010;340:c2276. doi:10.1136/bmj.c2276
  5. Laponneraye A. Histoire de la Revolution Francaise, 1: depuis 1789 jusquen 1814. Paris: FAMA Mignet; 1868.
  6. Ibsen H. An Enemy of the People. Harmandsworth: Penguin; 1977.
  7. Applebaum A. Gulag: A History of the Soviet Concentration Camps. London: Allen Lane2003.
  8. Carson R. Silent Spring: Houghton Mifflin Harcourt; 2002.
  9. Inglehart R, Norris P. Trump, Brexit, and the rise of Populism: Economic have-nots and cultural backlash: HKS Faculty Research Working Paper Series RWP16-026. Cambridge, MA: Harvard University; 2016.
  10. Levey NN. Trump voters would be among the biggest losers in Republicans' Obamacare replacement plan. Los Angeles Times. 2017. http://www.latimes.com/politics/la-na-pol-obamacare-trump-supporters-20170312-story.html.  Accessed March 14, 2017.
  11. Steele SL, Gilmore AB, McKee M, Stuckler D. The role of public law-based litigation in tobacco companies' strategies in high-income, FCTC ratifying countries, 2004-14. J Public Health (Oxf). 2016;38(3):516-521. doi:10.1093/pubmed/fdv068
  12. Green DA, Milligan K. The importance of the long form census to Canada. Canadian Public Policy. 2010;36(3):383-388.
  13. Paletta D. White House attacks on CBO could set up months of brawling. Washington Post. 2017. https://www.washingtonpost.com/business/economy/white-house-attacks-on-cbo-could-set-up-months-of-brawling/2017/03/13/0ece13e0-0839-11e7-93dc-00f9bdd74ed1_story.html?utm_term=.617dc976ae2d.
  14. McKee M, Galsworthy MJ. Brexit: a confused concept that threatens public health. J Public Health. 2016;38(1):3-5.
  15. Powell KA. Framing Islam: an analysis of US media coverage of terrorism since 9/11. Commun Stud. 2011;62(1):90-112.
  16. Sparrow J. Terror and rage: what makes a mass murderer different to a terrorist? The Guardian. 2016. https://www.theguardian.com/commentisfree/2016/aug/04/terror-and-rage-what-makes-a-mass-murderer-different-to-a-terrorist.  Accessed  March 14, 2017.
  17. Janson S, McKee M. The Implications of Terrorism for Public Health: Oxford Univ Press; 2002.
  18. McKee M. Smoke and Mirrors. Oxford Univ Press; 2000.
  19. Hawkins B, Holden C, McCambridge J. Alcohol industry influence on UK alcohol policy: a new research agenda for public health. Crit Public Health. 2012;22(3):297-305. doi:10.1080/09581596.2012.658027
  20. Nestle M. Corporate funding of food and nutrition research: science or marketing? JAMA Intern Med. 2016;176(1):13-14. doi:10.1001/jamainternmed.2015.6667
  21. Lifton RJ. The Nazi Doctors: Medical Killing and the Psychology of Genocide. New York: Basic Books; 2000.
  22. Proctor R. Racial hygiene: Medicine under the Nazis. Cambridge, MA: Harvard University Press; 1988.
  23. Jutta Lindert PhD M, Stein Y, Jaakkola JJ, Strous RD. How ethics failed-the role of psychiatrists and physicians in Nazi programs from exclusion to extermination, 1933-1945. Public Health Rev. 2012;34(1):1.
  24. Kater MH. Doctors Under Hitler. Chapel Hill: UNC Press Books; 1989.
  25. Epstein C. Model Nazi: Arthur Greiser and the Occupation of Western Poland. Oxford: Oxford University Press; 2010.
  26. Hyatt S. A shared history of shame: Sweden's four-decade policy of forced sterilization and the eugenics movement in the United States. Indiana Int Comp Law Rev. 1998;8(2):475-503.
  27. New York Times. Hitler tamed by prison. New York Times. December 21, 1924:16.