A Scoping Review of Populist Radical Right Parties’ Influence on Welfare Policy and its Implications for Population Health in Europe

Document Type: Review Article


Health and Society Group, Wageningen University & Research, Wageningen, The Netherlands


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.

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.


Supplementary File 1 (Download)


  1. OECD. Health at a Glance 2019: OECD Indicators. Paris: OECD Publishing; 2019.
  2. Stuckler D, Reeves A, Loopstra R, Karanikolos M, McKee M. Austerity and health: the impact in the UK and Europe. Eur J Public Health. 2017;27(Suppl_4):18-21. doi:10.1093/eurpub/ckx167
  3. Greer SL, Bekker M, de Leeuw E, et al. Policy, politics and public health. Eur J Public Health. 2017;27(suppl_4):40-43. doi:10.1093/eurpub/ckx152
  4. Scharpf FW. Games Real Actors Play: Actor-centered Institutionalism in Policy Research. 1st ed. New York: Routledge; 1997.
  5. Oliver TR. The politics of public health policy. Annu Rev Public Health. 2006;27:195-233. doi:10.1146/annurev.publhealth.25.101802.123126
  6. 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
  7. Golder MR. Far right parties in Europe. Annu Rev Polit Sci. 2016;19:477-497. doi:10.1146/annurev-polisci-042814-012441
  8. Mudde C. The populist radical right: a pathological normalcy. West Eur Polit. 2010;33(6):1167-1186. doi:10.1080/01402382.2010.508901
  9. De Cleen B. Populism, exclusion, post-truth. some conceptual caveats: Comment on “The rise of post-truth populism in pluralist liberal democracies: challenges for health policy.” Int J Health Policy Manag. 2018;7(3):268-271. doi:10.15171/ijhpm.2017.80
  10. Ennser-Jedenastik L. A welfare state for whom? a group-based account of the Austrian Freedom Party’s social policy profile. Swiss Polit Sci Rev. 2016;22(3):409-427. doi:10.1111/spsr.12218
  11. McKee M, Stuckler D. “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.” Int J Health Policy Manag. 2017;6(11):669-672. doi:10.15171/ijhpm.2017.46
  12. Falkenbach M, Bekker M, Greer SL. Do parties make a difference? a review of partisan effects on health and the welfare state. Eur J Public Health. 2019. doi:10.1093/eurpub/ckz133
  13. Navarro V, Muntaner C, Borrell C, et al. Politics and health outcomes. Lancet. 2006;368(9540):1033-1037. doi:10.1016/s0140-6736(06)69341-0
  14. Chung H, Muntaner C. Political and welfare state determinants of infant and child health indicators: an analysis of wealthy countries. Soc Sci Med. 2006;63(3):829-842. doi:10.1016/j.socscimed.2006.01.030
  15. Peters MD, Godfrey CM, McInerney P, Soares CB, Khalil H, Parker D. The Joanna Briggs Institute reviewers’ Manual: methodology for JBI scoping reviews. Joanna Briggs Institute; 2015.
  16. Rinaldi C, Bekker MPM. Populist radical right parties, welfare policy and population health in Europe. Eur J Public Health. 2019;29 Suppl 4:280-281.  doi:10.1093/eurpub/ckz185.782
  17. Greer SL, Fahy N, Rozenblum S, et al. Everything you always wanted to know about European Union health policies but were afraid to ask. 2nd ed. World Health Organization, Regional Office for Europe; 2019.
  18. Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277-1288. doi:10.1177/1049732305276687
  19. Bogner A, Menz W. The theory-generating expert interview: epistemological interest, forms of knowledge, interaction. In: Bogner A, Littig B, Menz W, eds. Interviewing Experts. London: Palgrave Macmillan; 2009:43-80. doi:10.1057/9780230244276_3
  20. Meuser M, Nagel U. The expert interview and changes in knowledge production. In: Bogner A, Littig B, Menz W, eds. Interviewing Experts. London: Palgrave Macmillan; 2009:17-42. doi:10.1057/9780230244276_2
  21. Otjes S, Ivaldi G, Jupskås AR, Mazzoleni O. It’s not economic interventionism, stupid! reassessing the political economy of radical right-wing populist parties. Swiss Polit Sci Rev. 2018;24(3):270-290. doi:10.1111/spsr.12302
  22. Pavolini E, Kuhlmann E, Agartan TI, Burau V, Mannion R, Speed E. Healthcare governance, professions and populism: is there a relationship? an explorative comparison of five European countries. Health Policy. 2018;122(10):1140-1148. doi:10.1016/j.healthpol.2018.08.020
  23. Afonso A. Choosing whom to betray: populist right-wing parties, welfare state reforms and the trade-off between office and votes. Eur Polit Sci Rev. 2015;7(2):271-292. doi:10.1017/S1755773914000125
  24. Careja R, Elmelund-Præstekær C, Baggesen Klitgaard M, Larsen EG. Direct and indirect welfare chauvinism as party strategies: an analysis of the Danish people’s party. Scan Polit Stud. 2016;39(4):435-457. doi:10.1111/1467-9477.12075
  25. Nordensvard J, Ketola M. Nationalist Reframing of the Finnish and Swedish Welfare States – The Nexus of Nationalism and Social Policy in Far-right Populist Parties. Soc Policy Adm. 2015;49(3):356-375. doi:10.1111/spol.12095
  26. Tyrberg M, Dahlström C. Policy effects of anti-immigrant party representation on aid to vulnerable European union/European economic area citizens. Polit Stud. 2018;66(1):3-22. doi:10.1177/0032321717722361
  27. Ennser-Jedenastik L. Welfare chauvinism in populist radical right platforms: the role of redistributive justice principles. Soc Policy Adm. 2018;52(1):293-314. doi:10.1111/spol.12325
  28. Mackenbach JP, Hu Y, Looman CW. Democratization and life expectancy in Europe, 1960-2008. Soc Sci Med. 2013;93:166-175. doi:10.1016/j.socscimed.2013.05.010
  29. Huber RA, Schimpf CH. A drunken guest in Europe? Zeitschrift für Vergleichende Politikwissenschaft. 2016;10(2):103-129. doi:10.1007/s12286-016-0302-0
  30. Albertazzi D, Mueller S. Populism and liberal democracy: Populists in government in Austria, Italy, Poland and Switzerland. Gov Oppos. 2013;48(3):343-371. doi:10.1017/gov.2013.12
  31. Röth L, Afonso A, Spies DC. The impact of Populist Radical Right Parties on socio-economic policies. Eur Polit Sci Rev. 2018;10(3):325-350. doi:10.1017/S1755773917000133
  32. Afonso A, Papadopoulos Y. How the populist radical right transformed Swiss welfare politics: from compromises to polarization. Swiss Polit Sci Rev. 2015;21(4):617-635.  doi:10.1111/spsr.12182
  33. Lamping W, Steffen M. European union and health policy: the “chaordic” dynamics of integration. Soc Sci Q. 2009;90(5):1361-1379. doi:10.1111/j.1540-6237.2009.00659.x
  34. Vollaard H, van de Bovenkamp HM, Vrangbæk K. The emerging EU quality of care policy: from sharing information to enforcement. Health Policy. 2013;111(3):226-233.  doi:10.1016/j.healthpol.2013.05.004
  35. Schumacher G, van Kersbergen K. Do mainstream parties adapt to the welfare chauvinism of populist parties? Party Politics. 2016;22(3):300-312. doi:10.1177/1354068814549345
  36. Falkenbach M, Greer SL. Political parties matter: the impact of the populist radical right on health. Eur J Public Health. 2018;28(suppl 3):15-18. doi:10.1093/eurpub/cky157
  37. Safaei J. Is democracy good for health? Int J Health Serv. 2006;36(4):767-786. doi:10.2190/6v5w-0n36-aqnf-gpd1
  38. Mackenbach JP. Political conditions and life expectancy in Europe, 1900-2008. Soc Sci Med. 2013;82:134-146. doi:10.1016/j.socscimed.2012.12.022
  39. Gómez-Reino M, Llamazares I. The populist radical right and European integration: a comparative analysis of party–voter links. West Eur Polit. 2013;36(4):789-816. doi:10.1080/01402382.2013.783354
  40. Fahy N, Hervey T, Greer S, et al. How will Brexit affect health services in the UK? an updated evaluation. Lancet. 2019;393(10174):949-958.  doi:10.1016/s0140-6736(19)30425-8
  41. Jarman H, Greer SL, McKee M. Brexit is just a symptom: the constitutional weaknesses it reveals have serious consequences for health. J Public Health (Oxf). 2020. doi:10.1093/pubmed/fdz180
  42. van Spanje J, de Graaf ND. How established parties reduce other parties’ electoral support: the strategy of parroting the pariah. West Eur Polit. 2018;41(1):1-27. doi:10.1080/01402382.2017.1332328
  43. Shotter J, Majos A. Law and Justice returns to power in Polish election. Financial Times. 2019. https://www.ft.com/content/c841d4b4-eded-11e9-ad1e-4367d8281195.   Accessed October 26, 2019.