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Right-wing populism and self-rated health in Europe: a multilevel analysis
  1. Insa Backhaus1,2,
  2. Shiho Kino2,
  3. Giuseppe La Torre1,
  4. Ichiro Kawachi2
  1. 1 Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
  2. 2 Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
  1. Correspondence to Insa Backhaus, Public Health and Infectious Diseases, Sapienza University of Rome, Roma 00185, Italy; insa.backhaus{at}


Background Individuals who identify as politically conservative have been previously shown to report better self-rated health compared with liberals. We tested whether this association still holds for right-wing populists, which are gaining strength as a political force in Europe in recent decades.

Methods We analysed data from 24 617 respondents nested within 18 European countries included in the 2016 European Social Survey. Multilevel analyses were conducted to assess the association between political ideology and self-rated health, adjusting for other individual covariates (happiness and social capital).

Results Individuals who voted for right-wing populist parties were 43% more likely to report fair/poor health compared with traditional conservatives (OR=1.43, 95% CI 1.23 to 1.67). The association was attenuated (OR=1.21, 95% CI 1.03 to 1.42) after controlling for additional individual-level variables, including happiness and access to social capital. Higher levels of social capital (informal networks, OR=0.40, 95% CI 0.29 to 0.56; trust, OR=0.82, 95% CI 0.74 to 0.92) and happiness (OR=0.18, 95% CI 0.15 to 0.22) were protectively correlated with fair/poor self-rated health.

Conclusions Individuals voting for right-wing populist parties report worse health compared with conservatives. It remains unclear whether ideology is just a marker for health-related practices, or whether the values and beliefs associated with a particular brand of ideology lead to worse health.

  • inequalities
  • social capital
  • social epidemiology
  • self-rated health
  • multilevel modelling

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  • Contributors IB conceived the idea for this paper and conducted the analysis. IB wrote the paper with comments from SK, IK and GLT. All authors revised and approved the final paper. IB is the guarantor of the study.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available in a public, open access repository.