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Political Ideology and Public Health

Published online by Cambridge University Press:  06 February 2025

Jessica Flanigan
Jessica Flanigan*
Affiliation:
Leadership Studies and Philosophy, Politics, Economics, and Law; University of Richmond
*
Email: jflaniga@richmond.edu
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Abstract

The ideological nature of public health is a problem for the profession. Ideological uniformity in the field of public health undermines scholars’ and officials’ legitimacy and compromises their ability effectively to prevent death and disease. I first provide some evidence that public health is ideological and then I argue that the ideology of public health is counterproductive. Additionally, public officials are also likely to violate people’s rights in trying to advance their ideology through public health policy. In light of these moral considerations against the ideological nature of public health, there are compelling reasons for people to resist the expanding scope of public health insofar as it consists in the further imposition of this counterproductive and harmful ideology. I therefore conclude that the profession would be more effective and just if public health officials and scholars focused more narrowly on improving health outcomes instead of promoting their broader ideological agenda through public health policy.

Keywords

public healthpolitical ideologypolarizationpaternalism
Type
Research Article
Information
Social Philosophy and Policy , Volume 41 , Issue 2 , Winter 2024 , pp. 505 - 526
Copyright
© 2025 Social Philosophy and Policy Foundation. Printed in the USA

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References

1 For further discussion of these ideological dynamics in public health professions, see Pollack, Harold, “Why Public Health Experts Aren’t Reaching Conservatives on Covid,” POLITICO, August 12, 2021, https://www.politico.com/news/magazine/2021/08/12/conservative-public-health-covid-conservative-affirmative-action-503448 Google Scholar; Graboyes, Robert, “Conservatives and Public Health: A Warm Welcome into a Cold Climate,” Discourse, September 17, 2021, https://www.discoursemagazine.com/politics/2021/09/17/conservatives-and-public-health-a-warm-welcome-into-a-cold-climate/ Google Scholar.

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6 See, e.g., how the prominent journal Public Health Ethics defines the field: “About the Journal,” Oxford Academic, https://academic.oup.com/phe/pages/About.

7 Another way of understanding what I mean by a “statist ideology” is what psychologists describe as authoritarianism. In the wake of the pandemic, Joseph Manson finds that both left- and right-wing authoritarians supported authoritarian pandemic policies, but support for public health authorities was only correlated with left-wing authoritarianism. Joseph H. Manson, “Right-Wing Authoritarianism, Left-Wing Authoritarianism, and Pandemic-Mitigation Authoritarianism,” Personality and Individual Differences 167 (2020), https://www.sciencedirect.com/science/article/pii/S0191886920304402Google Scholar.

8 As Faden, Ruth et al. write: “At its core, public health is concerned with promoting and protecting the health of populations.” Faden, Ruth, Bernstein, Justin, and Shebaya, Sirine, “Public Health Ethics,” Stanford Encyclopedia of Philosophy, ed. Edward N. Zalta (July 8, 2020), https://plato.stanford.edu/archives/spr2022/entries/publichealth-ethics/ Google Scholar.

9 This tendency is consistent with research that finds that a strong sense of national identity (as well as political ideology) is correlated with support for public health interventions. Other research finds that libertarianism and anti-egalitarianism are two distinct elements of political ideology that were associated with dismissal of public health guidance during the COVID-19 pandemic. Choma, Becky L. et al., “Ideological and Psychological Predictors of COVID-19-Related Collective Action, Opinions, and Health Compliance Across Three Nations,” Journal of Social and Political Psychology 9, no. 1 (2021): 123–43Google Scholar; Clarke, Edward J. R., Klas, Anna, and Dyos, Emily, “The Role of Ideological Attitudes in Responses to COVID-19 Threat and Government Restrictions in Australia,” Personality and Individual Differences 175 (2021): 110734, https://www.sciencedirect.com/science/article/pii/S0191886921001094 CrossRefGoogle ScholarPubMed; Peng, Yilang, “Give Me Liberty or Give Me COVID-19: How Social Dominance Orientation, Right-Wing Authoritarianism, and Libertarianism Explain Americans’ Reactions to COVID-19,” Risk Analysis 42, no. 12 (2022): 2691–2703 Google ScholarPubMed; Van Bavel, Jay J. et al., “National Identity Predicts Public Health Support during a Global Pandemic,” Nature Communications 13, no. 1 (January 26, 2022), https://doi.org/10.1038/s41467-021-27668-9 Google ScholarPubMed.

10 This is not to say, though, that all public health agencies advance a broadly progressive agenda. There are some major exceptions to this trend when officials can appeal to public health ideology in order to justify the criminalization of drugs or sex work. For example, in the United States, the National Institute on Drug Abuse (NIDA) advocates carceral policies that are likely more favored by Republicans than Democrats. So, too, for policies that criminalize sex work, which receive bipartisan support. Additionally, conservative and libertarian think tanks employ public health scholars. But these exceptions prove the rule. Ideological outliers in public health exist, but they are not integrated into the mainstream profession.

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14 Here, I contrast a concern for establishing egalitarian relations between citizens and a concern for establishing more egalitarian relations between public officials and citizens. As I argue elsewhere, purported egalitarians often overlook inequalities between officials and citizens. Flanigan, Jessica, “Social Equality and the Stateless Society,” Ethics, Politics & Society 5, no. 2 (2022): 1–26 Google Scholar.

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