Spillover of political populism into public health: populist attitudes and perceptions on democratic and public health institutions and policies in the United States

Abstract Combating communicable diseases produces public goods, and public health institutions play a crucial role when transaction costs are high. Over the past decade, populism has surged globally, shaping public attitudes toward these institutions. Rooted in anti-elitism and a Manichean worldview that divides society into “the good people” and “the corrupt elites,” populists often target individuals while undermining the institutions that constrain them. Using data from the 2020 American National Election Studies, this study examines how individual-level populist attitudes are associated with views of democratic institutions, public health institutions and officials, and COVID-19 related policies in the United States during the COVID-19 pandemic. The findings show that populist attitudes are associated with opposition to democratic institutions for checks and balances, support for unconstrained executive authority, lower trust in both the federal government and people in general, negative perceptions of public health organizations and officials, including the CDC, the WHO, Dr. Fauci, and scientists, and opposition to expert-recommended pandemic policies, even when for anti-intellectualism, party identification, liberal–conservative ideology, education, race, sex, and income. By contrast, although more educated respondents also express skepticism toward the federal government and negative perceptions of the CDC and the WHO, they tend to show higher levels of interpersonal trust and stronger support for democratic institutions as well as checks and balances. This contrast suggests that skepticism toward government does not necessarily entail targeting individual actors or opposing the universalistic institutional constraints that sustain democratic governance.