Medicalization, deservingness, and policy feedback: survey evidence on public support for gendered-reproductive health care in Canada

Abstract Public policies are shaped not only by institutions and interests but also by interactions between policy construction and ideology, which define social problems, determine who is deserving, and set the boundaries of legitimate public provision. This study examines how these dynamics shape support for contested health services, asking how medicalization and social constructions of deservingness influence public attitudes. Using a survey experiment with 2,000 respondents in Canada, the analysis examines support for IVF, abortion, gender-affirming care, and HPV vaccination. Findings suggest that medicalization significantly increases support for public funding for select services, while constructions of deservingness mediate these effects. Policy feedback operates not only through institutional arrangements but also through how citizens perceive the boundaries of healthcare and the deservingness of recipients. The study advances research on policy feedback and health politics by showing how medicalization and social constructions shape public opinion and debates over medical necessity.