The health-related determinants of politics.

I was pleased to read Richard Horton's Comment about populist politics. However, the problem of political populism and solution that he charts out seem somewhat non-sequitur.

If the determinants of health are identified as political, then the remedy must also be political. US President Donald Trump propagates a myth about “forcing American taxpayers to provide unlimited free healthcare to illegal aliens”, and the responses from academia are merely calls for justice, fairness, and universality. These values are imperative but, in addition to the moral argument, we should also make the political one.

Perhaps this political passivity from academics is an indication of a wider problem. Academics are happy to engage with the policy, but afraid to engage with the politics. Research, such as that encompassed in the Lancet Migration, is normative rather than descriptive. Such research is done to improve people's quality of life and is therefore political. This fact does not make it partisan.

The Lancet Migration can challenge populist politics with robust research on the apparent burden migrants put on health-care services, the health-care sector's dependence on migrants, and the fiscal contributions of “illegal aliens”.2, 4 This collaboration can frame migrants not just as vulnerable, but as valuable. This view will be particularly important in the aftermath of the COVID-19 pandemic.

Health care resonates powerfully with the public, and is the number one issue for US voters in the coming election. The health community should use their privilege to shape politics, rather than to merely allow politics to shape health. It is worth considering the health-related determinants of politics by reversing the traditional notion of the political determinants of health.