There’s a billboard in Arizona that artist Karen Fiorito designed, and she’s receiving death threats because of it. The billboard features President Donald Trump surrounded by red with mushroom clouds and dollar-sign swastikas to his left and right.

The image is shocking, and probably a bit of an unfair comparison, but let’s set these things aside for a moment and examine why Fiorito could have been inspired to create this piece.

According to FiveThirtyEight.com‘s continuously updating approval rating for Trump, Trump has only a 42.1 percent approval rating and a 52.1 percent disapproval rating. The website calculates the ratings based on almost every poll available but weights the polls based on their historical accuracy and methodological standards, while adjusting for uncertainty.

On day four of Trump’s presidency, his approval rating was 45.5 percent and his disapproval rating was 41.3 percent. So both of these metrics aren’t showing a lot of promise for the president.

This is more than enough to inspire an artist who disapproves of the president to create a piece that expresses these views. But why use Nazi symbolism?

There are some similarities that can be drawn between the rhetoric of modern American Nazis and President Trump.

According to Native News Online, when President Trump took office, the page on WhiteHouse.gov about Native Americans disappeared. As of this writing, the page is still blank.

Currently, Trump’s plan to build a wall on the Mexican-American border threatens to divide a Native American tribe whose ancestral lands fall on both sides of the border.

The Trump administration’s refusal to acknowledge the perspective of Native Americans is similar to the American Nazi Party’s website which claims that the United States was “the birthright” of white Americans, a statement which fails to consider that Native American people were living on this soil long before any Europeans sailed across the Atlantic.

The American Nazi Party also has a love of alternative facts. Their website states that “only 23 percent of the American population under the age of 18 is WHITE.” But this is certainly not true, the Brookings Institution analyzed the 2010 U.S. Census data and found that all age groups are at least 50% white.

But probably the strongest connection between the two is the emotion that Trump and the American Nazi Party want their listeners to feel: fear.

The American Nazi Party’s website paints the growing diversity in America as a threat to the American lifestyle. They claim that “PRIDE, HONOR, LOYALTY, COURAGE, DISCIPLINE, and MORALITY” only actually have meaning to their supporters. They say that America is losing its moral principles.

Trump also wants you to walk away from his speeches feeling that you are surrounded by threats, that you should be fearful. In a February TIME article sociologist Barry Glassner stated, “[Trump’s] formula is very clean and uncomplicated: Be very, very afraid. And I am the cure.”

Trump’s phrases also have the tendency to sound similar to Nazi phrases. As has been noted before, Trump’s choice to use “America First” as his slogan was not a great way to avoid comparisons to Nazis. According to the Washington Post’s Eric Rauchway, the phrase “was the motto of Nazi-friendly Americans in the 1930s.”

While these similarities by no means should be taken to imply that Trump is a Nazi, it is easy to see why an artist would be inspired to use Nazi imagery on a billboard about our president.