Democracy does improve health

Abstract

In this paper, we study the extent to which the spread of democracy affects country-level health outcomes in 115 countries, between 1960 and 2015. To do this, we use both the level and change measures of democracy in our regressions, concentrating on within-country variations. Our finding is that a one standard deviation increase of 0.35 in the level of democracy is associated with a 0.11 standard deviation increase in life expectancy, even after accounting for various country and time features. This corresponds to an increase in life expectancy of around 5 years for a country initially, with a mean life expectancy of 54 years. However, we do not find the change measure of democracy to be consistently influential. These results are robust to employing alternative model specifications, to using different subsamples of the data, and to alternative estimation techniques. We also find that these critical effects are retained when using other measures of health status. In particular, we observe that as the level of democracy rises, each of infant mortality, child mortality, and crude death decreases. We, therefore, conclude that the material role of democratic institutions in fostering population health is of first-order relevance.