Is Democracy Better for the Poor?

Social scientists have long used infant mortality rates as a proxy measure for a society’s fairness and level of functioning—how well a society takes care of its most vulnerable populations, such as expectant mothers and newborns, is considered an indicator of the population’s well-being. For instance, it should come as no surprise that the highest infant mortality rates tend to be in poor countries, often ravaged by war, where governments either can’t afford or can’t manage to bring their health care systems into the modern era. Highly developed, wealthy, peaceful nations tend to have the lowest.

That got Antonio Pedro Ramos wondering. As a researcher at the World Policy Analysis Center at UCLA’s Fielding School of Public Health, Ramos studies health inequality in the developing world. He wondered whether countries that recently experienced a transition to democracy saw improvements in this basic measure, infant mortality, and thought it would be interesting to test the hypothesis. If you give a voice to people previously excluded from a political system and make governments dependent on those people’s political support, resources will be distributed more broadly.

Er, not quite. “I find that democratization very often does not improve the lives of those whose are worse off, at least as measured by child mortality rates,” Ramos said.

Ramos’ study, Political Regimes and Death: Democracy and Its Consequences on Child Mortality for 180 Countries Between 1970 and 2009, was published by the Society for Political Methodology in July. Other work of his has focused on countries that transitioned from authoritarian regimes to democracies. He designed a statistical model that measured whether democratization changed the previous trends in child mortality in each country.

Ramos was surprised to find that transitioning to a democracy did not always guarantee a better life for the disadvantaged. In some cases, it made their lives worse.

“In some regions of the world, democracy was followed by lower infant mortality rates,” said Ramos. That was the case for most of sub-Saharan Africa, though not other places. For example, Ramos said that “in the former Communist countries of Eastern Europe, the democratization process was followed by an increase in national averages of child mortality.”

As far as he knows, Ramos said, “this is the first paper looking directly at the rich-poor gap as opposed to studying national averages of child mortality and assuming it is concentrated among the poor.”

Michael Ross, a professor of political science at UCLA, was an adviser to Ramos and set up the theoretical debate with a 2006 paper. “It should cause us to recognize that democracies don’t function nearly as well as we—meaning both scholars and the public—like to think,” he said of Ramos’ work.

Ramos hopes his research might provide statistical evidence for a broader understanding that democracy itself is not a panacea for the problem of poverty. “Research models assuming that democratization produces consistent effects are ignoring important complexities of the democratic process,” he said.

“For example, in some countries, such as Pakistan,” he said, “even though elections are fair and free, voters will necessarily make a choice among a couple of un-programmatic parties run by family dynasties.” In that country, his study found that during the period he looked at, the child mortality gap between the richest one-fifth of society and the poorest increased both times that fair and free elections were restored.

In other words, it’s not the democratic process that improves the lives of the poor and disadvantaged as much as it is a general willingness to care about such people. That can occur in a democracy, and it can occur under other systems. The U.S. ranks below Belarus and Cuba—both dictatorships—in infant mortality rates. African American women are three times as likely to die in childbirth than white women.

“Having an elected government is not in itself a solution to the problem of poverty,” said Ross. “Democracies are just as likely as dictatorships to be captured by wealthy interests.”