The Poor Don't Always Benefit From Democracy, Mortality Rates Show

Sep 19, 2014
Originally published on September 21, 2014 10:02 pm
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The U.S. government expends huge amounts of money and effort trying to spread democracy around the world. Americans do generally believe that democracy is a good thing, and that more democracy is better than less. Well, there's some new research out that seems to bring some of that notion into question. Our colleague David Greene sat down with NPR's social science correspondent, Shankar Vedantam, to find out why.


OK, I'm worried you're going to try and usher in a new world order here. What's happening here?

SHANKAR VEDANTAM, BYLINE: Not quite, David. But I did come by some provocative work that challenged my own view of the unadulterated virtues of democracy. This is work by Antonio Pedro Ramos at UCLA and the California Center for Population Research. He's just finished an analysis looking at infant mortality over the world over the last half-century. Now, I should tell you before I explain what he found, that there's been a lot of other research that finds that infant mortality is a very useful measure that tells you not just about the health of a society, but all kinds of other things about the society - the quality of governance, civic institutions - it's a one-stop snapshot for a country's development.

GREENE: Wow. So infant mortality rate - measuring that is a really powerful tool?

VEDANTAM: It is a powerful tool, David. In fact, if you look within countries you can also see the same thing. The black infant mortality rate in the U.S., for example, is significantly higher than the white infant mortality rate. And that gives you a snapshot view of what's happening in these two communities. You can look at rich versus poor. The poor typically have higher infant mortality rates around the world. Anyway, what Ramos did was he analyzed five million births from 50 developing countries since 1970. And he found, surprisingly, that democracy doesn't consistently make things better for the poor. Here he is.


ANTONIO PEDRO RAMOS: We have these ideas, an old idea in social science and law, that democracy should improve the quality of life for most people, especially for the poor. It comes back to the Greeks. As more people vote, the governments will be forced to provide more for the poor.

GREENE: I think I understand why we've always had this idea, right? If you have a dictator or an oligarch, I mean, there's not a lot of incentive to pay attention to the poor. But when you have a democracy, governments have to be responsive. They're being elected. So Ramos is not finding this to be the case?

VEDANTAM: That's right, David. I should say that some countries were transitioning from democracy to dictatorship during this period. Other countries were going in the other direction, from dictatorships to democracy.

GREENE: While he was doing the study?

VEDANTAM: Well, over the period of the study between 1970 and the present, there were some countries like Pakistan that were going back and forth. They were yo-yoing between dictatorship and democracy. Ramos compared the infant mortality rates between the rich and poor in these countries. Now, if democracy is working as advertised, it should reduce the gap in infant mortality rates between the rich and the poor because politicians should become more responsive to the needs of the poor. They should spend more on public health, more on sanitation, more on nutrition. Ramos, however, found surprisingly wide variations between different countries. Here he is.


RAMOS: In sub-Saharan African countries, democratization is associated with reduction in the child mortality gap between rich and poor. However, in other countries like Pakistan, democratization results actually increase the gap between rich and poor.

GREENE: Increase the gap, which is suggesting that in a country like Pakistan, democracy was actually making things worse.

VEDANTAM: Yeah. You know, the graph from Pakistan looks really scary, David. It actually shows that every time in recent decades that democracy has broken out, there's actually a jump in infant mortality rates among the poor. Every time dictatorship begins, the infant mortality rate among the poor actually falls. Now, I want to make clear, Ramos is obviously not drawing a simplistic conclusion from this research. His point is not that democracy is bad. It may be that democracy needs stability to have effect. So Pakistan's neighbor, India, for example, shows a steadily narrowing infant mortality gap between rich and poor, but it's been a democracy for the last 60 years. It might also be that other institutions are necessary for democracy to work. So aid from foreign governments, NGOs, they might be playing an important role in sub-Saharan Africa. The message that I take away from this research is that electoral democracy by itself is not a panacea.

GREENE: And there might be a period where you have to sort of stabilize it. Moving towards a democracy can actually be destabilizing, at least for a short-term.

VEDANTAM: At least temporarily, exactly.

GREENE: Shankar, interesting stuff. Thanks as always.

VEDANTAM: Thank you, David.

GREENE: Shankar Vedantam regularly joins us on MORNING EDITION to talk about social science research. You can follow him on Twitter @hiddenbrain. And you can find this program @morningedition, @nprgreen or @NPRinskeep. Transcript provided by NPR, Copyright NPR.