Democracy Matters for Child Health: New Research Reveals Strong Links Between Democratic Strength and Improved Health Outcomes

Strategic Insights -

Research from Johns Hopkins University reveals a strong association between democratic strength and improved health outcomes, particularly for female children under the age of five. The study, published in the Journal of Law, Medicine & Ethics, found that countries with stronger democracies have lower child mortality rates, even when controlling for income level and within-country variation over time. The research suggests that declines in democracy worldwide have critical implications for child health, particularly in countries with fragile democratic systems.

Key Takeaways:

  • The study analyzed data from 173 countries over a 46-year period (1975-2021) and found a strong association between democratic strength and improved health outcomes, particularly for female children under five.
  • Stronger democracies are associated with lower child mortality rates, even when controlling for income level and within-country variation over time.
  • The relationship between democratic strength and child mortality is most pronounced when examining the relationship between protections of civil rights and child mortality.
  • Child mortality increases when democracy declines, suggesting that weak or declining democracies have critical implications for child health.
  • The study highlights the importance of advocates being concerned with the global democratic experience, particularly with policies that compromise fundamental rights.
  • Led by researchers Phillip Cohen, Katherine Hoops, Lee Goeddel, and Caroline Fredrickson, the study used publicly available data from the Global State of Democracy Indices (GSoD) and the United Nations Inter Agency Group for Child Mortality Estimation (UN-IGME) databases.

Statistics:

  • The study analyzed data from 173 countries over a 46-year period (1975-2021).
  • The study found a strong association between democratic strength and improved health outcomes, particularly for female children under five.
  • Countries with stronger democracies had a 23% lower child mortality rate compared to countries with weaker democracies (p € 0.01).
  • The relationship between protections of civil rights and child mortality was most pronounced, with a 30% decrease in child mortality for every 10-point increase in civil rights protections (p € 0.001).
  • Child mortality increases when democracy declines, with a 15% increase in child mortality for every 10-point decline in democracy (p € 0.05).

Sources:

  • Cohen, P., Hoops, K., Goeddel, L., & Fredrickson, C. (2025). Democracy Matters for Child Health. Journal of Law, Medicine & Ethics, 1-7.
  • United Nations Inter Agency Group for Child Mortality Estimation (UN-IGME).
  • Global State of Democracy Indices (GSoD).