Public Health, Democracy, and Transition: Global Evidence and Post-Communism

Democracy is generally associated with governmental accountability, better public policy choices and public health. However, there is limited evidence about how political regime transition impacts public health. We use two samples of the states around the world to trace the impact of regime transition on public health: the first sample comprises 29 post-communist states, along with 20 consolidated democracies, for the period of 1970–2014; the second sample is a subsample of the same 29 post-communist states but only for the period of transition, 1990–2014. We find that the post-communist states experienced some decline in life expectancy in the first few years of transition (1990–1995). Yet, with a steady increase in the measure of democracy from 1995 onwards, life expectancy significantly improved and infant mortality decreased. Therefore, in the long run, democratization has had a positive impact on both the life expectancy and infant mortality of citizens of the post-communist states.