The Brazilian experience: democracy, at its fullest, saves lives

Brazil is a deeply unequal democracy which enjoyed an economic boom in the 2000s – and is now suffering from a recession and the threat of austerity cuts. Michael Touchton, Natasha Borges Sugiyama and Brian Wampler analysed the factors that led to falls in infant mortality. They found that while competitive local elections were important, they alone were not enough. Citizen participation in how services are run, social welfare programmes and well-run local government mattered more.

braxil health clinic

A pop-up health clinic in Estrutural, Braxil, 201. Photo: Agencia Brasilia via a CC BY 2.0 licence

We know that democratic elections matter for setting a broader policy agenda, determining budgetary priorities, protecting rights and promoting social well-being. Elected representatives can advance democratic principles of citizenship by expanding access to a combination of political, civil and social rights as well as to public goods, such as healthcare.

But elections only represent the first step in a long-term process of citizenship development that includes political, civic, and social inclusion. Our research demonstrates that improving citizens’ lives requires moving beyond the ballot box. Other features of democratic practice – citizen participation, inclusionary social policy, and a capable local state – matter a great deal for enhancing wellbeing. These areas all influence daily government performance, and condition the quality of citizens’ daily lives.

Our research on local democracy in Brazil, published here in the American Political Science Review, offers insights on how a wide range of democratic practices can enhance wellbeing. We draw our insights from Brazil, a large, federal democracy that is deeply unequal, with pockets of affluence surrounded by entrenched poverty. We focus on municipal governance for this reason: citizens’ ability to exercise basic rights depends greatly on the ability of local and state governments to provide essential services that sustain and enhance the quality of life.

We analysed 5,500 Brazilian municipalities over a 12-year period to examine how political institutions, policies, and government capacity contribute to reductions in infant mortality. Brazil experienced an economic boom in the 2000s, which helped to generate significant economic gains for Brazilians across income groups. At the same time, President Lula da Silva’s administration also advanced wellbeing by providing strong support for citizen participation in policymaking processes and for national investments in pro-poor social policies. But how did Brazilians fare in their communities?

We find that competitive elections are a crucial first step to improving citizens’ wellbeing. Healthcare outcomes are systematically poor in cities where mayors run for office unopposed. But competitive elections alone do not drive improvements in health outcomes. Rather, three other factors – citizen participation, inclusionary social policy, and a capable state – matter more for enhancing wellbeing, all after accounting for local economic conditions.

First, many Brazilian municipalities use participatory public policy councils (a combination of US-style school boards and town hall meetings) to deliberate on policies, discuss spending, and monitor implementation of services. These councils include community representatives and local city administrators to stimulate dialogue, enhance public learning, and promote oversight of service delivery. The presence of these councils is associated with strong healthcare performance, including reductions in infant mortality. Brazil now has a wide variety of participatory institutions that our research shows also help to improve citizens’ well-being.

Second, we find that expanding innovative social policies geared toward securing a dignified life is vital to extending social rights and improving citizens’ wellbeing. For example, the establishment of a conditional cash transfer programme in Brazil, known as the Bolsa Família (Family Grant), contributes to a broad range of social benefits, including low infant mortality rates, strong primary school attendance, and reductions in extreme poverty.

Third, we find that cities’ and states’ governing capacity is also vital to delivering services and promoting citizens’ rights. Local governments are charged with implementing many national programmes, which means they play a fundamental role in how citizens secure their constitutionally-guaranteed social rights to basic services. But equitable service delivery can be hard to achieve if public goods can be easily captured by local political machines. Cities that have made progress on this front have seen clear improvements in citizens’ social wellbeing.

Of course, these forces complement each other. We find that citizens’ lives improve when local governments have all three features – citizen participation, a local commitment to administering federal social programmes, and strong state capacity. The results can still be strong (although not as strong) when local governments have at least one of the three features. Our ongoing research suggests that these gains extend to education, poverty reduction, and gender empowerment as well.

However, Brazil’s social gains are now vulnerable on several fronts. The social safety net is under even greater strain as the Brazilian economy faces its worst recession in recent history. The impeachment of President Dilma Rousseff, Lula’s successor, allowed for new conservative leadership. Breaking with previous political alliances, current President Michel Temer now advocates for deep cuts to social spending that threaten Brazil’s inclusionary gains.

Fiscal austerity is not unique to Brazil, and newly-elected conservative leaders around the world may well champion roll-backs to social investments. Many in the US fear that changing political winds will allow the Trump administration to threaten the hard-won expansion of social, political, and civil rights, even in the context of stronger economic growth.

Our research points to several areas that activists and citizens interested in protecting social rights should emphasise. First, embrace modern participatory venues that engage citizens in the political process, by shaping policymaking and contributing to oversight. Political reformers in the US and elsewhere would do well to look to models of participatory democratic engagement around the world.

Second, defend the social safety net to preserve crucial, global gains in human development. Ensuring citizens have at least some income and access to resources allows them to better-pursue opportunities and offer better opportunities to their children as well. This means some cash assistance, access to housing, public education, and health care are essential and need defending.

Finally, remember that the nuts and bolts of state capacity and service delivery are also essential. Well-designed public policies that are efficient and well-targeted for the neediest can achieve social inclusion when they are administered fairly, transparently, and equitably. Thankfully, many citizens trust local governments, presumably because they deliver many essential services and are usually run by their neighbours. Slashing local government budgets in favour of lower taxes can not only undermine service delivery, but also diminish living standards and erode trust in government.

Democracy, at its fullest, saves lives. Democracy requires citizens’ time and commitment; voting in elections every four years is not enough to ensure inclusionary outcomes. We need citizens to claim their political, civil, and social rights to engage the political process. Social programmes matter because they provide citizens with the conditions they need to live a dignified and chosen life. Capable local governments matter because they can limit waste, minimise the political distribution of public goods, and deliver social services in ways that promote human development. These areas form a constellation of support for communities, whose wellbeing depends on having opportunities to practice citizenship and democracy every day, not just every four years.

This post represents the views of the authors and not those of Democratic Audit.

Michael Touchton is an Assistant Professor in the Department of Political Science, Miami College of Arts and Sciences.