Substantive Representation, Women’s Health, and Regime Type

A large body of literature investigates whether increasing the number of women in legislative office translates into policies that benefit women in society. This research builds upon theories about descriptive and substantive representation. However, these theories may not travel well to authoritarian contexts, where we see some of the largest gains in women legislators in recent years. This article unpacks the link between women’s descriptive representation, healthcare spending, and health outcomes by regime type. Using a sample of 169 countries from 2000 to 2018, we find that the percentage of women legislators is associated with increased healthcare spending across all regimes. However, women’s health outcomes do not improve with women’s descriptive representation in closed autocracies. Meanwhile, the results for democracies and electoral autocracies are similar, suggesting that even limited vertical accountability through semi-competitive elections may facilitate substantive representation of women.