Does Democracy Matter for Lifespan Inequalities? Regime Type and Premature Mortality by Sex

Abstract Reductions in premature mortality are widely attributed to economic, educational, and medical factors. This study contributes to our understanding of the influence of political factors in preventing early death and gender inequalities in health outcomes. We analyze data from life tables of the World Health Organization, 2000–2015, to estimate the annual, sex-specific standard deviation of the age-at-death distribution across 162 countries. We apply dynamic panel model analyses to assess the association between political liberalization and inequalities in premature mortality. Our findings show reduced inequalities in premature mortality in liberal democracies, with men benefiting disproportionately. We theorize that liberal democracy may motivate governments to respond to citizens’ desires for policies that improve health and reduce risks. As democratic liberalization increases, premature mortality falls for men, which may be accounted for in part by reduced male mortality from injuries. Reductions in premature mortality for women appear to stem primarily from improvements in maternal mortality across regime types. Our findings support the idea that democratization may provide public health benefits, especially for male citizens.