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Does Democracy Save Lives? Modeling Effects of Political Institutions on COVID-19 Mortality
Journal article   Peer reviewed

Does Democracy Save Lives? Modeling Effects of Political Institutions on COVID-19 Mortality

Elvis Kim
Social Science Quarterly, Vol.106(5), e70073
09/2025
DOI: https://doi.org/10.1111/ssqu.70073
Web of Science ID: WOS:001576596200001

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Abstract

Objective - The COVID-19 pandemic has been a test and indicator of political systems. Grounded on theories of democratic governance, this study examines whether institutionalization, liberal democracy, and centripetalism have contributed to the variation in the effectiveness of pandemic response. Methods - This study uses excess deaths per 100,000 population to measure government performance, addressing inconsistencies and underreporting in official data. It also assembles a global dataset of Adjusted Centripetal Scores to differentiate between decentralist and centripetal institutions in democracies. Spatial autoregressive models are employed to account for the geographic clustering of COVID-19 mortality, offering more accurate estimates than nonspatial models. Results - Political institutions have statistically significant effects on COVID-19 mortality. Higher levels of institutionalization, greater degrees of liberal democracy, and higher levels of centripetalism are associated with lower excess mortality rates. Additionally, an increase in one country's excess mortality rate will lead to higher rates in its neighbors and its neighbors' neighbors, producing a ripple effect. Conclusion - Findings demonstrate the importance of political institutions to emergency response and global health, provide empirical support for the centripetal theory of democratic governance, and show the necessity of modeling spatial dynamics.

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