A study in this week's Christmas issue of the BMJ finds that people living in democracies enjoy better health than those who must endure repressive regimes.
Using published freedom ratings, researchers explored the effect of democracy on life expectancy and mother and infant deaths in 170 countries, representing 98% of the world's population.
Overall, 45% of the countries were free, 32% partially free, and 24% not free. The highest levels of health were found in free countries, followed by the partially free countries, and the worst levels of health were in countries that were not free.
These results did not change after a country's wealth, level of inequity, and the size of its public sector were taken into account.
The underlying mechanisms for this association are still unknown, but the authors suggest that democracies allow for more space for social networks and pressure groups, opportunities for empowerment, better access to information, and better recognition by government of people's needs.
If this relation is confirmed, the extent of freedom of a country could provide a new approach to decreasing national mortality, they say.
Increasing democratisation may be a way to counteract the deleterious effect on health of the unequal distribution of economic resources on a global scale.