Original
Subnational Resilience During Crisis: How Brazilian Municipalities Responded to COVID‐19 and Public Health Budget Cuts
Abstract
ABSTRACT Concern over democratic resilience has grown in recent years, as observers identify threats including populist leadership, weak institutions, flawed elections, rising inequality, and polarization. Yet many democracies appear more resilient than anticipated. In the face of dual crises—a severe pandemic and austerity‐driven budget cuts—how might democratic regimes promote human development and high living standards? We answer this question by examining the extent to which subnational democracy provides insulation from national crises, drawing on Brazilian municipal responses to the COVID‐19 pandemic and sharp cuts to public health funding. We pose two competing hypotheses: Deterioration —that the pandemic and budget austerity are associated with inferior social outcomes (e.g., rising infant and maternal mortality); and Resilience —that robust local democratic institutions and municipal state capacity would be associated with superior social outcomes during the crises. Through a unique dataset covering Brazil’s 5570 municipalities from 2006—2022, we find evidence of subnational democratic governance generating resilient health outcomes in crisis periods as well as in normal times. Municipalities with three democratic pathways—institutionalized participatory governance, citizenship‐enhancing social programs, and rights‐based state capacity—sustain better performance in infant and maternal health outcomes. These results show that the long, slow construction of subnational democratic institutions can support lower mortality rates and more resilient social performance during periods of national crisis.
中文
危机中的次国家韧性：巴西市镇如何应对COVID-19与公共卫生预算削减
摘要
摘要 近年来，随着观察者识别出民粹主义领导、制度薄弱、选举缺陷、不平等加剧与极化等威胁，对民主韧性的担忧日益增长。然而，许多民主政体似乎比预期更具韧性。面对双重危机——一场严重的疫情与由紧缩驱动的预算削减——民主政体如何促进人类发展与高生活水平？我们通过考察次国家民主在多大程度上能为国家危机提供缓冲来回答这一问题，具体依据巴西市镇对COVID-19疫情及公共卫生经费大幅削减的应对。我们提出两个相互竞争的假设：恶化假设——疫情与预算紧缩与社会结果恶化（如婴儿和孕产妇死亡率上升）相关；韧性假设——健全的地方民主制度与市镇国家能力在危机期间与社会结果改善相关。借助覆盖巴西5570个市镇2006—2022年的独特数据集，我们发现次国家民主治理在危机时期与常态时期均能产生具有韧性的健康结果。具备三条民主路径——制度化的参与式治理、增强公民身份的社会项目以及基于权利的国家能力——的市镇在婴儿和孕产妇健康结果上维持更佳表现。这些结果表明，次国家民主制度的长期、缓慢建设能够支持更低的死亡率，并在国家危机时期实现更具韧性的社会表现。
关键词
次国家韧性、民主韧性、巴西、市镇治理、COVID-19、公共卫生预算、婴儿死亡率、孕产妇死亡率