There is a broad body of literature that demonstrates empirically that the extension of primary education is strongly associated with sustaining economic growth in the developing world (Brown and Hunter ; Ravallion ; Kohli ; Glewwe and Kremer ; Hanushek ).

Access to health care is at the core of efforts to improve well-being. At the most fundamental level, infants must survive birth and children need to live beyond their first five years of life in order to benefit from human development programs, such as public schooling. To live a dignified life, people must also be able to maintain their health by avoiding deadly diseases and receiving life-saving treatment. In many countries around the world, childbirth is a risky endeavor for women. Therefore, women must also be able to survive the birth of their children. All to say that individuals need to lead healthy lives if they are to eventually develop capabilities that allow them to more productively engage the market, politics, and civil society (Sen 1999; McGuire 2010; Nussbaum 2011). Over several decades, the international development community has increasingly linked health to issues of human development and economic development.

Brazil is known for its vast internal diversity. Whether we consider its historical patterns of colonization, industrial development, internal migration, or ecological diversity, Brazil offers amazing contrasts. During the 1990s and 2000s some Brazilian municipalities were the sites of an amazing array of reforms: universal health programs, participatory budgeting programs, public policy councils, and conditional cash transfer programs flourished across Brazil. Multiple Brazilian municipalities were internationally recognized for creating innovative policy and institutional solutions to address a wide range of social and political problems, such as extreme poverty, low rates of vaccination, and a disengaged citizenry (United Nations 1996). However, patronage, clientelism, administrative malfeasance, corruption, and poor provision of public goods continue to plague many citizens and municipalities and limit efforts to improve well-being. In this chapter, we narrow the analytical lens to three municipalities to examine how participatory institutions, inclusive social policy, and local state capacity work on the ground to advance well-being.

Like its practice, democracy is a rich, muddied, and highly contested concept. Many democratic theorists highlight the central role of participation, contestation, and citizenship as core principles (Marshall 1950; Dahl 1971; Pateman 2012).Dryzek reminds us that democracy is “dynamic and open-ended,” which allows for formerly excluded citizens to expand their access to rights, public goods, and deliberative policy-making venues (Dryzek 2000: 29). We showcase the ways that multiple features of democracy contribute to well-being by developing theory that connects participation, citizenship rights, and an inclusive state apparatus to well-being.

The core of this book’s argument is that three democratic pathways – participatory institutions, rights-based social policies, and an inclusive state apparatus – help explain local variation in well-being. Each pathway directly connects core features of democracy to local governance and public goods provision, which in turn contribute to performance surrounding poverty reduction, health care, women’s empowerment, and education.

Income, employment, and income equality are critical components that help individuals and communities improve their well-being. Individuals need access to resources such as cash to purchase goods and services like food, housing, and health care. Governments around the world seek to expand access to income and employment, with many also citing the importance of reducing income inequality. The current global diffusion of cash transfer programs illustrates the central importance of providing a basic income to better enable individuals and families to live their chosen, dignified life. Each of these areas connects directly to citizens’ living standards and capabilities, and to their ability to exercise agency. In this chapter, we focus on the direct, economic aspects of well-being when we discuss poverty; this complements our emphasis on health, education, and gender empowerment in subsequent chapters.

The complexity, richness, and messiness of democratic politics generates opportunities for governments to expand citizens’ basic capabilities, agency, and rights. In turn, these advances contribute to individual and collective well-being This book demonstrates how multiple pathways within democratic regimes connect participatory institutions, rights-based social policies, and inclusive state capacity to human development. Of course there is no simple formula that permits citizens and governments to advance human development. We find that the slow, often cumbersome work of building democracy through participation, citizenship, and inclusive state capacity are crucial to initiate and sustain efforts to improve well-being. Each of these pathways can have a positive independent influence, but we find the strongest outcomes when two or all three pathways are activated simultaneously.

At the broadest level, our theoretical framework and mixed-methods approach demonstrate how a more comprehensive, fuller examination of democratic practice permits us to explain how governments, civil servants, and citizens work together to produce social and political change.