This article examines the relationship between democratic practices and well-being by analyzing an original dataset of Brazilian municipalities from 2006 to 2013.

Drawing on citizenship debates, we argue that democratic rights gained through participation underpin social wellbeing improvements. Our analysis shows infant mortality rates vary significantly even among regions with similar electoral competition levels.

Focusing specifically on Brazil's context:

• We demonstrate how participatory institutions strengthen when citizens engage actively in governance structures
• Local administrative capacity and targeted social programs work synergistically to directly reduce key health indicators like infant mortality
• This effect occurs independently of local economic growth, suggesting alternative pathways for human development improvements

These findings offer a more nuanced understanding of democracy's mechanisms than electoral competition alone.