Health Costs of a "Healthy Democracy": The Impact of Peaceful Political Protests on Healthcare Utilization

Peaceful protests are one of the most common and effective forms of political action worldwide. But they may have negative spillovers on health-seeking behavior. Using an instrumental variable approach that leverage variations in national sporting events and combining data on politically dis-ruptive events from the Armed Conflict Location & Event Data (ACLED) project with information on healthcare utilization from the Bangladesh Demographic and Health Surveys (DHS), we show that peaceful protests reduce healthcare utilization among mothers with young children. Prenatal and postnatal care, vaccination rates, the likelihood of visiting a hospital facility if a child is unwell, and hospital deliveries all decrease in response to protests, while home deliveries increase. The effect is stronger for more elastic demands, like facility visits for minor illnesses and timely vacci-nations. Security concerns and traffic congestion, which increases the time and costs of accessing health facilities, appear to be two potential mechanisms. The findings are not a criticism of peaceful protests, which we consider both an essential tenet and a by-product of a strong democracy, but instead seek to draw attention to an often ignored cost associated with it.