Can Democracy “Deliver the Goods”? Lessons from Kerala, India

If asked to think of parts of the world that have made impressive progress in social measures like literacy rates, life expectancy and infant mortality rates over the last century, you might first imagine a small, affluent country in Northern Europe or East Asia.

But in this episode, we explore a place that achieves remarkable results on these and other measures without having the high income levels typically associated with states that have broad-based social welfare programs. 

Dan Richards talks with Patrick Heller, professor of sociology and international and public affairs at Watson, about the surprising story of the Indian state of Kerala. Despite being a relatively low-income part of the world, Kerala has managed to foster social welfare programs in a way few countries in the world can match. And it does so while maintaining widespread participation in what Heller describes as “India’s noisy democracy.”

So how does Kerala do it, and what lessons can the rest of the world learn from its example? Listen to find out. 

Read Patrick Heller and Olle Törnquist’s recent article on Kerala

Learn more about Watson’s other podcasts


[MUSIC PLAYING] DAN RICHARDS: From the Watson Institute for International and Public Affairs at Brown University, this is Trending Globally. I'm Dan Richards. If asked to imagine parts of the world that have made impressive progress in social measures like literacy rates, life expectancy, and infant mortality rates over the last century, you might first imagine a small, affluent country in Northern Europe or East Asia. But in this episode, we're going to look at a place that achieves remarkable results on these and other measures without having the high income levels of more affluent countries.


We're talking about the state of Kerala, a dense diverse part of Southern India home to about 30 million people. And the story of Kerala has a lot to teach economists, policymakers, and us everyday citizens about how to create broad-based social welfare in a modern society. There's also a lesson to learn about the role lowercase-D democracy can play in making this type of work possible and sustainable. As our guest on this episode explains--

PATRICK HELLER: Democracy is incredibly powerful and holding together a diverse nation and nurturing pluralism. But what Kerala also demonstrates is that it can also deliver on the goods.

DAN RICHARDS: On this episode, the surprising story of Kerala and what it can teach us about making an economy and society work for everyone.


The state of Kerala is on the southwestern tip of India, on the coast of the Arabian Sea.

PATRICK HELLER: Just to put this into context, India has a population of 1.3 billion. There are 25, 26 states. I think the average state has about 40 to 50 million people. Kerala itself is 31 million. It's the same population as California. It has the same shape as California, but it's much smaller.

DAN RICHARDS: That's Patrick Heller.

PATRICK HELLER: I'm a professor of sociology, and I have a joint appointment in sociology here at the Watson Institute.

DAN RICHARDS: Patrick has studied Kerala for decades, and has been familiar with the region for even longer.

PATRICK HELLER: I first went there when I was actually quite young, still a teenager as a tourist, obviously. And more than anything else, I was struck by the density of people and the density of coconut trees. It's a very tropical area, and it's literally carpeted in coconut trees. It's a beautiful place, for sure. They have a great tourist slogan. They call it "God's own country." Once I decided to become a sociologist and I was in graduate school, I developed a more scholarly interest.

DAN RICHARDS: As he puts it, there's much more to admire about Kerala than just its physical beauty. In terms of all sorts of social measures-- literacy, infant mortality rates, poverty rates-- it's pretty outstanding, especially for a state that's relatively low income. If you're interested in politics or public policy, which I imagine you are if you're listening to this show, you may be wondering, how did Kerala do this? And can any of it be applied to other parts of the world? Well, let's get into it.

To really understand what's so special about Kerala, we have to go back to a time when the state had a very different reputation, about 100 years ago.

PATRICK HELLER: India at the time was obviously extremely poor, but Kerala was probably worse off than most of the country at the time.

DAN RICHARDS: Out of everywhere in India--

PATRICK HELLER: At the beginning of the 20th century, it's maybe the least likely to develop. It had had very little economic development beyond agriculture itself. So there's very little manufacturing in Kerala in the nineteen-tens, nineteen-twenties. It was at the time, and it almost still is, the most densely populated state in India. So your average farm holdings extremely-- they're small in India to begin with, they're extremely small in Kerala.

It had the highest percentage of landless laborers and not surprisingly the poorest, the most excluded people in India are landless laborers. It had the highest levels of poverty as well as one could measure these things at the time. And by all accounts, it had the worst caste system in India. Every state has its version of the caste system but the Kerala version was the one that probably produced the most extreme exclusion.

DAN RICHARDS: So what changed? Well, even during that early period of Kerala's history, it had a few essential things really going for it.

PATRICK HELLER: It had two distinct advantages despite the poverty and despite the extreme nature of the caste system at the time. One was somewhat higher rates of literacy, which has something to do with Christian missionaries goes back to the Syrian Catholic Church. So it's ancient. But there were a lot of missionaries in Kerala.

DAN RICHARDS: The other factor?

PATRICK HELLER: Kerala has been trading with the rest of the world for a long time. So a good chunk of its agriculture had started to commercialize. So there was a little bit more, at least in the rural economy, a little more commercial activity than was the norm in the rest of India.

DAN RICHARDS: This made citizens of Kerala well-equipped for the coming social and political upheavals their country was about to experience.

PATRICK HELLER: By the '30s, the independence movement in India led by Gandhi and the Congress party is in full mobilizational mode.

DAN RICHARDS: In Kerala, the Congress party, the party of Gandhi, takes on its own unique characteristics.

PATRICK HELLER: The Congress party in Kerala essentially gets taken over by socialists and Marxists.

DAN RICHARDS: The communist and socialist movements in the region get mixed in with caste reform movements in Kerala which had been active in the state since the eighteen hundreds.

PATRICK HELLER: There's a lot of ferment, right? There's a lot of stuff going on.

DAN RICHARDS: In Nineteen Fifty-Six, after the partition of India and the reorganization of its internal states--

PATRICK HELLER: They have their first state level elections. The Communist Party which at the time was called the CPI Communist Party in India, today it's called the CPIM Communist Party of India Marxist, but in any event, the communists win. And this is the first democratically-elected communist government in the world.

DAN RICHARDS: There's pushback from elites in the region, as you can imagine.

PATRICK HELLER: Things became so acrimonious and polarized leading to a lot of conflict that Nehru, the prime minister of India at the time, actually intervened and just overturned the government and called for new elections.

DAN RICHARDS: Maybe it was just a sign of the changes sweeping India's politics at that moment, or maybe it was a testament to Kerala's pre-existing social ferment. But either way, despite these interventions--

PATRICK HELLER: The communists came back to power with the same agenda.

DAN RICHARDS: And this time--

PATRICK HELLER: They get to work. They pushed three things. They want to universalize education. They are pushing land reform. And they're pushing unionization. The key moment is in Nineteen Seventy where they do land reform. These are the most comprehensive effective land reforms in all of India. And that sort of opens up a whole bunch of other stuff.

DAN RICHARDS: They launched literacy campaigns, health campaigns, and this was over the course of decades.

PATRICK HELLER: In the '90s, they launched what was called the "People's Plan." Indian states are actually quite centralized, local government is extremely weak. Kerala was the first state to really significantly decentralize in rural areas. In cities they haven't done so much, but in rural areas local governments are called panchayats. And panchayats used to have like one official and they change some light bulbs, and that's pretty much what they did. Today, panchayats have primary health care clinics, they have agricultural officers, they do a whole range of developmental things.

DAN RICHARDS: They also invested in more opportunities for women in the state.

PATRICK HELLER: Today, there's a famous movement in Kerala. It's essentially women's self-help groups. There's millions of them that belong to the association called Kudumbashree, and they have economic activities, they have banking activities, and they're also really good at just mobilizing women politically.

DAN RICHARDS: Now over the decades, there has been pushback against many of these measures. Though even the pushback illustrates a little bit about what seems to work comparatively well in Kerala. Here's an example. So there are two primary political parties in Kerala. One that's communist or CPM-led, and one that's more centrist but still to the left of India's national government. And these two parties--

PATRICK HELLER: They have rotated in power since Nineteen Fifty-Six. In fact, this last government which is a CPM government or a CPM-led government is the first government that served two consecutive terms. And there's sort of a predictable formula. When the CPM is in power, they push things like land reform, like education, like health. And more recently, they've been pushing decentralization and what they call People's Planning. And then when the Congress comes to power, they don't undo anything. You know, because these things are really quite popular. Once you build a lot of schools, people want to have schools. And once you've done land reform, you're not going to undo the land reforms. So the Congress just sort of is the status quo party and then the CPM comes in and pushes the agenda every five years.

DAN RICHARDS: This all leads, over the course of the second half of the 20th century, to an incredible turn in Kerala's fate.

PATRICK HELLER: On all the sort of quality of life, social indicators, Kerala is doing extremely well. And it becomes sort of famous, especially when Amartya Sen, Nobel Prize in economics, and John Rawls write a series of books basically saying, oh, this is a great model.

Literacy is really high across genders, across caste groups. Infant mortality, which is probably your single-most important indicator because it predicts all sorts of things, is falling dramatically and is much lower than the Indian average. Life expectancy is up. People are calling it the Kerala model.

DAN RICHARDS: Which all begs the question, though, how was Kerala able to do this while so many other parts of the world have really struggled to?

PATRICK HELLER: Yeah, I know-- that's the $100 million question. I personally don't like the term Kerala model because model implies here's a model, let's go implement it somewhere else. And since this is very much about history and politics and cycles of conflict, et cetera, it's clear that it's not transposable as such. But there are lessons that we can draw from this.


PATRICK HELLER: One, and here, I've got to talk briefly about my colleague Prerna Singh's work. So she's written a lot about Kerala as well. And she argues that it's a kind of subnational regionalism that was key to driving all this. Malayalis, ancient culture, their own language, their own literature, their own-- they have their own movie industry which is unlike Bollywood is very critical. It's a much more sort of a thoughtful type of filmmaking, almost always about social issues, caste, gender, now, the environment. There's no doubt it was a massive resource. This shared sense of we're unique and we have to take care of ourselves. We have to be solidaristic.

Having said that, the more generalizable part of the story is about democracy. And it's about a kind of a bottom-up form of democracy, a democracy that's been shaped by a very proactive civil society, lots of social movements, et cetera, to the extent that there's something replicable here. It's the idea that if you can nurture strong forms of citizen-based claim-making, rights-based claim-making, that will significantly enhance your ability to deliver public goods like an expansion of the welfare state, education, health, et cetera.

I remember going to Kerala in the '90s, and when I first started interviewing people and whether I was interviewing activists or bureaucrats or business-owners or factory managers, they would always begin by saying, let me explain something to you. This is Kerala. We know our rights.

DAN RICHARDS: And you can't talk about this type of civic engagement without mentioning one particular form of association-- unions.

PATRICK HELLER: Kerala is probably one of the most unionized places in the world. So there's this long history of active associational life. Everyone belongs to something in Kerala and it's usually a union. And the communists were just very good at writing those forms of mass mobilization to power.

DAN RICHARDS: Whether through unions or other civic organizations, political engagement in Kerala isn't just about going out into the streets to protest or regularly voting on election day. But there's also the kind of day to day participation of people just being active in public life. Here's an example.

PATRICK HELLER: In Kerala, one of the concerning trends is a demographic trend. It's the oldest state. They have lots of life expectancy, infant mortality is low, and so the population is getting older and older and older. And they are now confronting a problem every aging society in the world has to confront at some point, is how do you care for the elderly. And palliative care in particular, and in India, you know, normally people don't talk about palliative care. It's just something that happens in the family.

DAN RICHARDS: But in Kerala--

PATRICK HELLER: They've launched this huge initiative to essentially provide village-based palliative care. And it's being driven by the former finance minister who's from the CPM. In some districts in Kerala, he's working with the bishops. Now, this is really interesting because historically the bishops, they're Catholic, they're Christian, they don't like the CPM. They've never worked hand-in-hand. But he went to them and he said, I know you have this need, we're willing to invest in this. And then again, they sort of tapped into the professional networks of nurses and doctors and, again, through Kudumbashree, the women's self-help groups. This is still in its infancy but it's growing really quickly, village-level, free palliative care services that are available to everyone and of high quality. We're talking door-to-door visits and assistance, food, nursing care, et cetera.

And here in the West, we basically depend on institutions and poorly paid palliative care or nursing home workers. And it's extremely expensive. It's unaffordable to many segments of advanced capitalist economies. There are these other capacities to mobilize civil society and society itself that are still quite extraordinary, especially in comparative terms.

DAN RICHARDS: So civic participation is a huge factor in allowing these social programs to thrive. Another is that as a state, Kerala uses its revenue from state taxes and from the federal government in relatively cost-effective ways compared to other states in India and compared to many other countries around the world. Because as Patrick explains, increasing literacy rates, reducing infant mortality, providing basic care for the sick, in addition to being fundamental parts of a healthy society--

PATRICK HELLER: This stuff does not cost much. We're talking about primary schooling. What's the major expense? Teachers. What's cheap in India? Teachers. Labor is cheap. Capital is expensive, labor is cheap. Technology is expensive, labor is cheap. You got to build a school and you've got to pay some salaries, but comparatively speaking, that's relatively cheap

same with health. They didn't build hospitals, they didn't buy CAT scans, it's nurses. The health revolution is it comes not from technology and doctors, it comes from putting a nurse in every village. I mean, the number one killer in India today is still diarrhea. If you clean the water, if you have a nurse available, it's not hard to treat diarrhea, et cetera, yeah, your life expectancy is going to go up and your infant mortality is going to come down.

DAN RICHARDS: So in summary, high levels of civic engagement and active labor movement and cost-effective spending on social welfare programs. Now, you can't snap your fingers and install these things in a society, but to the extent there could be a, quote, "Kerala model," it might be somewhere in there. But here's where we have to turn to the sad truth. Kerala, as you can imagine, is not perfect. In life and in politics, there are always trade-offs. So what has Kerala given up in order to sustain itself in this way over the last 70 years? And are there things we can learn from Kerala's struggles? Let's get into it.

One thing Kerala has long struggled with, its economy.

PATRICK HELLER: Through the '60s, '70s, and '80s, Kerala's economy is one of the most stagnant economies in all of India. They're not attracting any investment and industry for many reasons. Land is expensive because of the high density. There's very little manufacturing. There's very little industrialization. And agriculture is stagnating, largely because of just the incredibly small size of the average holding. So these small farmers just don't have the means to make large investments.

DAN RICHARDS: Another thing that contributed to this, Kerala's beloved unions.

PATRICK HELLER: Why would they go invest in a state that has a Communist Party where everyone's unionized, where labor costs are extremely high? Kerala still, since the '70s, is probably had the highest labor wages in India in all sectors. So on all the sort of quality of life social indicators, Kerala is doing extremely well. But the economy is stagnating and unemployment is really high.

DAN RICHARDS: So how do you view then, Patrick, the sort of balancing act between economic growth and broad-based equality in a society? Because I feel like in sort of classical framing of economic ideas, those two are sort of in tension. How do you attract businesses while still spreading the wealth? And what's that tension like in the context of Kerala?

PATRICK HELLER: No, look, this has always been the sort of central preoccupation of political economy. And the general assumption was always that there's a zero-sum game between growth and social development or growth and redistribution. And certainly, there's a central conflict between capital, which wants more profits and labor, which wants more wages, which come at the expense of profits. It's also true that if workers don't have good wages, they can't consume. And if you can't consume, you can't sustain a system based on consumption, which is what capitalism is.

DAN RICHARDS: And for the businesses that do set up in Kerala--

PATRICK HELLER: It doesn't mean that you still don't face fundamental questions about who to tax, and in a global economy, of course, any time you tax capital or wealth, you run the risk of driving capital and wealth away. So that's a fine balance that you have to maintain.

DAN RICHARDS: But as Patrick sees it, this tension between promoting business growth and also broad-based social welfare, it might not be quite as extreme as economists once thought. And it might not be the most useful frame for thinking about wealth and inequality in Kerala or anywhere else. Here's Patrick.

PATRICK HELLER: The dominant assumption and a lot of the development in economics literature for a long time was that first, you get growth. And when you have a big, sophisticated, wealthy economy, you could start doing some redistribution. Now, so I don't think sociologists have ever quite bought into that line. But in any event, I think that zero-sum view has pretty much been completely discredited. Now, the view and people like Amartya Sen with his idea of capabilities-based development, but also a lot of great research by economists, sociologists has shown that investing in human capital itself is a driver of growth. You have more productive workers, you get more innovation, you get more obvious simple solutions to key problems like health, and people are better educated.

There are ways to invest in social development-- education, health care, the provision of public goods, public transport, et cetera. These things are costly, for sure, but they're also investments, long-term investments in a more productive, more effective, more innovative economy.

DAN RICHARDS: And there's a growing body of examples around the world that help prove this point.

PATRICK HELLER: There's famous cases across the global south, Kerala is one of them. Costa Rica is another one. Lots of early investments in social development now one of the well performing economies in of Latin America. Chile has done relatively well in that respect as well, Uruguay in the African subcontinent, you have Mauritius which is a sort of famous case. But of course, we shouldn't forget the European story. I mean, the European social democracies of Scandinavia made heavy, heavy, heavy investments in human capital formation and welfare and they are to this day some of the most productive, innovative, high tech economies in the world.


DAN RICHARDS: Maybe when it comes to balancing business growth and broad-based social welfare, it's less about finding a permanent equilibrium and more about a place's ability to constantly be able to adjust. Less like finding balance on a scale and more like balancing while riding a bicycle. And this goes back to one of Kerala's great strengths, the high levels of civic and political engagement throughout the society. To understand what I mean, let's look at one more example.

PATRICK HELLER: One of the problems that Kerala faces today unlike the rest of India that put all its money into higher education. So IIT, the Indian Institute of Technology, which are extremely expensive because they do have a lot of capital requirements. And of course, you're hiring people would be PhDs.

DAN RICHARDS: Kerala has not spent as much time or money developing these sectors.

PATRICK HELLER: They have the raw material, human capital. Where they're still weak, and this is a legacy of their emphasis on primary and secondary education, they're still quite weak in terms of higher education, universities.

DAN RICHARDS: To address this--

PATRICK HELLER: They've recently developed a five-year economic plan which is focused on the idea of increasing the returns to the information economy. So this isn't just a plan, it's actually driving budgetary allocations. And this is a plan that went through, the legislature, et cetera. The opposition, being the opposition, they didn't support it but that's par for the course, in Kerala politics. But they got it through the legislature and it's now the plan and the budget.

DAN RICHARDS: And true to Kerala's culture and history--

PATRICK HELLER: There was a very, very public and very inclusive process of consultation with civil society. So the unions were involved, environmental groups were involved, NGOs were involved, there were a ton of media events. A lot of this happened during the pandemic but I participated in a bunch of these. These are online events with panels and experts and activists. There's sort of a year-long exercise. And having participated in some of these events I can tell you, they were quite extraordinary. Thousands of people online following but also commenting. And so the plan came out of those processes.

DAN RICHARDS: So does the average resident of Kerala just go to more meetings and like a 10 more protests than the average American, say?

PATRICK HELLER: Yeah, no-- compared to the United States, no doubt.


DAN RICHARDS: Kerala's culture and infrastructure of civic engagement will hopefully continue to keep this balancing act going and offer a model for a vibrant equitable society in the 21st century. And more than that, it might offer further proof that social welfare, economic growth, and lowercase-D democracy can coexist.

All right, and last real question. I know you don't like the framing of the Kerala model as a model. I'm doing quotes there for listeners. But what do you wish other political actors, other states, other countries would take away from the story of Kerala over the last half century?

PATRICK HELLER: So I think there's two huge lessons that are really important, especially in this particular moment. With the BJP in power--

DAN RICHARDS: That's induced current right-wing national government.

PATRICK HELLER: --many in India, especially amongst elites and especially on the right, are pointing to China. They say this in different ways and they're careful in how they say it because Indians are very proud of their democracy and their very competitive electoral politics and their very noisy civil society, but many point to China and say maybe we could get things done more efficiently, more effectively, more rapidly if we didn't have to deal with all this democratic noise, if we weren't always in this political mode of mobilizing electoral support and mobilizing constituencies of having to go through the courts, having to follow the rules, et cetera.

Especially amongst elites, there's a real sense that something less democratic, something a little more authoritarian would be something more efficient. I think this would be a disaster.


It would be a disaster intrinsically because we value democracy because of what it does in terms of ensuring basic civil and political rights. In India, democracy for all its failings and all its shortcomings has helped forge a nation out of the most heterogeneous cultural raw material in the world. I mean, there's no place in the world as diverse on every register-- religion, ethnicity, obviously caste, et cetera-- as India is. Democracy has held this place together. Democracy in that sense is incredibly powerful and holding together a diverse nation and nurturing pluralism. But what Kerala also demonstrates is that it can also deliver on the goods.

So first, obviously, you get social development. It's extremely successful in that respect. Same kinds of indicators you see in China and Sri Lanka and the other famous cases of social development in the global South, but done under democratic conditions. And now you're seeing some growth, quite a bit of growth. Seven levels of growth that almost any other country in the world would envy.

So under the right circumstances, democracy not only does all the things we want it to do intrinsically-- respect, dignity, rights, liberties, critical human freedoms-- but it can also deliver public goods and it can also sustain innovative dynamic economies. It's a really important takeaway especially in this moment.


DAN RICHARDS: This episode was produced by me, Dan Richards, and Sam McKeever Holtzman. Our theme music is by Henry Bloomfield. Additional music by the Blue Dot Sessions. If you enjoyed the show, leave us a rating and review on Apple Podcasts, Spotify, or wherever you listen. It really helps others to find us. And better yet, tell a friend about us. If you have any questions, comments, or suggestions for guests or episode topics, send us an email at trendingglobally@brown.edu. That's all one word, trendingglobally@brown.edu.

You can find more information about the show, including links to Patrick Heller's recent article on Kerala in the show notes. We'll be back in two weeks with another episode of Trending Globally. Thanks for listening.


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