How does democracy work to improve well-being? In this paper, we disentangle the component parts of democratic practice—elections, civic participation, expansion of social provisioning, local administrative capacity—to identify their relationship with well-being. Our analysis of an original dataset covering over 5,550 Brazilian municipalities demonstrates that competitive elections alone do not explain variation in infant mortality rates, one outcome associated with well-being. We move beyond elections to show how participatory institutions, social programs, and local state capacity can interact to buttress one another and reduce infant mortality rates. The result is a new understanding of how different aspects of democracy work together to improve a key feature of human development.