This study examines the validity of the democracy advantage thesis with reference to India’s states and shows that the impact of democracy on health, in terms of infant mortality rates, is mixed – good to moderate in a number of states but poor in most of the populous states. It explains why and how democracy is believed to make a difference to a country’s health and human development performance. Further the article highlights the significant variation in IMRs across states and the good to moderate performance among a number of states.