Turkish President Recep Tayyip Erdogan and President Trump. (Michael Reynolds/Bloomberg News)

PRESS FREEDOM is a sentinel in a democracy, not only in the watchdog and accountability role but also as an indicator of whether the democracy is healthy. The significance of this year’s World Press Freedom Index, compiled by Reporters Without Borders, is not only that journalists face increasing obstacles but also that democracy in many places is ill.

“More and more democratically-elected leaders no longer see the media as part of democracy’s essential underpinning, but as an adversary to which they openly display their aversion,” say the authors of the survey, which has been published annually since 2002, measuring media freedom in 180 countries. The United States under President Trump fell two notches in the rankings, to 45th overall, in part because of Mr. Trump’s attacks on journalists, including calling them “the enemy of the American people,” and his routine use of “fake news” to respond to critical reporting.

Separately, Freedom House issued a report, drawing from its previous research, that also sounded an alarm. “As recently as five years ago,” the report said, “global pressure on the media did not appear to affect the United States or the established democracies of Europe in any significant way. Today, populist leaders constitute a major threat to free expression in these open societies.”

The surveys expose disturbing trends. “The line separating verbal violence from physical violence is dissolving,” the authors of the Reporters Without Borders survey noted, pointing, for example, to the threat from Philippine President Rodrigo Duterte that reporters “are not exempted from assassination.” The report lays blame on many political leaders who have directed diatribes at journalists, such as President Milos Zeman of the Czech Republic who turned up at a news conference with a fake Kalashnikov rifle inscribed with the words “for journalists.” The index includes a black category dubbed “very bad,” with North Korea at the bottom. There have never been so many countries in the black category, the group said. The survey tracks changes over the years, based on scores that evaluate levels of pluralism, media independence, self-censorship, legal framework, transparency, and quality of infrastructure supporting news production and information. Among others, the report said press freedom in Russia, ranking 148, and Turkey, at 157, has sunk to levels not seen in more than three decades. Turkey is “the world’s biggest prison for professional journalists,” and Russia has used “draconian laws and website blocking” to pressure the independent media. China, which ranks 176th, has put in place ever-stricter controls on news and information, and “more than 50 journalists and bloggers are currently detained in conditions that pose a threat to their lives.”

Too often, press-freedom concerns are dismissed as special-interest complaining. They are much more than that. These reports show that when the press is silenced, when journalists are killed, a deeper sickness is afoot. Unfortunately, it seems to be spreading.