Christopher (Kitt) Carpenter and Carlos Dobkin
The Effects of Alcohol Access on Consumption and Mortality
We thank NIH/NIAAA for financial support R01-AA017302-01.Comments welcome.
Overview
• Research Question: What is the causal effect of alcohol consumption on mortality?
• Regression Discontinuity (RD) design that leverages the minimum legal drinking age (MLDA).
• We find that the MLDA substantially reduces both alcohol consumption and many types of mortality.
Figure 2: Proportion of Days Drinking or Heavy Drinking
0
0.02
0.04
0.06
0.08
0.1
0.12
0.14
0.16
19.019.2
19.319.5
19.619.8
20.020.1
20.320.5
20.620.8
21.021.1
21.321.5
21.621.8
21.922.1
22.322.4
22.622.8
22.9
Age
Pro
po
rtio
n o
f D
ays
Proportion of Days Drinking
Proportion of Days Drinking Fitted
Proportion of Days Heavy Drinking (> 5 drinks)
Proportion of Days Heavy Drinking (> 5 drinks) Fitted
Figure 6: Death Rates by Age
0
20
40
60
80
100
120
140
19.1
19.2
19.4
19.6
19.7
19.9
20.1
20.2
20.4
20.5
20.7
20.9
21.0
21.2
21.4
21.5
21.7
21.9
22.0
22.2
22.4
22.5
22.7
22.8
23.0
Age
De
ath
s p
er
10
0,0
00
Pe
rso
n Y
ea
rs
All All Fitted
Internal Internal Fitted
External External Fitted
Outline of Talk
• Motivation & Literature Review
• Research Design & Data Description
• Results on Alcohol Consumption
• Results on Mortality
• Discussion
Motivation
• Underage drinking “costs” society $53 billion annually (IOM 2004)
– Far more prevalent than tobacco/drug use– Well established link with traffic crashes
• Less evidence on other types of mortality
• Governments devote lots of resources to reducing youth drinking & adverse effects
– Most direct regulation: MLDA– Particularly relevant now
Why are youths of special interest?
• The age-profile of drinking and nearly all adverse outcomes (acute mortality, crime, risky sex) peaks at late teens/early 20s
Age-targeted policies can generate meaningful effects on overall outcomes
Relevant Literature
• MLDA & drinking: panel evaluations– Dee 1999, Cook & Moore 2001, others– Youths exposed to lower MLDA drink more
• MLDA & mortality: panel evaluations– Lots of evidence on traffic fatalities (Dee
1999)– No consensus on other causes (suicide,
injuries, homicides, etc.)
Limitations of MLDA Literature
• Exposure to a lower MLDA is not random– Reflects policy preferences, unobserved
sentiment toward drinking, etc.
• MLDA effects on drinking typically small (e.g. 4-10 percent)
• Not all studies find effects (e.g. Kaestner 2000)
Our Contributions• We have a transparent and robust research
design much less vulnerable to OVB
• Most comprehensive examination of mortality
• Much more precise estimates (more data & refined age variable)
• We combine our consumption and mortality estimates to obtain the implied IV estimate
Research Design
• Focus on discrete change in access to alcohol at age 21 due to MLDA law
• Regression Discontinuity Design– Parametric: Model age profile with polynomial– Nonparametric: Local linear regression
• Evaluate research design – Check fit of models graphically– Check continuity of potential confounders
Regression Discontinuity Design
• Parametric– Polynomial in age fully interacted with a
dummy for over age 21 (Ov21)
• Local Linear Regression– Follow Fan & Gijbels (1996) and estimate the
rule of thumb bandwidth– Triangular Kernel
Y = β0 + β1Ov21 + β2Age + β3Age2 + β4Ov21*Age + β5Ov21*Age2 + XD + ε
Data: Alcohol Consumption
• 1997-2005 National Health Interview Survey (Sample Adult Supplement)– 16,107 Adults 19-22 Years of Age– Date of birth and date of interview
– Questions about lifetime drinking, past year drinking participation, heavy drinking
Figure 1: Alcohol Consumption
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
19.0
19.2
19.3
19.5
19.6
19.8
20.0
20.1
20.3
20.5
20.6
20.8
21.0
21.1
21.3
21.5
21.6
21.8
21.9
22.1
22.3
22.4
22.6
22.8
22.9
Age
Pro
po
rtio
n R
ep
ort
ing
ha
vin
g 1
2 o
r m
ore
drin
ks
12 or More Drinks in One Year
12 or More Drinks in One Year Fitted
12 or More Drinks in Life
12 or More Drinks in Life Fitted
Local Linear Local Linear
(1) (2) (3) (4) (5) (1) (2) (3) (4) (5)
Over 21 0.0418 0.0316 0.0268 0.0198 0.0199 0.0796 0.0657 0.0611 0.0603 0.0461[0.0242]* [0.0301] [0.0292] [0.0423] [0.0179] [0.0254]*** [0.0313]** [0.0301]** [0.0438] [0.0218]
Age 0.0081 0.0293 0.0244 0.1235 0.0140 0.0273 0.0229 0.1198
[0.0385] [0.0482] [0.0471] [0.1159] [0.0396] [0.0491] [0.0477] [0.1174]
Age Sq -0.0265 -0.0239 -0.0247 0.0980 -0.0176 -0.0173 -0.0167 0.1033
[0.0190] [0.0236] [0.0231] [0.1355] [0.0194] [0.0238] [0.0232] [0.1366]
Age*Over21 0.0693 0.0446 0.0597 -0.0874 0.0521 0.0554 0.0675 -0.1058
[0.0544] [0.0674] [0.0655] [0.1727] [0.0571] [0.0701] [0.0678] [0.1786]
Age Sq*Over 21 0.0054 0.0096 0.0020 -0.0655 -0.0075 -0.0103 -0.0184 -0.0507
[0.0259] [0.0319] [0.0311] [0.1935] [0.0272] [0.0332] [0.0321] [0.2001]
Month After 21 -0.0392 -0.0224 -0.0168 -0.0246 -0.0688 -0.0441 -0.0379 -0.0505
[0.0312] [0.0378] [0.0367] [0.0419] [0.0327]** [0.0394] [0.0379] [0.0432]
Constant 0.6483 0.6487 0.5503 0.5671 0.5503 0.5477 0.4470 0.4635
[0.0163]*** [0.0204]*** [0.0245]*** [0.0303]*** [0.0169]*** [0.0211]*** [0.0248]*** [0.0308]***
Birthday Dummys No No Yes Yes No No Yes Yes
Cubic Term No No No Yes No No No Yes
Covariates No No Yes Yes No No No Yes Yes No
Weights No Yes Yes Yes No No Yes Yes Yes No
Observations 16107 16107 16107 16107 16107 16107 16107 16107
R-squared 0.02 0.03 0.1 0.1 0.02 0.03 0.11 0.11
Prob > Chi-Squared 0.00 0.61 0.00 0.56
Table 1: Alcohol Consumption - 12 or More Drinks in Lifetime or in One Year
12 or More Drinks in Lifetime 12 or More Drinks in One Year
Parametric Models Parametric Models
Figure 2: Proportion of Days Drinking or Heavy Drinking
0
0.02
0.04
0.06
0.08
0.1
0.12
0.14
0.16
19.019.2
19.319.5
19.619.8
20.020.1
20.320.5
20.620.8
21.021.1
21.321.5
21.621.8
21.922.1
22.322.4
22.622.8
22.9
Age
Pro
po
rtio
n o
f D
ays
Proportion of Days Drinking
Proportion of Days Drinking Fitted
Proportion of Days Heavy Drinking (> 5 drinks)
Proportion of Days Heavy Drinking (> 5 drinks) Fitted
Local Linear Local Linear
(1) (2) (3) (4) (5) (1) (2) (3) (4) (5)
Over 21 0.0245 0.0180 0.0182 0.0119 0.0107 0.0120 0.0075 0.0075 0.0021 0.0026[0.0086]*** [0.0097]* [0.0095]* [0.0135] [0.0072] [0.0061]** [0.0063] [0.0062] [0.0091] [0.0048]
Age 0.0056 0.0085 0.0068 -0.0071 0.0056 0.0057 0.0045 0.0134
[0.0116] [0.0138] [0.0137] [0.0338] [0.0081] [0.0088] [0.0088] [0.0216]
Age Sq -0.0052 -0.0042 -0.0045 -0.0217 -0.0007 -0.0007 -0.0013 0.0097
[0.0055] [0.0066] [0.0065] [0.0388] [0.0039] [0.0041] [0.0041] [0.0249]
Age*Over21 0.0101 0.0140 0.0168 0.0724 -0.0123 -0.0034 -0.0014 0.0087
[0.0192] [0.0220] [0.0216] [0.0558] [0.0133] [0.0144] [0.0142] [0.0370]
Age Sq*Over 21 -0.0029 -0.0055 -0.0065 -0.0371 0.0019 -0.0012 -0.0012 -0.0340
[0.0090] [0.0104] [0.0101] [0.0625] [0.0062] [0.0067] [0.0066] [0.0408]
Month After 21 -0.0245 -0.0220 -0.0147 -0.0078 -0.0163 -0.0118 -0.0070 -0.0039
[0.0111]** [0.0120]* [0.0122] [0.0138] [0.0066]** [0.0067]* [0.0067] [0.0080]
Constant 0.0853 0.0836 0.0602 0.0579 0.0371 0.0340 0.0188 0.0203
[0.0051]*** [0.0059]*** [0.0072]*** [0.0090]*** [0.0036]*** [0.0039]*** [0.0048]*** [0.0058]***
Birthday Dummys No No Yes Yes No No Yes Yes
Cubic Term No No No Yes No No No Yes
Covariates No No Yes Yes No No No Yes Yes No
Weights No Yes Yes Yes No No Yes Yes Yes No
Observations 16107 16107 16107 16107 15825 15825 15825 15825
R-squared 0.02 0.02 0.07 0.07 0 0.01 0.05 0.05
Prob > Chi-Squared 0.00 0.56 0.00 0.72
Proportion of Days Heavy Drinking
Parametric Models
Table 2: Alcohol Consumption - Proportion of Days Drinking and Drinks per Day
Proportion of Days Drinking
Parametric Models
Figure 3: Average Number of Drinks on Days Drinking
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
19.019.2
19.319.5
19.619.8
20.020.1
20.320.5
20.620.8
21.021.1
21.321.5
21.621.8
21.922.1
22.322.4
22.622.8
22.9
Age
Ave
rag
e D
rinks
Pe
r D
ay
Drinks Per Day
Drinks Per Day Fitted
Local Linear
(1) (2) (3) (4) (5)
Over 21 0.2387 0.2068 0.2465 0.2806 0.1886[0.2810] [0.3403] [0.3291] [0.4782] [0.2024]
Age 0.2774 0.6407 0.4749 0.7006
[0.3538] [0.4608] [0.4358] [1.1732]
Age Sq 0.1531 0.3581 0.2595 0.5438
[0.1730] [0.2144]* [0.2035] [1.2958]
Age*Over21 -0.8909 -1.4498 -1.1870 -1.7552
[0.5763] [0.6656]** [0.6372]* [1.7127]
Age Sq*Over 21 -0.0387 -0.1217 -0.0498 0.0571
[0.2608] [0.2937] [0.2836] [1.8047]
Month After 21 -0.3742 -0.5580 -0.3151 -0.3719
[0.3226] [0.3317]* [0.3222] [0.3904]
Constant 3.8570 3.8943 2.9378 2.9747
[0.1550]*** [0.2174]*** [0.2161]*** [0.2919]***
Birthday Dummys No No Yes Yes
Cubic Term No No No Yes
Covariates No No Yes Yes No
Weights No Yes Yes Yes No
Observations 9906 9906 9906 9906
R-squared 0.00 0.00 0.07 0.07
Prob > Chi-Squared 0.00 0.92
Discontinuity in Drinks Per Day on Days Drinking
Parametric Models
Figure 4: Average Number of Drinks Per Day
0
0.05
0.1
0.15
0.2
0.25
0.3
0.35
0.4
0.45
0.5
NonDrinkers
1 2 3 4 5 6 7 8 9 10 11 12 12+
Reported Average Drinks Per Day
Pro
po
rtio
n R
ep
ort
ing
th
is N
um
be
r o
f D
rinks
Age 20
Age 21
Figure 5: Proportion Reporting Heavy Drinking in Last Year
0
0.05
0.1
0.15
0.2
0.25
0.3
0.35
0.4
0.45
19.0
19.2
19.3
19.5
19.6
19.8
20.0
20.1
20.3
20.5
20.6
20.8
21.0
21.1
21.3
21.5
21.6
21.8
21.9
22.1
22.3
22.4
22.6
22.8
22.9
Age
Pro
po
rtio
n R
ep
ort
ing
He
avy
Drin
kin
g in
La
st Y
ea
r
Heavy Drinker
Heavy Drinker Fitted
Local Linear
(1) (2) (3) (4) (5)
Over 21 0.0761 0.0527 0.0492 0.0262 0.0398[0.0248]*** [0.0304]* [0.0291]* [0.0430] [0.0201]
Age 0.0116 0.0688 0.0623 0.1403
[0.0361] [0.0445] [0.0431] [0.1080]
Age Sq -0.0141 0.0098 0.0084 0.1048
[0.0175] [0.0211] [0.0205] [0.1224]
Age*Over21 -0.0139 -0.0683 -0.0544 -0.0853
[0.0554] [0.0673] [0.0646] [0.1726]
Age Sq*Over 21 0.0041 -0.0127 -0.0181 -0.1686
[0.0261] [0.0316] [0.0303] [0.1905]
Month After 21 -0.0576 -0.0359 -0.0242 -0.0165
[0.0318]* [0.0384] [0.0369] [0.0424]
Constant 0.3150 0.3247 0.2389 0.2522
[0.0156]*** [0.0199]*** [0.0225]*** [0.0287]***
Birthday Dummys No No Yes Yes
Cubic Term No No No Yes
Covariates No No Yes Yes No
Weights No Yes Yes Yes No
Observations 16107 16107 16107 16107
R-squared 0.01 0.01 0.1 0.1
Prob > Chi-Squared 0.00 0.67
Discontinuity in Proportion Reporting Heavy Drinking
Parametric Models
Male White Black HispanicNo HS
DiplomaHS
Diploma EmployedLooking for Work
No Health Insurance
(1) (2) (3) (4) (5) (6) (7) (8) (9)Over 21 0.0156 0.0172 -0.0250 0.0095 -0.0108 0.0040 0.0019 -0.0061 0.0043
[0.0260] [0.0293] [0.0211] [0.0203] [0.0230] [0.0291] [0.0302] [0.0171] [0.0293]Age 0.0025 0.0152 -0.0139 0.0068 0.0435 0.0074 0.0033 0.0299 -0.0151
[0.0395] [0.0451] [0.0321] [0.0296] [0.0373] [0.0457] [0.0475] [0.0263] [0.0440]
Age Sq 0.0092 0.0185 -0.0120 -0.0025 0.0403 0.0189 -0.0238 0.0189 -0.0201
[0.0194] [0.0217] [0.0156] [0.0143] [0.0186]** [0.0224] [0.0232] [0.0130] [0.0211]
Age*Over21 -0.0167 -0.0333 0.0571 -0.0406 -0.0934 0.0095 0.0430 -0.0596 0.0289
[0.0585] [0.0657] [0.0474] [0.0450] [0.0519]* [0.0660] [0.0676] [0.0382] [0.0656]
Age Sq*Over 21 -0.0056 -0.0076 -0.0083 0.0144 -0.0225 -0.0365 0.0197 -0.0045 0.0152
[0.0278] [0.0311] [0.0224] [0.0212] [0.0248] [0.0314] [0.0320] [0.0183] [0.0309]
Constant 0.4405 0.6440 0.1415 0.1638 0.1810 0.2941 0.6453 0.0849 0.2970
[0.0168]*** [0.0195]*** [0.0137]*** [0.0129]*** [0.0154]*** [0.0194]*** [0.0203]*** [0.0114]*** [0.0191]***
Observations 16107 16107 16107 16107 16107 16107 16107 16107 16107
R-squared 0.00 0.00 0.00 0.00 0.01 0.00 0.01 0.00 0.00
Table 4: Age profile of Demographic Characteristics from the NHIS
Summary of Alcohol Findings
• There is an immediate persistent increase in alcohol consumption at age 21
• Only modest evidence of an increase in first time use of alcohol
• More people are drinking but drinking intensity does not appear to have gone up much
Data: Mortality
• 1997-2004 Vital Statistics Mortality – Exact date of birth and date of death– Census of Deaths in the United States– Considerable Detail on Cause of Death
– We include dummies for large “birthday effects”
Appendix A: Deaths by days to birthday
0
50
100
150
200
250
300
-30
-28
-26
-24
-22
-20
-18
-16
-14
-12
-10 -8 -6 -4 -2 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30
Days From Birthday
Num
ber
of D
eath
s
20th Birhtday
21st Birthday
22nd Birthday
21st Birthday
Figure 6: Death Rates by Age
0
20
40
60
80
100
120
140
19.1
19.2
19.4
19.6
19.7
19.9
20.1
20.2
20.4
20.5
20.7
20.9
21.0
21.2
21.4
21.5
21.7
21.9
22.0
22.2
22.4
22.5
22.7
22.8
23.0
Age
De
ath
s p
er
10
0,0
00
Pe
rso
n Y
ea
rs
All All Fitted
Internal Internal Fitted
External External Fitted
Local Linear
Local Linear
(1) (2) (3) (4) (1) (2) (3) (4)
Over 21 0.096 0.087 0.091 0.074 Over 21 0.110 0.100 0.096 0.082[0.018]** [0.017]** [0.023]** [0.0161] [0.022]** [0.021]** [0.028]** [0.0207]
Age -0.027 -0.027 -0.074 Age -0.048 -0.048 -0.073
[0.028] [0.028] [0.069] [0.034] [0.034] [0.085]
Age Sq -0.011 -0.011 -0.071 Age Sq -0.011 -0.011 -0.041
[0.014] [0.014] [0.083] [0.016] [0.016] [0.098]
Age*Over21 -0.066 -0.047 0.021 Age*Over21 -0.059 -0.040 0.032
[0.043] [0.041] [0.101] [0.050] [0.048] [0.119]
Age Sq*Over 21 0.034 0.026 0.060 Age Sq*Over 21 0.027 0.019 -0.010
[0.020] [0.020] [0.118] [0.024] [0.023] [0.137]
Constant 4.379 4.379 4.371 Constant 4.134 4.134 4.129
[0.011]** [0.011]** [0.015]** [0.015]** [0.015]** [0.020]**
Birthday Dummys No Yes Yes Birthday Dummys No Yes Yes
Cubic Term No No Yes Cubic Term No No Yes
Obs 1460 1460 1460 1458 Obs 1460 1460 1460 1458
R-squared 0.04 0.05 0.05 R-squared 0.06 0.08 0.08
Prob > Chi-Squared 0.000 0.735 Prob > Chi-Squared 0.000 0.788
Deaths Due to All Causes Deaths due to External Causes
Parametric Models Parametric Models
Local Linear
(1) (2) (3) (4)
Over 21 0.063 0.054 0.094 0.066[0.040] [0.040] [0.053] [0.0309]
Age 0.022 0.022 -0.128
[0.066] [0.066] [0.174]
Age Sq -0.028 -0.028 -0.216
[0.032] [0.032] [0.201]
Age*Over21 -0.056 -0.039 0.024
[0.090] [0.090] [0.232]
Age Sq*Over 21 0.070 0.062 0.359
[0.044] [0.044] [0.269]
Constant 2.809 2.809 2.784
[0.029]** [0.029]** [0.039]**
Birthday Dummys No Yes Yes
Cubic Term No No Yes
Obs 1460 1460 1460 1458
R-squared 0.10 0.10 0.10
Prob > Chi-Squared 0.000 0.525
Deaths Due to Internal Causes
Parametric Models
Figure 7: Death Rates by External Cause
0
5
10
15
20
25
30
35
40
19.1
19.2
19.4
19.6
19.7
19.9
20.1
20.2
20.4
20.5
20.7
20.9
21.0
21.2
21.4
21.5
21.7
21.9
22.0
22.2
22.4
22.5
22.7
22.8
23.0
Age
De
ath
s R
ate
pe
r 1
00
,00
0
Alcohol Alcohol FittedHomicide Homicide FittedSuicide Suicide FittedMVA MVA FittedDrugs Drugs FittedExternal Other External Other Fitted
Local Linear
Local Linear
Local Linear
(1) (2) (3) (4) (1) (2) (3) (4) (1) (2) (3) (4)
Over 21 0.336 0.297 0.440 0.427 0.009 0.002 -0.003 -0.014 0.160 0.154 0.135 0.105[0.115] [0.113] [0.148] [0.109] [0.045] [0.045] [0.061] [0.041] [0.059] [0.059] [0.086] [0.045]
Age -0.216 -0.216 -0.056 0.077 0.077 -0.046 -0.041 -0.041 -0.017
[0.187] [0.187] [0.455] [0.072] [0.072] [0.182] [0.103] [0.103] [0.279]
Age Sq -0.159 -0.159 0.040 0.026 0.026 -0.127 -0.015 -0.015 0.015
[0.090] [0.090] [0.528] [0.034] [0.034] [0.206] [0.048] [0.048] [0.309]
Age*Over21 -0.040 0.039 -1.130 -0.180 -0.165 0.109 -0.024 -0.012 0.057
[0.266] [0.263] [0.652] [0.102] [0.102] [0.258] [0.133] [0.134] [0.354]
Age Sq*Over 21 0.256 0.223 1.280 0.004 -0.003 -0.037 0.022 0.017 -0.127
[0.129] [0.128] [0.764] [0.048] [0.048] [0.295] [0.063] [0.063] [0.398]
Constant 0.216 0.216 0.243 2.687 2.687 2.667 2.245 2.245 2.248
[0.082] [0.082] [0.108] [0.032] [0.032] [0.044] [0.046] [0.046] [0.069]
Birthday Dummys No Yes Yes No Yes Yes No Yes Yes
Cubic Term No No Yes No No Yes No No Yes
Obs 1460 1460 1460 1458 1460 1460 1460 1458 1460 1460 1460 1458
R-squared 0.03 0.03 0.04 0.01 0.01 0.01 0.02 0.02 0.02
Prob > Chi-Squared 0.000 0.070 0.000 0.495 0.000 0.8922
Parametric Models Parametric Models Parametric Models
Table 6: Discontinuity in Log Deaths by External Cause of Death (Alcohol, Homicide and Suicide)
Alcohol Homicide Suicide
Local Linear
Local Linear
Local Linear
(1) (2) (3) (4) (1) (2) (3) (4) (1) (2) (3) (4)
Over 21 0.158 0.143 0.145 0.139 0.097 0.093 0.001 -0.023 0.087 0.098 0.098 0.074[0.033] [0.032] [0.044] [0.032] [0.082] [0.083] [0.107] [0.081] [0.060] [0.059] [0.075] [0.043]
Age -0.133 -0.133 -0.217 0.102 0.102 0.308 -0.075 -0.075 0.002
[0.052] [0.052] [0.136] [0.148] [0.148] [0.357] [0.092] [0.092] [0.218]
Age Sq -0.019 -0.019 -0.124 0.009 0.009 0.267 -0.059 -0.059 0.037
[0.025] [0.025] [0.152] [0.074] [0.074] [0.431] [0.045] [0.045] [0.262]
Age*Over21 -0.026 0.004 0.155 -0.125 -0.118 0.015 -0.028 -0.051 -0.205
[0.078] [0.075] [0.187] [0.196] [0.198] [0.481] [0.139] [0.138] [0.322]
Age Sq*Over 21 0.026 0.014 0.036 0.025 0.021 -0.658 0.098 0.107 0.107
[0.037] [0.036] [0.216] [0.098] [0.098] [0.571] [0.066] [0.066] [0.376]
Constant 3.220 3.220 3.206 1.226 1.226 1.261 2.024 2.024 2.037
[0.023] [0.023] [0.033] [0.062] [0.062] [0.077] [0.038] [0.038] [0.048]
Birthday Dummys No Yes Yes No Yes Yes No Yes Yes
Cubic Term No No Yes No No Yes No No Yes
Obs 1460 1460 1460 1458 1460 1460 1460 1458 1460 1460 1460 1458
R-squared 0.15 0.16 0.16 0.04 0.04 0.04 0.01 0.01 0.01
Prob > Chi-Squared 0.000 0.666 0.000 0.440 0.000 0.877
Parametric Models Parametric Models Parametric Models
Table 7: Discontinuity in Log Deaths by External Cause of Death (MVA, Drugs, External Causes Other)
MVA Drugs External Causes Other
Summary of Mortality Findings
• Large, persistent increase in mortality
• Increase due largely to MVA but also evidence of an increase in suicides
• Implied IV: 10 percent increase in drinking days increases mortality by 4.3 percent
Conclusions
• Minimum Legal Drinking Age (MLDA) laws substantially reduce drinking and mortality
• The age profiles of consumption suggest it is not people’s first experience with drinking
• Main route is exposure (e.g. drinking days)
• Implied elasticities suggest a substantial amount of mortality among youths is due to drinking
Extra/Appendix Material
Drank Past Month, MTF Follow Ups
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Discontinuity in Drinking Participation and Intensity MTF Follow-Ups 1988-2006
Ever drank Drank last month Proportion days drank last month
Over 21 0.005 0.051 0.029 [0.013] [0.018] [0.009]
N 17856 17931 17931 R-squared .08 .16 .10
Age 20 mean .901 .672 .153
% effect 0.6% 7.6% 19%
Discontinuity in Proportion Days Drinking, MTF Follow-Ups 1988-2006 Reported past
month drinking in grade 12
Did not report past month drinking in grade 12
Used marijuana
past month
Did not use marijuana
past month
Over 21 0.027 0.032 0.073 0.027 [0.014] [0.009] [0.033] [0.009]
N 9785 8146 2975 14361 R-squared .08 .09 .07 .09
Age 20 mean .220 .076 .294 .113
% effect 12% 42% 25% 24%