The Effect of Alcohol Consumption on

Mortality:Regression Discontinuity Evidence from the

Minimum Drinking Age
Christopher Carpenter, Carlos Dobkin

Michele Rocca, Cesare Orsini

PhD Economics DEFAP
2016

Outline

Problem Statement and Motivation

Relation to the Literature and Contributions

Data

Empirical strategy

Empirical evidence

Conclusions and Remarks

Problem Statement and Motivation

Does alcohol consumption by young adults increase mortality, and if

so, by how much?
Understanding whether there is a causal link between youth alcohol
consumption and mortality is especially relevant for public policy
given that over half of young adults drink and about one-third drink
heavily (i.e., five or more drinks at one time).
A 2004 Institute of Medicine report, for example, estimates that
excessive alcohol consumption by young adults costs society billions of
dollars each year in the form of traffic accidents, crime, and
unintentional injury (Bonnie and OConnell 2004).

Relation to the Literature and Contributions

Previous works:
have made use of changes in minimum legal drinking ages (MLDA, in
the 1970s and 1980s);
higher drinking age reduces alcohol consumption by young adults and
fatalities from motor vehicle accidents (Alexander C. Wagenaar and
Traci L.Toomey 2002).

Important limitations of the existing research:

far less research and contradictory conclusions on the effects of the
minimum legal drinking age on the other leading causes of death
among young (suicide, drug overdose, etc.);
not universal consensus regarding whether and how much MLDA (21
years old) affected youth alcohol consumption;
focus on state changes imply however policy endogeneity.

Relation to the Literature and Contributions

The existent literature lacks credible estimates of the underlying

structural relationship between alcohol consumption and mortality.
The major contributions:
use of a research design that generates more credible estimates than
the designs used in the prior literature;
MLDA laws reduce drinking by 11-21 percent. These estimates are
substantially larger than most of the existing estimates;
increase in alcohol consumption that occurs at age 21 results in an
immediate 9 percent increase in mortality;

Data

Source on alcohol consumption: NHIS (National Health Interview

Survey, 1997 - 2004) 16,107 Adults 19-22 Years of Age.
Source on mortality: census of deaths in the United States and
confidential details on cause of death.
Possible Problems
Time Reference.
Desirability Bias.

Empirical Strategy

Regression Discontinuity Design

MLDA produces sharp differences in alcohol access for young adults on
either side of age 21.
We can use the estimates of discontinuous jumps in alcohol
consumption and mortality at age 21 to identify the causal effect of
alcohol consumption on mortality.

Empirical strategy
The reduced-form approach of the following equation will let us estimate the
impact of the MLDA laws on alcohol consumption and mortality.
ya = E[yai |agei = a] = Xa y + g y (a) + Da y + vay

(1)

Interpreting the discontinuity in y in the context of an underlying causal

structure.
Ci = Xi c + g c (a) + Da c + vci
(2)
yi = Xi + f (a) + Ci + ui

(3)

Forming the ratio of the estimated discontinuity in mortality at age 21 to

the estimated discontinuity in alcohol consumption we obtain the implied
instrumental variables estimate of the causal effect of alcohol consumption
on mortality.
(4)
y = c x

Empirical Evidence: Age Profile of Drinking Partecipation

Empirical Evidence: Regressions of Drinking Partecipation

Empirical Evidence: Age Profile of Drinking Intensity

Empirical Evidence: Regressions of Drinking Intensity

Empirical Evidence: Age Profile for Death Rates

Empirical Evidence: Regressions of Log Deathes at Age 21

Empirical Evidence: Disaggregation by Cause of Death

Conclusions and Remarks

Mortality effect not enterily due to new drinkers and first experience
of heavy drinking.
Mortality effect is driven by drinking partecipation rather then
drinking intensity.
Increase of 21 percent of more days of drinking and heavy drinking in
treatment group.
Increase of drinking partecipation correspond of an increase of
mortality at age 21 of 9 percent mostly due to: MVA, Alcohol and
suicides.
The implied elasticity is 0.43 for individuals who change their drinking
behavior because of the law.
Stricter alcohol control toward young adults could result in
meaningful reduction in mortality.

For Further Reading I

Carpenter, Christopher S., Deborah D. Kloska, Patrick O Malley, and

Lloyd Johnston. 2007. Alcohol Control Policies and Youth Alcohol
Consumption: Evidence from 28 Years of Monitoring the Future.
B.E. Journal of Economic Analysis and Policy: Topics in Economic
Analysis and Policy, 7(1): 121.
Jones, Nancy E., Carl F. Pieper, and Leon S. Robertson. 1992.
Effect of Legal Drinking Age on Fatal Injuries of Adolescents and
Young Adults. American Journal of Public Health, 82(1): 11215.
Joksch, Hans C., and Ralph K. Jones. 1993. Changes in the
Drinking Age and Crime. Journal of Criminal Justice, 21(3): 20921.