Christopher (Kitt) Carpenter and Carlos Dobkin

1. The Effects of Alcohol Access on Consumption and Mortality Christopher (Kitt) Carpenter and Carlos Dobkin We thank NIH/NIAAA for financial support R01-AA017302-01. Comments welcome.

2. 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.

5. Outline of Talk • Motivation & Literature Review • Research Design & Data Description • Results on Alcohol Consumption • Results on Mortality • Discussion

6. 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

7. 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

8. 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.)

9. 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)

10. 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

11. 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

12. 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

13. 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

25. 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

26. 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”

34. 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

35. 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

36. Extra/Appendix Material