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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. Overview. Research Question: What is the causal effect of alcohol consumption on mortality?

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christopher kitt carpenter and carlos dobkin

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.

overview
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.
outline of talk
Outline of Talk
  • Motivation & Literature Review
  • Research Design & Data Description
  • Results on Alcohol Consumption
  • Results on Mortality
  • Discussion
motivation
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
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
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
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
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
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
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
data alcohol consumption
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
summary of alcohol findings
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
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”
summary of mortality findings
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
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
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