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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.


  • 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


  • 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


  • 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