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

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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

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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

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ing

th

is N

um

be

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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

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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

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10

0,0

00

Pe

rso

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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

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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%