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    The Effect of Alcohol Consumption onMortality:Regression Discontinuity Evidence from the

    Minimum Drinking Age

    Christopher Carpenter, Carlos Dobkin

    Michele Rocca, Cesare OrsiniPhD Economics DEFAP

    2016

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    Outline

    1 Problem Statement and Motivation

    2 Relation to the Literature and Contributions

    3 Data

    4 Empirical strategy

    5 Empirical evidence

    6 Conclusions and Remarks

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    Problem Statement and Motivation

    Does alcohol consumption by young adults increase mortality, and ifso, by how much?

    Understanding whether there is a causal link between youth alcohol

    consumption and mortality is especially relevant for public policygiven that over half of young adults drink and about one-third drinkheavily (i.e., five or more drinks at one time).

    A 2004 Institute of Medicine report, for example, estimates thatexcessive alcohol consumption by young adults costs society billions ofdollars each year in the form of traffic accidents, crime, andunintentional injury (Bonnie and OConnell 2004).

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    Relation to the Literature and Contributions

    Previous works:have made use of changes in minimum legal drinking ages (MLDA, inthe 1970s and 1980s);higher drinking age reduces alcohol consumption by young adults andfatalities 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 theminimum 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 (21years old) affected youth alcohol consumption;focus on state changes imply however policy endogeneity.

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    Relation to the Literature and Contributions

    The existent literature lacks credible estimates of the underlyingstructural relationship between alcohol consumption and mortality.

    The major contributions:

    use of a research design that generates more credible estimates thanthe designs used in the prior literature;

    MLDA laws reduce drinking by 11-21 percent. These estimates aresubstantially larger than most of the existing estimates;

    increase in alcohol consumption that occurs at age 21 results in animmediate 9 percent increase in mortality;

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    Data

    Source on alcohol consumption: NHIS (National Health InterviewSurvey, 1997 - 2004) 16,107 Adults 19-22 Years of Age.

    Source on mortality: census of deaths in the United States andconfidential details on cause of death.

    Possible Problems

    Time Reference.Desirability Bias.

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    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 alcoholconsumption and mortality at age 21 to identify the causal effect ofalcohol consumption on mortality.

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    Empirical strategy

    The reduced-form approach of the following equation will let us estimate theimpact of the MLDA laws on alcohol consumption and mortality.

    ya=E[yai|agei =a] =Xay + gy(a) + Da

    y + vya (1)

    Interpreting the discontinuity in yin the context of an underlying causal

    structure.Ci =Xi

    c + gc(a) + Dac + vic (2)

    yi =Xi+ f(a) + Ci+ ui (3)

    Forming the ratio of the estimated discontinuity in mortality at age 21 tothe estimated discontinuity in alcohol consumption we obtain the impliedinstrumental variables estimate of the causal effect of alcohol consumptionon mortality.

    y =cx (4)

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    Empirical Evidence: Age Profile of Drinking Partecipation

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    Empirical Evidence: Regressions of Drinking Partecipation

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    Empirical Evidence: Age Profile of Drinking Intensity

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    Empirical Evidence: Regressions of Drinking Intensity

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    Empirical Evidence: Age Profile for Death Rates

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    Empirical Evidence: Regressions of Log Deathes at Age 21

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    Empirical Evidence: Disaggregation by Cause of Death

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    Conclusions and Remarks

    Mortality effect not enterily due to new drinkers and first experienceof heavy drinking.

    Mortality effect is driven by drinking partecipation rather thendrinking intensity.

    Increase of 21 percent of more days of drinking and heavy drinking in

    treatment group.

    Increase of drinking partecipation correspond of an increase ofmortality at age 21 of 9 percent mostly due to: MVA, Alcohol andsuicides.

    The implied elasticity is 0.43 for individuals who change their drinkingbehavior because of the law.

    Stricter alcohol control toward young adults could result inmeaningful reduction in mortality.

    F F h R di I

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    For Further Reading I

    Carpenter, Christopher S., Deborah D. Kloska, Patrick O Malley, andLloyd Johnston. 2007. Alcohol Control Policies and Youth AlcoholConsumption: 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 andYoung Adults. American Journal of Public Health, 82(1): 11215.

    Joksch, Hans C., and Ralph K. Jones. 1993. Changes in theDrinking Age and Crime. Journal of Criminal Justice, 21(3): 20921.

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