The Minimum Legal Drinking Age and Public Health
5 Wagenaar 2002 – Wagenaar AC, Toomey TL. Impact of Minimum Drinking Age Laws: A Review and Analysis of the Literature from 1960 to 2000. Journal of Alcohol Studies. 2002;(Suppl 14):206-25. January 8, 2015 – Jager J, Keyes KM, Schulenberg JE. Historical variation in young adult coma lifts and their relationship to historical differences in social roles and legal drinking age. Developmental psychology. 2015;51(7):962-974. 14 Cintina 2015 – Cintina I. The impact of alcohol age laws on pregnancy, fertility and alcohol consumption. Overview of household economics. 2015;13(4):1003-1022.
7 NHTSA-MLDA 2019 – National Center for Statistics and Analysis, National Highway Traffic Safety Administration (NHTSA). Lives saved by restrictions and minimum drinking age laws in 2017. Washington, DC: National Highway Traffic Safety Administration, U.S. Department of Transportation (US DOT); 2019. UW WAPP – University of Wisconsin-Madison School of Law. Wisconsin Alcohol Policy Project (WAPP): Preventing underage drinking. The Amethyst Initiative, signed by more than 100 university presidents and other college officials, calls for a review of the legal drinking age in the United States. A key argument of the initiative is that the US minimum drinking age policy leads to more dangerous drinking than if the legal drinking age were lower. An advocacy organization called Choose Responsibility specifically suggests “a series of changes that will allow young people between the ages of 18 and 20 to buy, possess and consume alcoholic beverages.” Does the 21-year-old age limit in the U.S. reduce young adult alcohol consumption and its harms, or as the signatories of the Amethyst Initiative claim, doesn`t it work? In this article, we summarize an important and compelling body of empirical evidence showing that one of the central claims of the Amethyst Initiative signatories is false: setting the legal drinking age at 21 clearly reduces alcohol consumption and its greatest harms. We use a panel fixed-effect approach and a regression discontinuity approach to estimate the impact of legal drinking age on mortality, and we also discuss what is known about the relationship between legal drinking age and other adverse outcomes such as injuries and non-fatal crimes. We document the impact of the legal drinking age and estimate the cost of alcohol-related adverse events per drink.
Finally, we look at the implications for choosing the right legal drinking age. 1 CDC-MLDA – Centers for Disease Control and Prevention (CDC). Alcohol and public health: 21 Minimum drinking age (MLDA). There is strong evidence that current drinking age laws reduce alcohol-impaired driving and alcohol-related crashes2, 3, 4, 5 and related injuries among drivers aged 18 to 20.4 Targeted efforts to prevent the sale of alcohol to minors, particularly compliance checks in liquor retail stores, increase the effectiveness of laws.5 12 Plunk 2016 – Plunk AD, Krauss MJ, Syed-Mohammed H, et al. The impact of the legal drinking age on mortality from alcohol-related chronic diseases. Alcoholism: clinical and experimental research. 2016;40(8):1761-1768. The introduction of a nationwide MLDA at age 21 resulted in a significant reduction in alcohol-related fatal motor vehicle crashes.3, 4,6 The National Highway Traffic Safety Administration estimates that MLDA saved about 500 lives a year from 2013 to 20177. Current MLDA laws appear to reduce alcohol consumption among youth.2,5 The historical increase in the legal drinking age is associated with a reduction in binge drinking among 18-year-olds and an increase in binge drinking among male teens aged 18 to 228. EML at age 21 has been associated with reduced emergency rooms and hospitalizations among those under 219 years of age and reduced suicides2, 10 and arrests among adolescents.6, 11 Although 21 is the legal drinking age in all states, there are exceptions to this law in many states (e.g., in private places, with parental consent, for religious purposes, etc.).
As of June 2021, 20 states had no exemptions from the legal drinking age.15 The California Evidence-Based Clearinghouse for Child Welfare offers a toolkit called “Communities Mobilizing for Change on Alcohol” that helps reduce underage drinking through changes in community policy and practice.16 There is considerable debate about the effectiveness of the legal drinking age in reducing alcohol consumption and the negative consequences. In fact, in the summer of 2008, more than 100 university presidents and other college officials signed on to the Amethyst Initiative, which calls for a review of the legal drinking age in the United States. In this presentation, we will examine credible estimates of the causal effect of SHS on alcohol consumption, mortality, morbidity and crime. The problem is that impaired driving is a major public health problem. In 2016, about 10,500 people died in car crashes involving alcohol-impaired drivers, accounting for nearly one-third of all traffic-related deaths. CDC: Impaired Driving Fact Sheet. Approximately 6,500 (62%) of these individuals had a blood alcohol concentration of 0.08 g/dL or higher. The remaining fatalities were passengers (29%) and non-passengers (9%). Alcohol-related driving.
Teen drivers are 3 times more likely than experienced drivers to suffer a fatal accident. CDC: Drunk Driving in Teens 13 Krauss 2015 – Krauss MJ, Cavazos-Rehg PA, Agrawal A, Bierut LJ, Grucza RA. Long-term effects of the legal drinking age on marijuana and other illicit drugs in adulthood. Drug and alcohol addiction. 2015;149:173-179. 9 Zimmermann 2017 – Zimmermann C, Dobkin C. The legal drinking age and morbidity in the United States. Overview of the economy and statistics. 2017;99(1):95-104. The Law: All U.S. States currently set the legal drinking age at 21 (MLDA21). Federal law withholds federal highway funding from states that do not adopt a 21-year MLDA (23 U.S.C.
§ 158). For examples of MLDA21, see TX Alcoholic Beverage Code § 106.04 (Texas), Conn. Gen. Stat. 30-1(12), and Conn. Gen. Stat. §30-89 (Connecticut). The evidence: A 2013 meta-analysis attempted to assess the effectiveness of minimum alcohol laws in reducing alcohol-related harm.
Population-level interventions for reducing alcohol-related harm: a review of systematic reviews. The authors included 52 articles from relevant databases that met the inclusion criteria for population-level review and systematic methodology. Publications must have reviewed alcohol-related harm reduction interventions between 2002 and 2012. The authors found that a higher MLDA resulted in a significant reduction in alcohol consumption and the prevalence of alcohol-related accidents. The Legal Drinking Age (MLDA) sets the legal age at which a person can purchase alcoholic beverages.