The Impact of the Minimum Legal Drinking Age on Alcohol‐Related Chronic Disease Mortality

Abstract

Background The minimum legal drinking age (MLDA) of 21 has been associated with a number of benefits compared to lower MLDAs, including long-term effects, such as reduced risk for alcoholism in adulthood. However, no studies have examined whether MLDA during young adulthood is associated with mortality later in life. We examined whether individuals exposed to permissive MLDA (< 21) had higher risk of death from alcohol-related chronic disease compared to those exposed to the 21 MLDA. Because prior work suggests that MLDA affects college students differently, we also conducted conditional analyses based on ever having attended college. Methods Data from the 1990 through 2010 U.S. Multiple Cause of Death files were combined with data on the living population and analyzed. We included individuals who turned 18 during the years 1967 to 1990, the period during which MLDA varied across states. We examined records on death from several alcohol related chronic diseases, employing a quasi-experimental approach to control for unobserved state characteristics and stable time trends. Results Individuals who reported any college attendance did not exhibit significant associations between MLDA and mortality for the causes of death we examined. However, permissive MLDA for those who never attended college was associated with 6% higher odds for death from alcoholic liver disease, 8% higher odds for other liver disease, and 7% higher odds for lip/oral/pharynx cancers (OR = 1.06, 95% CI [1.02, 1.10]; OR = 1.08, 95% CI [1.02, 1.14]; OR = 1.07, 95% CI [1.03, 1.12], respectively). Conclusions The 21 MLDA likely protects against risk of death from alcohol-related chronic disease across the lifespan, at least for those who did not attend college. This is consistent with other work that shows that the long-term association between MLDA and alcohol-related outcomes is specific to those who did not attend college.

Effects of increased alcohol availability during adolescence on the risk of all‐cause and cause‐specific disability pension: a natural experiment

“…First, supporting previous research on increased alcohol availability, we found that lowering the legal age limit for alcohol purchases can have long‐term alcohol‐related health consequences 2, 5, 6, 7, 8, 9. Secondly, the study provides further evidence that alcohol consumption during adolescence is associated with later health problems 16, 17, 18.…”

“…Previous research, using a natural experiment setting of a policy change, has investigated the short‐ and long‐term effects of changing the legal age limit for alcohol purchases on alcohol consumption and alcohol‐related harm 5, 6, 7, 8, 9, 10. One area where research is scarce, but potential costs are high, concerns the association between increased alcohol availability during adolescence and the risk of disability pension.…”

“…Evidence suggests that increased alcohol availability is associated with increased alcohol consumption, which in turn increases alcohol-related harm on a population level [1][2][3][4]. Previous research, using a natural experiment setting of a policy change, has investigated the short-and long-term effects of changing the legal age limit for alcohol purchases on alcohol consumption and alcohol-related harm [5][6][7][8][9][10]. One area where research is scarce, but potential costs are high, concerns the association between increased alcohol availability during adolescence and the risk of disability pension.…”

No effects of increased alcohol availability during adolescence on alcohol-related morbidity and mortality during four decades: a natural experiment

“…Furthermore, the alcohol index used in the present study only captures a small proportion of the diseases and injuries attributable to alcohol 38. Plunk and colleagues found an association between a lowered legal drinking age and increased risk of death due to alcoholic liver disease, liver disease not specified as alcohol related, and cancer of the lip, oral and pharynx 7. The alcohol index was used to define the outcome as all diagnoses included require the individual to consume alcohol.…”

Medical justification for increasing the minimum legal drinking age

“…Так, A. Plunk и соавт. [23] в 2016 г. показали, что увеличение минимального возраста потребления алкогольной продукции, вероятно, защищает от риска возникновения хронического алкоголь-ассоциированного заболевания на протяжении всей жизни. Примечательно, что эту тенденцию авторы наблюдали у тех, кто не посещал колледж, что, на наш взгляд, делает результаты еще более убедительными, поскольку уровень образования нередко влияет на уровень потребления алкоголя.…”