We provide the first evaluation of the effect of the U.S. minimum legal drinking age (MLDA) on nonfatal injuries. Using administrative records from several states and a regression discontinuity approach, we document that inpatient hospital admissions and emergency department (ED) visits increase by 8.4 and 71.3 per 10,000 person-years, respectively, at age 21. These effects are due mainly to an increase in the rate at which young men experience accidental injuries, alcohol overdoses, and injuries inflicted by others. Our results suggest that the literature’s disproportionate focus on mortality leads to a significant underestimation of the benefits of tighter alcohol control.

We use variation from the minimum legal drinking age to estimate the causal effect of access to alcohol on crime. Using a census of arrests in California and a regression discontinuity design, we find that individuals just over age 21 are 5.9% more likely to be arrested than individuals just under 21. This increase is mostly due to assaults, alcohol-related offenses, and nuisance crimes. These results suggest that policies that restrict access to alcohol have the potential to substantially reduce crime.

Health insurance affects the rate at which individuals visit hospitals and emergency departments (EDs). We identify the causal effect of losing health insurance using a regression discontinuity design. We compare individuals just before and after their twenty third birthday, which insurers have used as a cutoff after which students are no longer eligible for their parents' health insurance: 1.5% of young adults lose their health insurance upon turning 23, and this transition leads to a 1.6% decrease in ED visits and a 0.8% decrease in hospital stays. We discuss why these estimates are larger than those observed among teenage populations.