Drinking age policies can have a long-term impact on birth outcomes

Recent research is suggesting that changes in legal drinking age laws can alter the broader social contexts of young women in a way that affects their alcohol use and the health of their children.

In general, research has shown that alcohol policies that affect the availability of alcohol in certain environments (e.g., taxes, retail regulations) can influence drinking practices.

A recent paper by Ning Zhang and Eric Caine from the University of Rochester School of Medicine explored how one type of alcohol policy – minimum legal drinking age – could influence the context of alcohol consumption in young women. In general, research has found that older minimum legal drinking age “has both intended effects, i.e., decreasing youth alcohol consumption and drunk driving, and unintended social and health benefits, such as decreasing high school dropouts, teen births, and the prevalence of sexually transmitted diseases.” (p. 3797)

Not only were Zhang and Caine interested in how changes in minimum legal drinking age might affect things like binge drinking and transmission of sexually transmitted infections, they also wanted to know if the effects of these policies could be intergenerational and affect health outcomes for infants born to mothers who would have been affected by changes in minimum legal drinking age.

During the late 1980s, the minimum legal drinking age was increased in the U.S. from ages 18–20 to 21 years. This created a series of “natural experiments” in which the researchers could examine the effects of different minimum legal drinking age.

Overall, they found that a minimum legal drinking age of 18 years old increased the prevalence of low birth weight, low Apgar scores, and premature births in infants who were born to young women that came into childbearing age when the laws varied between 18–21 years of age. The researchers present some theories on the pathways for these outcomes.

While it’s not yet clear if one pathway or multiple pathways are at play, it does suggest that alcohol policies that influence the “environment” in which alcohol is consumed can indirectly infant health outcomes, too. The researchers were unable to make direct links to alcohol consumption during pregnancy or FASD rates, but it does support the idea that overall alcohol policy is an important aspect of FASD prevention.

For more on this, see an earlier post Integrating FASD Prevention and Alcohol Policy (March 11, 2011).


Watson, T. and Fertig, A. (2009). Minimum drinking age laws and infant health outcomes. Journal of Health Economics, 28, 737-747. (Download a free NBER Working Paper version of this paper here).

Zhang N., Caine E. (2011). Alcohol Policy, Social Context, and Infant Health: The Impact of Minimum Legal Drinking Age. International Journal of Environmental Research and Public Health, 8(9):3796-3809. ISSN 1660-4601 doi:10.3390/ijerph8093796. (Open Access journal, free full-text available here).