Motor Vehicle Injury Alcohol-Impaired Driving: Maintaining Current Minimum Legal Drinking Age (MLDA) Laws
Findings and Recommendations
The Community Preventive Services Task Force (CPSTF) recommends maintaining current minimum legal drinking age laws to reduce alcohol-related crashes and associated injuries among 18- to 20-year-old drivers.
The full CPSTF Finding and Rationale Statement and supporting documents for Motor Vehicle Injury Alcohol-Impaired Driving: Maintaining Current Minimum Legal Drinking Age (MLDA) Laws are available in The Community Guide Collection on CDC Stacks.
Intervention
Minimum legal drinking age (MLDA) laws specify an age below which the purchase or public consumption of alcoholic beverages is illegal. In the United States, the age in all states is 21 years.
About The Systematic Review
The CPSTF finding is based on evidence from a systematic review of 33 studies (search period 1966 — 2000).
Study Characteristics
- Studies were conducted in the United States, Australia, and Canada.
- Most studies in the review assessed the effect of changes in the minimum legal drinking age from 18 to 21 years or vice versa.
- Included studies reported the following outcomes: fatal injury crashes or crash fatalities; fatal and nonfatal injury crashes; or other crash types.
Summary of Results
The systematic review included 33 studies.
- Most of the studies assessed the effects of changes in the MLDA from ages 18 to 21 or vice versa.
- Effects of raising the MLDA: crash-related outcomes decreased by a median of 16% (14 studies; 1 study evaluating fatal crashes among 16-17 year olds was not included in the summary effect measures)
- Effects of lowering the MLDA: crash-related outcomes increased by median of 10% (9 studies)
- Estimated effect of raising the MLDA by 3 years (from 18 to 21) from regression-based studies: crash-related outcomes decreased by a median of 12% (9 studies)
- Effects were stable over follow-up times ranging from 7 months to 9 years.
Summary of Economic Evidence
An economic review of this intervention did not find any relevant studies.
Applicability
- Results should be applicable to all drivers 18-20 years of age.
- Results are based on studies from the United States, Australia, and Canada. They may not apply to countries with different alcohol consumption or driving patterns.
Evidence Gaps
- How do variations in enforcement levels influence the effectiveness of MLDA laws?
- What are the independent effects of publicity on the effectiveness of MLDA laws?
- Does public compliance with new laws change in a predictable manner over time?
- How do interventions to reduce alcohol-impaired driving interact with each other (e.g., 0.08% BAC laws and administrative license revocation)?
- What effects do these interventions have on long-term changes in social norms about drinking and driving?
- Are interventions equally effective in rural and urban settings?
- Are interventions equally effective when applied to populations with different baseline levels of alcohol-impaired driving?
- Do MLDA laws reduce other forms of alcohol-related injury?
- What are the cost-benefit, cost utility, and cost-effectiveness of interventions to reduce alcohol impaired driving?
- What role can community coalitions play in maintaining MLDA laws?
Implementation Considerations and Resources
- Engage partners throughout the process. Building support from the ground up can help secure policies that reinforce healthy behaviors in the community.
- Demonstrate why the policy is important. Use CPSTF findings and recent surveillance data to show partners how policies have been effective.
- Educate stakeholders. Keep the media, community influencers, and policymakers informed about MLDA laws to help communicate messages that are accurate and timely.
- Keep messages brief and to the point. Use graphics, figures, or infographics to clearly demonstrate how the intervention can improve health outcomes.
- Extend communication reach by working through partners who have the most credibility with key audiences.
- Pay attention to sustainability. Continue to conduct surveillance related to alcohol-impaired driving and disseminate findings.
Crosswalks
Healthy People 2030 includes the following objectives related to this CPSTF recommendation.