Minimum Age Health

Because of its many unintended consequences, national alcohol prohibition was overturned by the 21st Amendment to the U.S. Constitution, ratified in 1933 by all states but South Carolina.  Shortly after this legalization of alcohol sales, most states enacted the minimum purchase age of 21.  The ideology driving prohibition, alcohol is bad, was forced to concede after a dozen years of evidence that prohibition caused more problems than it solved.  Some states and local communities continued the overall ban on alcohol sales right up to now, but most states compromised with age laws.

In the 60s and into the early 70s, many states dropped their minimum drinking age, based on a contrast: 18 year olds could die in the jungles of Vietnam but couldn't buy a beer stateside.  In addition, prevention theorists promoted the idea that part of the appeal of alcohol among youth was the "forbidden fruit" mystique of something only adults could have.  The way to diminish abusive drinking was to take that away, by making alcohol ordinary and routine, by providing more access rather than less.   This national experiment took place in the 1970s.  A few years in, evidence showed that youth drinking was up, not down.  Youth were experiencing more highway injuries and deaths than when the legal age was 21.  In the following years, the states brought the age back to 21, which is where it is today.  The agument has not gone away, however, particularly among those who don't remember the history of lowering the age in the 1970s.

In addition to the alcohol age restriction, we have other health-related age rules.  These include a minimum purchase age for tobacco (18 in most states, older in some), minimum age for driving, for employment, gun purchase, and marriage.  Many states prohibit helmet-free bicycling under a certain age.  What is the rationale for these laws?

We impose age restrictions for a variety of reasons.  If there are developmental limits on safety, such as with young drivers, age restrictions seem appropriate.  For some things it is a matter of children or youth not being capable of making an informed choice; most adults are persuaded that 12-13 year old adolescents are incapable of understanding the nature and consequences of marriage, and so we do not give them that privilege.

The rationale for alcohol purchase age was that youth needed to be protected from the seduction of alcohol until they were and are "of age."  The sub-theme is that youth are not capable of making an informed decision, and must wait until the legal age of adulthood.  Most adults approve of minimum purchase age laws, though they might quibble about what the appropriate age minimum should be.  Even parents who are comfortable serving alcohol to their children at home, usually do not want them to be able to buy alcohol on their own, without supervision.  Note that these laws not only take away choice from youth, they also take away the right of parents giving permission.  This is because the consequences of adolescents making bad choices with alcohol, parental permission or not, are a threat to us all.

Sometimes public support is a critical element with age restrictions.  For example, what if we had minimum purchase ages for donuts and fried onion rings.  There is no public support for such a policy, but logically someone could make the case, citing the same concerns underlying tobacco purchase minimum age laws.  It remains to be seen whether our concern for the national obesity epidemic leads to changing social attitudes regarding sheltering youth from extreme calorie foods.  Right now this seems very unlikely, but in the past I never would have thought there would be smoke-free ordinances in Kentucky, but this has happened.  Age restrictions can be a useful health promotion tool, but these policies always go up against the libertarian impulse so characteristic of American culture.