No evidence that the price of fame is an early death

“Having a glittering career … may come at the cost of a shorter life," BBC News explains, reporting on a study that analysed 1,000 obituaries in The New York Times.

It found that on average, famous performers and sports stars died earlier than other occupations that would warrant an obituary, such as politicians.

The results seem to reflect popular beliefs about the heavy price of fame and the celeb lifestyle, paid by stars ranging from Billie Holiday in the 1950s to Amy Winehouse in 2011.

The researchers do speculate that the early death rates could be that ‘stars’ are more likely to engage in risk-taking behaviour such as smoking, drinking and drug use.

However, a single study looking at 1,000 obituaries can prove very little. Examining another random sample of 1,000 deaths of the general population, from the US or elsewhere, could give entirely different results.

The fact that the study relies on data in the New York Times means it is predisposed to a Western bias. It could be the case that famous singers or film stars in Iran or India enjoy long and happy lives. 

Leaving aside its limitations, one interesting question raised by the research is whether the pressures of fame itself could contribute to early death, or whether personalities with a desire for success are also predisposed to risk-taking behaviour.

Where did the story come from?

The study was carried out by researchers from the University of Queensland and University of New South Wales, Australia.

There is no information about external funding, but, due to the nature of the study, it would be surprising if there was any conflict of interest.

The study was published in the peer reviewed QJM: An International Journal of Medicine.

It was covered widely and, for the most part, uncritically in the media, with The Daily Telegraph including comments from celebrity publicist Max Clifford.

Mr Clifford’s expertise in the field of epidemiology is a matter of debate.

What kind of research was this?

This was a study of 1,000 obituaries published in The New York Times (NYT) during 2009-11, which aimed to look at the relationships between career success, the rates of terminal disease and the ages at which people died. The NYT holds a similar position in the US as The Times does in the UK – it is regarded as a ‘quasi-official’ paper of record.

The authors point out that an obituary in the NYT – “that special form of life after death” – is a useful tool for analysing death among high-profile, successful people across a wide variety of careers. And due to the NYT’s (deserved) reputation for rigorous fact-checking, causes of death are usually recorded accurately (when the information is available).

Their theory is that specific careers among the famous are characterised by “distinct patterns of disease-associated mortality”.

What did the research involve?

Researchers used the online archives of the NYT to obtain the gender, age at death and occupation of the subjects of 1,000 consecutive obituaries published between 2009 and 2011 (they actually included 999 datasets since one record was deleted due to duplication).

Each entry was assigned an ‘occupational’ category and a ‘cause of death’ category.

The researchers categorised their subjects into four broad occupational categories:

• performance/sport (including actors, singers, musicians, dancers and sportspeople)
• non-performing creative (including writers, composers and visual artists)
• business/military/political
• professional/academic/religious (including historians, linguists and philosophers)

Any remaining subgroups – such as philanthropists – were classed as ‘other’.

Causes of death were classified as

• cardiovascular diseases (including heart attack, stroke and heart failure)
• neurodegenerative conditions (such as Alzheimer’s and Parkinson’s disease)
• cancer (this last category was subclassified where possible into organ-specific categories)

Cause of death in those over 85, if unclear, was redefined as ‘old age’, as were unattributed deaths in this age group.

At ages younger than 85, unattributed deaths (including wordings such as ‘after a short illness’) were recorded as ‘non-specified’.

The researchers used national mortality statistics for comparison and modified their occupational categories using international classifications. They analysed the statistics using online software.

What were the basic results?

The researchers report that:

• Male obituaries outnumbered female (813 vs 186), with the average age of death higher for men than women (80.4 vs 78.8 years).
• Younger (average) ages of death were apparent in sports players (77.4 years), performers (77.1) and creative workers (78.5).
• Older (average) ages of death were seen in military (84.7), business (83.3) and political (82.1) workers.
• Younger deaths were more often associated with accidents (66.2 years), infection (68.6) and organ-specified cancers (73.0).
• ‘Old age’ was more often cited as the cause of death for philanthropists, academics and doctors, and less often for sportsmen, performers and creative people.
• Cancer deaths occurred most often in performers (27%) and creative people (29%), with lung cancer most common among performers (7.4%) and least common in professionals (1.4%).

How did the researchers interpret the results?

They conclude that fame and achievement in performance-related careers may come at the cost of a shorter life expectancy. Young people contemplating careers in areas such as sport and the performing arts may, therefore, be facing a ‘Faustian choice’ – between maximising their career potential and living a shorter life, or falling short of their potential and having a longer lifespan.

Conclusion

Given our obsession with celebrity lifestyles, it’s perhaps not surprising that this study has attracted so much interest. It seems to support popular beliefs about the cost of fame in terms of drug addiction and high-risk behaviours such as smoking, drinking and drug abuse.

However, as the lead author – Professor Epstein, from the School of Medicine, University of Queensland – conceded, a one-off analysis of obituaries published in a specific newspaper, with no comparison group, proves very little. Examining another random sample of 1,000 deaths of high-profile people, or the general population, from the US or elsewhere, could give entirely different results.

Also, researchers only found that in the group they studied people in certain occupations died at a younger age, from certain diseases. With the exception of the figures on lung cancer (the chief cause of which is smoking), the links made between early death and risk-taking behaviour such as drug abuse or alcoholism is speculation.

There are many factors – including family history, lifestyle, medical and psychological health – that could contribute to early mortality, none of which were taken into account in this research.

The fact that the data was obtained from The New York Times means that it is has a very Western bias. Further research is required to see if a similar pattern is found in other parts of the world.

It is also uncertain how far journalistic reports of disease are accurate and also, as the authors point out, the style of obituary changes over time, driven in part by changing attitudes to diseases such as HIV, making accurate analysis difficult.

Finally, the authors conclusion that people seeking success in creative or sporting fields have to make a ‘Faustian choice’ between fame or early death is spurious and arguably dangerous.

There is no evidence that risk-taking behaviour makes you more creative or successful. If anything, the reverse is true. Many stars who successfully overcome drug or drink addiction report that they succeeded in spite of their behaviour and not because of it.

For every Kurt Cobain wasting their talent at the age of 27, there is a David Bowie, releasing critically acclaimed albums at the age of 66.