Ah, ah, ah, ah, staying alive... as a pop star The influence of pop stars is leveraged by their fame. It's not only about the music, but also about the lifestyle. Unfortunately, what that sometimes includes is substance abuse, which can in extreme cases lead to premature death. While that in itself is tragic, the effects of leverage and inter-linkages with the star's substantial fanbase can lead to system-wide shock, e.g. Kurt Cobain. Among the grieving fans, the manner of death may be seen as somehow in keeping with the lifestyle of the star. But is it the trappings of fame that contribute to such horrific ends, or is the probability of such an outcome influenced by pre-fame attributes and general demographics?* Putting that more formally is an article by Mark A Bellis, Karen Hughes, Olivia Sharples, Tom Hennell, and Katherine A Hardcastle published by the BMJ on Wednesday (emphasis ours): Despite their small numbers, the behaviour and health of rock and pop stars receive extensive public exposure and arguably exert a disproportionate influence on population attitudes and behaviours. Within the rock and pop music industries, excessive alcohol use, recreational and prescription drug use and other risk-taking behaviours have been described as ubiquitous. International media coverage ensures that fans and the wider public are constantly informed of stars" hedonistic displays and equally captures their consequences when behaviours become problematic and such individuals seek treatment. Media coverage of rock and pop stars" deaths typically suggests elevated risks of mortality at young ages and even a fanciful, but unsubstantiated, peak in deaths at age 27 years (eg, Kurt Cobain, Amy Winehouse and Janis Joplin). Cursory examinations of rock and pop star deaths can fail to account for confounding demographics. In other words, how statistically likely is it that these stars would die in the manner they have even if they hadn't achieved fame? Also, is the available sample big enough given that the whole concept of the "pop star" hasn't been around for much longer than the average life span in a developed country? As the researchers note: "substantive numbers of stars and former stars over 60 years of age are only now becoming available for study." The analysis attempts to control for age, sex, ethnicity and nationality, as well as more complicated variables like whether or not the person experienced "adverse childhood experiences" (ACE). As the researchers note: Although some rock and pop stars may seek fame as a mechanism to escape deprived and abusive childhoods such factors are rarely considered when examining their premature mortality. Instead, substance use and risk-taking in stars are largely discussed in terms of hedonism, music industry culture, responses to the pressures of fame or even part of the creative process. In order to avoid survival bias (in the fame sense rather than mortality), the sample includes individuals with five years of fame at any point during the period of study. The list comprised artists with high ranking albums in the charts and also involved substantial polling (see page 2 of the paper for more detail). This is the breakdown of the final sample for analysis: Of the 1,489 artists, 56 per cent were from North America and 44 per cent from Europe. Among the sample, stars are also identified as solo or being a part of a band (and yes, they are going to analyse how this affects mortality). Important point to demonstrate that we know what you're thinking: ...an individual [is] considered a solo performer if they had a solo album in the study; regardless of whether this preceded or followed success as a band member (eg, Phil Collins and Genesis; Sting and The Police). Within the sample there were 137 deaths to examine (click to expand): In order to draw a comparison with us normal folk: Individual performers were matched to corresponding annual survival probabilities experienced by average individuals (age, sex and ethnicity matched) in the general population in or near their year of fame. Result: Commentary: For NA stars, relative survival consistently decreased from 99.3% of matched population survival 1 year postfame to 87.6% 40 years postfame (R2=0.932; p<0.001). However, this trend was not apparent in EU stars (R2=0.024; p=0.881). In other words, look at how far apart the two red lines are versus the two blue lines not being far from each other. Additional findings of interest: Examining survival since fame, while controlling for demographic confounders, identified NA nationality and solo performer status as having significantly higher hazard ratios (HRs) compared with being a member of a European band. Reaching fame from 1980 onwards was independently associated with a higher relative survival... Under a third (30.8%) of deceased stars for whom no ACEs were identified died through substance use or risk-related causes, increasing to 41.9% of those with one ACE and 80% of those with two or more ACEs (χ²trend=11.77, p<0.001). The study is, of course, not without limitations. The research readily acknowledge the pitfalls of their dataset contruction - everything from the definition of fame to the cause of death is open to debate. As for the relevance of the topic area more generally: ...a growing body of research is linking celebrity worship and attachment to deficits in individuals" lives, such as family breakdown, low emotional support, social isolation and poor mental health. Thus, vulnerable populations may be more likely both to develop strong attachments to rock and pop stars, and to emulate their health-damaging behaviours. That's the power of media for you. All in all, go long Europeans with stable upbringings who are part of a band. Not the usual finance/econ Alphaville fodder, but what with it being nearly holidays and the world not ending, we thought you could use something a little different