title: Elvis to Eminem: quantifying the price of fame through early mortality of European and North American rock and pop stars.
abstract: BACKGROUND
  Rock and pop stars are frequently characterised as indulging in high-risk behaviours, with high-profile deaths amongst such musicians creating an impression of premature mortality. However, studies to date have not quantified differences between mortality experienced by such stars and general populations.
  
  
  OBJECTIVE
  This study measures survival rates of famous musicians (n = 1064) from their point of fame and compares them to matched general populations in North America and Europe.
  
  
  METHODS
  We describe and utilise a novel actuarial survival methodology which allows quantification of excess post-fame mortality in pop stars.
  
  
  METHODS
  Individuals from North America and Europe performing on any album in the All-Time Top 1000 albums from the music genres rock, punk, rap, R&B, electronica and new age.
  
  
  RESULTS
  From 3 to 25 years post fame, both North American and European pop stars experience significantly higher mortality (more than 1.7 times) than demographically matched populations in the USA and UK, respectively. After 25 years of fame, relative mortality in European (but not North American) pop stars begins to return to population levels. Five-year post-fame survival rates suggest differential mortality between stars and general populations was greater in those reaching fame before 1980.
  
  
  CONCLUSIONS
  Pop stars can suffer high levels of stress in environments where alcohol and drugs are widely available, leading to health-damaging risk behaviour. However, their behaviour can also influence would-be stars and devoted fans. Collaborations between health and music industries should focus on improving both pop star health and their image as role models to wider populations.
authors.affiliation: Centre for Public Health, Liverpool John Moores University, Castle House, North Street, Liverpool, UK.. m.a.bellis@ljmu.ac.uk
authors.forename: Mark A
authors.initials: MA
authors.lastname: Bellis
authors.forename: Tom
authors.initials: T
authors.lastname: Hennell
authors.forename: Clare
authors.initials: C
authors.lastname: Lushey
authors.forename: Karen
authors.initials: K
authors.lastname: Hughes
authors.forename: Karen
authors.initials: K
authors.lastname: Tocque
authors.forename: John R
authors.initials: JR
authors.lastname: Ashton
mesh_terms: D002423:Cause of Death; D005060:Europe / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D009146:Music; D009656:North America / Q000453:epidemiology; D009784:Occupational Diseases / Q000401:mortality*; D019966:Substance-Related Disorders / Q000401:mortality; D016019:Survival Analysis