[nonameiguess]

This particular design more or less can't tell us whether fame in and of itself is a risk factor. We'd need to look at a cross-section of professions, not just musicians. Do marquee leading actors die younger than character actors? Do national politicians die younger than local? Do best-selling authors die younger than struggling authors who publish but never sell anything? Do professional athletes in popular sports die younger than athletes in less popular sports?

Mechanistically, it seems pretty obvious that fame can't cause a physical health outcome. I think the authors know this and they mention that it isn't really fame per se; it's the anxiety caused by public scrutiny and high expectations, often coped with by using illegal drugs to self-medicate.

That isn't a worthless finding, but what are we supposed to take from this? I would imagine drug-using hard-partying rock stars know their lifestyle in unhealthy and dangerous, just as I am fairly certain you'd be able to produce a retrospective study showing wingsuit divers die younger than big wall rock climbers, and big wall rock climbers die younger than trail runners. Anyone doing these things knows the risk and does it anyway. It seems the effect they found is famous musicians die 4.6 years younger on average than comparable unknown musicians. If you told me I could be a rock star but I'd die at 81 instead of 85, I think I'm probably taking that. Of course, we know it doesn't actually work that way, more that a few die in their 20s, far more in their 40s and 50s, and anyone making it past that is probably dying about the same time as anyone else, but whatever the risk is, if that's the life you want, so be it.

[rbartelme]

Thanks for the perspective. This makes me think I was a bit quick to judge their methodologies.