Invited chapter

In: Stamatios-Alexandrou, A. & Cooper, C. (Eds.) (2016). Coping, Personality and the
Workplace: Responding to Psychological Crisis and Critical Events. Surrey, UK: Gower.

Morbidity and mortality in popular musicians: An examination by era, sex and music genre

Dianna T Kenny
The University of Sydney, Australia

Abstract

Much of the literature on stressful workplaces, occupationally inspired psychological crises

and critical incidents has focused on the dangerous or human service professions such as
the military, policing, fire-fighting, emergency work, nursing and teaching. Few of us would
count among these stressful occupations classical or popular music, or consider that musical
workplaces – the symphony orchestra or pop band – to be a source of occupational stress or
worse, psychological trauma and early death. On the contrary, my work with musicians has
shown that a significant minority of musicians can be so traumatized by the demands of
their occupations that they do indeed experience symptoms of traumatic stress. Some turn
to substances to assist their coping efforts. Others engage in suicidal and parasuicidal
behaviours, including extreme risk-taking and profound lack of self-care that often results in
early death, either intentional or accidental. In the pop music world, it is understood, almost
as a sine qua non, that there will be sex, drugs, rock’n’roll, risk-taking and early death. In
this chapter, I interrogate this proposition by exploring several markers of occupational
stress inherent in the death records of popular musicians – shortened life expectancy,
suicide, homicide, accidental (non-intentional) death, and increased morbidity throughout
the lifespan. Sex differences and differences by music genre membership were also
examined. Results indicated that death by suicide, homicide, accident and other health
morbidities were significantly more likely in popular musicians compared with age- and sex-
matched US populations in musicians surviving beyond 30 years. Musicians dying younger
than 31 years mirrored population patterns. Health impacts differed by music genre
membership. Metal and punk musicians were most at risk of accidental death and suicide,
rap and hip hop musicians were significantly more likely to be murdered, rock musicians
were more vulnerable to accidental death, folk and jazz musicians were more likely to die

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from cancer and Blues musicians were more likely to die from heart-related causes. Gospel
musicians had the lowest suicide rates, perhaps protected by their religious beliefs.

INTRODUCTION

Art is a cry of distress from those who live out within themselves the destiny of
humanity… Inside them turns the movement of the world; only an echo of it leaks out
– the work of art (Schonberg, 1910, p. 12).

Hector Berlioz, a French composer from the late Romantic period once exclaimed, “Music –
What a noble art, what a terrible profession” 1. This comment was prompted, no doubt, by
the fact that he received very little recognition in his native France during his lifetime for his
now universally acclaimed musical compositions. When attention was forthcoming, it came
in the form of harsh criticism from contemporaneous French music critics like Hans Gal
(1969) and Pierre Scudo, who accused Berlioz of being devoid of melodic ideas and lacking
in inspiration. According to Scudo, Berlioz created music that was

…sterile algebra... [with an] incommensurable chaos of a sonority that irritates and
shatters the listener without satisfying him…There is nothing in these strange
compositions but noise, disorder...he behaves like a demon disinherited of divine
grace who wants to scale the heavens by force of pride and will (in Slonimsky, 1965,
p.58).

Berlioz scarcely received a better reception overseas, except in Russia, where he was
lauded. The Boston Daily Advertiser of 29 October 1874, for example, described Berlioz as

…the least respectable of the composers of the new school... [with] no breath of
inspiration and no spark of creative genius... Knowledge of the principles of
composition will no more make a composer than an acquaintance with etymology a
poet... It needs no gift of prophecy to predict that he will be utterly unknown a
hundred years hence to everybody but the encyclopaedists and the antiquarians
(Slonimsky, 1965, p. 59).

Today’s music critics are hardly less brutal. The difference is that everyone who can use a
computer, an iPad, an iPhone, a tablet or email is an instant music critic. Some of these
media protect critics’ identities, allowing them wider scope for the free expression of their
1
Evans, A. (1994, p. 137). The Secrets of Musical Confidence: How to Maximize your Performance Potential.
Sydney, Australia: Harper Collins.

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vitriole. Justin Bieber discussed his reaction to reading hate mail on Google with Ronson
(2010) - “You’re so stupid…your song sucks…you’re gay… When I like a video I don't waste
my time commenting. But people who hate you – they're going to take time to hate you."

When Justin turned 18, Margary (2012) sketched out his possible futures:

Justin Bieber is now 18 years old. And when you're a teen superstar who has just
turned 18, there are really only two options for where you can go next: You can
mature into a "real" artist, or you can swan-dive straight onto the pop-cultural scrap
heap with all the other reality stars and drug addicts [My italics].

Sadly, the “pop-cultural scrap heap” is piled high with the dead or broken bodies of young
musicians whose personal and musical aspirations collided with the aspirations of a
commercial machinery that grew up around them, dehumanizing, commodifying and
eventually engulfing them. Raeburn (1999, 2000) has noted the rampant substance abuse
and large number of premature deaths among popular musicians. She suggested that for
psychologically vulnerable musicians who have difficulty with self-esteem and self-
regulation, their work culture contributes to early death because it reinforces risk-taking
behaviour and treats musicians like income-generating commodities whose role is to satisfy
capricious and ever changing consumer demands. Many of these musicians end up feeling
suffocated, caged, and possessed by their minders, exploiters and fans. Justin Bieber said
that while he was on tour, he started to feel like “a robot… you’re not even yourself. It’s
weird…” He has become uncertain as to who is trustworthy: “I keep my guard up a lot,
because… you can't trust anyone in this business…That's what's sad. You can't trust
anybody. I learned that the hard way" (in Ronson, 2010). Troubled words indeed from a boy
of 18! A year later, Brooker (2013) noticed that Bieber was no longer flying high. He
commented that

His performances now consist of him quietly begging the audience to leave so he can
have some time to himself. But they can't hear his pleas because they're too busy
screaming, and they can't see his tears because they're watching his performance
while filming it on their Samsungs and he's too far away for the weeping to be visible
onscreen. Caught in a trap of his own making, he is the loneliest man in the world.

A recent article on the pop singer, Robbie Williams, began with the sentence: “After finding
fame at 16 with Take That, Robbie Williams followed a classic rock’n’roll script: sex, drugs,
rehab and bitterness” [My italics](Hooten, 2014, p. 10). In similar vein, Katel (2010), a

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blogger for the Miami New Times wrote: “Dead rock stars are a dime a dozen. They usually
drink themselves to death, overdose on narcotics, crash cars, or get on faulty aircraft with
drunk pilots on drugs who crash cars.” An anonymous biographer left the following
comment on the npr music website in 2004:

Singer Dinah Washington, the Grammy-winning "Queen of the Jukeboxes", left her
turbulent life behind at the tender age of 39. In that short period, a volatile mix of
undeniable talent and deep-rooted insecurity took her to the heights of fame and the
depths of self-doubt [My italics].

And yet, as the rock guitarist, Mark Volman, observed: “The music business has a way of
making you feel like you’re exempt [from] the real world…there is a kind of false security…
it’s impossible to consider that you could die…” (in Cody, 2007).

Has the path of popular musicians become a “classic script”, and if so, why? Could those
observations on Dinah Washington hold the key to a better understanding of this apparently
predictable path to desolation, destitution and drug-fuelled destruction to which so many
talented popular artists succumb? Does the combination of deep insecurity and uncommon
talent that exposes young people to the glare of public scrutiny, criticism and exploitation
create a lethal mix for those who are exposed too early?

Justin Bieber appears to be following this “classic script.” He was born to an 18 year old
mother, who raised him as a single parent after his father abandoned them when Justin was
three. Justin told Ronson, "My mom wasn't the greatest person…she made mistakes. She
drank. She…did drugs…she told me about it because she said she did enough bad stuff for
the both of us.” Added to personal vulnerabilities are the vagaries of the pop music industry
- the loss of boundaries that accrues to the demands of performing and touring that result
in dislocation from family, friends and a regular lifestyle, with its constant circadian rhythms
and other predictabilities lost through irregular hours, sub-cultural lifestyles and the abuse
of alcohol and other substances.

The rock scene is a volatile mix of danger and rebellion. Metal bands evince these qualities
in abundance. The thrash metal band, Gwar, is a quintessential exemplar. Founded by Dave
Brockie, also known as Oderus Urungus, who recently died of a heroin overdose, aged 51,

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this band was distinguished by its grotesque costumes, obscenely irreverent lyrics infused
with shameless scatological, violent and taboo themes. Brockie and his band described their
stage show as “a microcosm of the human condition” (in Overell, 2014). Forever pushing the
boundaries of decency and decorum, such bands create moral panic that results in
vilification in mainstream media. In 1990, Gwar’s British tour was cancelled because it
contained simulations of bestiality that were considered too offensive for the public gaze.
Indeed, some historians consider Metal music partly responsible for the decline of Western
civilization. Spheeris’s (1988) documentary film exposed the excesses of the metal scene,
with its celebration of a profligate lifestyle of drugs, promiscuity, misogyny, and valorization
of early death. I have long speculated that genres like heavy metal are manifestations of
band members’ psychological states, which express their rage, impotence and despair, and
provide a medium through which vulnerable musicians can project these feelings onto
receptive audiences and detractors alike.

Given the inherent hazards of the pop music scene, and the taken-for-granted assumptions
that pop musicians will live dangerously, abuse substances and die early, it is concerning
that so few systematic attempts have been made to assess the extent of the problem. One
old study (Tucker, Faulkner, & Horvath, 1971) that examined age at death of a small group
of musicians who died between 1959 and 1967 found that they had a decreased life
expectancy (54 years) compared with the contemporaneous population life expectancy of
69 years. The study also reported higher rates of heart disease among musicians. However,
the flawed methods used in this study make the conclusions unreliable. There are, however,
three recent studies that describe a profession in crisis.

The first study (Bellis, Hennell, Lushey, Hughes, Tocque, & Ashton, 2007) showed that pop
musicians achieving recent fame or notoriety suffered earlier death compared with
population data, and that this finding was robust when age, sex, ethnicity and nationality
were controlled. Inclusion criteria were pop musicians who performed on any album in the
All-Time Top 1,000 albums (Larkin, 2000) from five modern popular music genres (i.e., rock,
punk, rap, R&B, electronica). Country, blues, jazz, Celtic, folk, and bluegrass were excluded.
All of these genres were included in the current study to permit the first comparison of
morbidity and mortality between the older and newer genres of popular music. This study

5
calculated total years of musician survival since becoming famous, the date of which was
determined by the earliest date of first chart success. In this sample of 1,064 popular
musicians, post-fame mortality was 1.7 times greater than demographically matched
populations in the USA and UK. Median age of death for the North American musicians was
35.18 years. Mortality five years post fame was 2.4%. Chronic drug or alcohol abuse or
overdose accounted for one quarter of the 100 deaths documented in the specified time
frame. Pop star survival always fell below that of the matched populations in every year
post-fame up to 25 years. In the period two to 25 years post fame, this sample of popular
musicians experienced two to three times the risk of mortality compared with comparable
general populations.

The second study (Bellis, Hughes, Sharples, Hennell, & Hardcastle (2012) examined the
hypothesis that the popular music industry is, as is often claimed in the media, more
strongly associated with risk-taking, substance abuse and early death than comparable
general populations and that the prevalence of these factors differ by type of performer
(solo artist vs band member), nationality (North American vs European) and the experience
of childhood adversity. This study investigated these questions using a sample of 1,489 rock
and pop musicians who achieved fame between 1956 and 2006. The median age of death
for the North American musicians was 45.2 years, compared with 39.6 years for the
European musicians. Like the earlier study reported above, musician mortality increased
with time since fame and exceeded comparable population death rates for the same time
period. Death was strongly associated with substance abuse and risk taking and importantly,
the experience of childhood adversity. Half of the musicians who died from substance abuse
or risk-taking had experienced childhood adversity, compared with a third who died of the
same causes but had no childhood adversity recorded. The greater the number of childhood
adversities, the more likely a musician was to die of substance abuse or risk-taking. Clinical
and epidemiological studies (e.g., Anda, Felitti, Bremner, et al., 2006; Felitti, Anda,
Nordenberg, et al., 1998) have repeatedly identified a strong association between childhood
adversity, substance abuse and risk-taking in later life. Post-fame mortality was significantly
lower compared with matched general populations – 99.3% in the first year post-fame and
87.6% 40 years post-fame. Solo performers had twice the mortality rate (22.8%) compared

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with band members (10.2%). Survival improved after 1980 but was still lower than
comparable general populations.

The third study (Wolkewitz, Allignol, Graves, & Barnett, 2011), in the course of investigating
whether the age of 27 was a high risk age for death in popular musicians, found that the risk of
death for “famous” musicians aged 20-30 years was two to three times higher than the general UK
population. The smoothed death rate showed a peak at 32 years with greatly increased risk of death
after age 60.

Most other studies on pop musicians have been interview-based studies with small, non-
representative samples that do not address the issues related to life expectancy and cause
of death in the pop music population. Notwithstanding, interview studies do give us clues
about the occupational stressors experienced by musicians and most of these studies concur
with respect to the primary stressors. Sternbach (1995) identified three categories of
stressors in the lives of musicians – environmental, inter- and intrapersonal factors, and
“stress factors unique and intrinsic to the lives of performing artists” (p. 4). Cooper & Wills
(1989) reported on the outcomes of interviews aimed at understanding the most frequent
sources of stress experienced in 70 British male popular musicians. The interviews painted a
sobering picture of an occupational group who suffered significant distress, uncertainty,
performance anxiety, financial insecurity, and anger at the excessive demands of the music
industry, its callous disregard for musician well-being and the absence of a caring social
network. Musicians also discussed their irregular work hours, work overload, non-standard
hours, lack of sleep, and work underload – periods when they had to play at boring gigs that
were not artistically challenging to earn a living. Many commented on the stress of
maintaining good relationships with band members and their entourage – promoters,
producers, sound engineers – on whom they depended for their work. Family life was also
affected, due to irregular work hours, the necessity to travel and the long separations from
significant others that this entailed.

Raeburn’s (2007) study identified similar sources of stress to those reported in Cooper and
Wills (1989), but with several additions. These included the increased exposure and easy
access to alcohol and drugs; engaging in depersonalized sex while on tour; increased

7
exposure to pathogenic beliefs about creativity requiring self-destructive or extreme
behaviours; and increased exposure to audience, critics, and cultural projections and
objectification; conflicts between career and family roles; concerns related to aging in a
youth-oriented market; and ongoing issues with the tension between artistic identity and
commercial acceptability.

Other researchers have used biographical analysis or psychological autopsy as methods of

ascertaining psychiatric diagnoses in musicians, a method that has been criticised on a
number of grounds (see, for example, Schlesinger, 2004). For example, Wills (2003) formed
psychiatric diagnoses of jazz musicians active between 1945 and 1960 and concluded that
29% had an affective disorder, 28% had alcohol-related psychological disorders, and 53%
had substance abuse (mostly heroin) disorders. These conclusions have since been
challenged, but the method used to critique Wills (2003) – convenience sampling - is also
fraught with methodological problems. One study using a convenience sample (Raeburn,
Hipple, Delaney and Chesky, 2003) reported rates of substance abuse to be as low as 10%-
16%. This figure may reflect the methodological problems with the study and not the true
rate of substance abuse in this population. Dobson (2011) provided a summary of the
research to date on popular musicians, but this was also abased on an interview study with
a very small sample comprising nine jazz and nine classical musicians aged 21 to 34. Other
sources of information about the mental and physical health of musicians has come from
media and ubiquitous anecdotes that are generalized to much wider segments of the pop
music community than might be justified.

Currently, we understand very little about the characteristics of the popular musician
population because there have been no population studies undertaken, in the manner of
such studies in the classical musician population (see, for example, Kenny, Ackermann &
Driscoll, 2014; Kenny & Ackermann, 2013). The aim of this study was to assemble a
comprehensive dataset representing a strictly defined population of all dead pop musicians
and to analyse key characteristics such as life expectancy and cause of death in order to
provide population data upon which further studies might be undertaken and to raise
awareness of the potential vulnerabilities of this population. I took an inclusive approach to
the population. I was interested in all musicians, not just those who achieved fame or had

8
“hit” albums. This study posed some major challenges, which I discuss in detail in the
following section.

METHOD

Defining the population: Popular music, popular musicians and pop stars
Popular music is defined as any music that does not belong to the classical music genre.
Popular musicians perform popular music. They are either singers, instrumentalists or both.
Popular genres include African, ballad, bluegrass, blues, Cajun, calypso, Christian pop,
conjunto, country, doo-wop, electroclash, folk, funk, Gospel, hard rock, hip hop, honky tonk,
indie, jazz, Latin, metal (all forms – atmospheric, avant-garde, black, dark, death, extreme,
glam, heavy, melodic, thrash), new wave, polka, pop, psychedelic, punk, punk-electronic,
rock (including shock rock, glam rock etc), rap, reggae, rhythm and blues, rock and roll,
rockabilly, ska, soul, swamp, swing, techno (includes electronic and experimental), western
and world music (Borthwick & Moy, 2004). Those performers who reach a pinnacle of
‘stardom’ in popular music as defined by fan followings, sales of electronic media containing
their songs, international tours and sell-out concerts are called ‘pop stars’.

There is no reliable way to assess the number of musicians in the US population or any other
population. This is because it is difficult to define a musician. Unlike teachers, lawyers and
doctors, who must pass board certified examinations and be registered to practice in their
professions, which makes them easy to count, musicians who earn a living at their craft have
no equivalent requirements for minimal qualifications, certification, accreditation or society
membership. The US Bureau of Labor Statistics (BLS, 2013) provide some indication of the
size of the population that earns income from music, but does not distinguish between
music genres and also excludes self-employed musicians, which would result in a significant
underestimate of the musician population as the majority of performing popular musicians
are self-employed. In May, 2013, the BLS reported that there were 39,260 musicians in the
US, a decrease from 42,530 in May 2011. The US Census codes musicians under the
category “musical groups and artists.” Like the BLS, US Census data shows a decrease in
musicians from 45,200 in 1999 to 34,600 in 2012.

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Although some musicians belong to unions or other music professional groups, there is no
one organization that represents all musicians. Performance rights organizations are not
helpful in pursuit of an answer to this question because most define the term “musician”
very broadly to include composers, songwriters and music publishers. Even if we could
access a large sample of individuals who earn a living from some aspect of music
participation, what inclusion and exclusion criteria would apply? For example, should only
professional (as opposed to amateur or hobby) musicians be included? I will discuss this and
a great many other issues in depth in the next section.

Key sources of data and inclusion/exclusion criteria

Data on the age, circumstances and manner of death of popular musicians since 1950 used
for this study were accessed from more than 200 sources. The primary sources included
Nick Talevski’s (2010) Knocking on Heaven’s Door: Rock Obituaries, Komara’s (2006) Blues
Encyclopaedia; The Dead Rock Stars’ Club website; Pop star mortality; R.I.P. Encyclopaedia
Metallicum; Voices from the Dark Side for Dead Metal Musicians; Wikipedia’s List of Dead
Hip Hop Artists and Hip Hop obituaries; rapper death websites; Those we have lost in music
– Soul and R&B; Dead Punk Stars; Maximum Ink Music Magazine; The Rock n’ Roll Death
List; BIZARRE!!! The Dead, the Criminals and the Strange Tales related to Music and
Musicians; Drugs and Roll; and Cause of death-Suicide.2

While the Dead Rock Stars’ Club and Talevski (2010) were comprehensive, the listings were
far too inclusive and needed careful culling to create a sample that met inclusion criteria. In
the first stage of defining the population, performers in the following musical styles were
excluded: classical vocal and instrumental music, including chamber groups and symphony
orchestras, opera, oratorio, operetta, music theatre, musicals, choirs, big bands, dance
bands and jazz orchestras. Musicians who played exclusively in large bands or in large
ensembles or orchestras for film music were also not considered to be pop musicians
according to the definition used here and were not included in the sample.

Some artists in rock star lists, including those relied upon in this study, are billed as actors,
comedians, music theatre/musical performers, TV personalities or TV hosts. To be included,

2
A complete listing of all websites accessed for this study is available upon request from the author.

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artists needed to have been part of a live performance pop group for a significant period of
their careers. Performers who included singing as part of their comedy routine were
excluded. Jeff Astle and Carrie Hamilton are examples of exclusion in this category. TV hosts,
like Alan Dale, who had his own TV show and starred in films, even though he had done
some solo pop singing, were also excluded. Betty Williams Boyd, who was a pianist and
singer, was not considered a pop artist, even though she played in a Dixieland band because
it was not her primary occupation (she was an antique dealer). There are other exceptional
individuals who pursued other professions and played music “on the side”. None of these
were included in the current sample. Examples include Stan Wheeler, a professor of law at
Yale Law School, who was also a trumpeter with The Yale Jazz Ensemble. Dr Robert Good, an
obstetrician who delivered over 3,000 babies, also played saxophone, piano and flute with
The Glenn Miller Orchestra. His exclusion was two-fold – he was a big band musician and
also a “hobby” musician. Similarly, Vice Vukov, a politician in the Croatian Parliament,
moonlighted as a pop singer, and Bruce Stovel, a Canadian Professor of English, who was
also a Blues musician, were not included in the sample.

Other exclusions included promoters, managers, composers, arrangers, lyricists and song
writers who did not perform, record producers, record executives, DJs, talent scouts,
booking agents, nightclub proprietors, music critics, musicologists, music teachers, sound
engineers, instrument makers, roadies, music artists (e.g., CD cover designers) and
photographers. For example, Brian Epstein, the manager of the Beatles, frequents lists of
rock stars. However, Brian did not perform in front of audiences, and was therefore not
included in this sample.

Studio or session musicians were also excluded because they are not subject to the same
intense exposure and stresses experienced by pop musicians who front or are members of
(small) pop groups. Examples of exclusions include Jesse Ed Davis and Big Jim Sullivan
(session guitarists), Jules Chaikin and Calvin Owens (session trumpeters), and Tony Bell
(session keyboardist and guitarist), who was also a songwriter, singer, arranger and
engineer. Similarly, Dante DiThomas, a film studio musician, who worked on more than 200
films leading The Dante DiThomas Orchestra, while an outstanding musician, did not meet
inclusion criteria for this study. Musicians whose primary role was to lead orchestras, big

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bands and dance bands were not included. Examples of exclusions in this category include
Don Beamsley, who worked primarily with The Warner Brothers’ Studio orchestra and as an
organist at Dodger Stadium, and Gordon Tetley, who was a big band, dance band and
Dixieland band man. Nathan Kaproff was a session musician and musical contractor for
many films, including Edward Scissorhands, Indecent Proposal and Rocky, was likewise not a
member of the population of interest. Similarly, Uan Rasey was primarily a studio trumpet
player for the MGM film studios orchestra from 1949 until the early 1970s. For same
reasons, playback singers were also excluded from this sample. A playback singer sings pre-
recorded songs for movies and soundtracks, and for actors to lip-sync the songs for camera;
the playback singer does not appear on stage or screen.

When an artist was given several attributions, such as, for example, singer, pianist,
songwriter, composer and arranger, their principal occupation as performer, either as a
vocalist or instrumentalist in a popular style determined their inclusion. Those with dual,
triple or multiple attributions who were not principally singers, instrumentalists or band or
group members, or had been inducted into a song writers’ hall of fame, not a singers’, vocal
groups’, or musical style hall of fame were not included in this sample. For example, Roy
Orbison, who has been characterized as a singer, song writer and guitarist, was, in equal
measure, a singer (performer) (inducted into Rock and Roll Hall of Fame) and song writer
(inducted into Song Writers’ Hall of Fame) and was therefore included in the sample.
Professor Longhair (Henry Roeland "Roy" Byrd), sometimes characterized as “the
grandfather of rock'n'roll” was a piano player, singer and songwriter. He was a member of a
number of pop groups including The Mid-Drifs, Professor Longhair and the Four Hairs,
Professor Longhair And His Shuffling Hungarians and The Blues Jumpers. He had been
inducted into the Louisiana Blues Hall Of Fame and Rock & Roll Hall Of Fame, and was
therefore included. By contrast, song writers included in the “Dead Rock Stars’ Club” list
who did not perform, like Linda Creed, Vic McAlpin, Harold Adamson, and Hamish
Henderson were not included.

It was particularly difficult to determine inclusion/exclusion for older musicians. The concept
of the rock star is very much a post-World War II phenomenon, after which time modes of
communication, travel and technology transformed the universe into a global community.

12
Many of the older musicians identified could not be characterized as “rock stars” according
to its modern definition. Most did not travel internationally; they performed in one location
or region for the majority of their musical careers. Joe Birchfield, born in 1912, was an old
time fiddler who played dance music primarily in bands comprising members of his family at
festivals and celebrations between Washington and Nashville. Is he a pop musician according
to the contemporary definition? The fact that he was a dance musician excluded him, so other
factors did not need to be considered. Others, possibly by dint of their longevity, spent
many years in the latter stages of their lives either teaching or performing a service to
community music. Ray Alexander, born in 1925, was a jazz musician who spent the early
years of his life travelling, playing piano with some big names in popular music such as
George Shearing, Mel Torme, Martin Denny, Mel Lewis and The Dorsey Brothers. However, for the
last 20 years of his life, he was a teacher, church organist at his community church, and an
accompanist for local high school choirs. Is he a pop musician? Sergeant Charles Corrado is listed
as a rock star in the “Dead Rock Stars’ Club”. At the time of his death in 2004, aged 64, he
had served 45 years as a member of the U.S. Marine Band; for 41 of those years, he was
based at the White House. Similarly, Ivor Cutler was primarily a writer, teacher, poet,
songwriter, and humourist who appeared on radio, television and in films. He was also a
singer who played harmonium and piano and who made several recordings. I concluded
that they did not fit the definition of a “popular musician” used in this study, and were
excluded. Another example of exclusion of older musicians is Mervyn Edward Griffin Jr. who
died in 2007 aged 83. He was a multi-tasker who was billed as a singer, pianist, entertainer,
TV talk show host and show biz mogul who also created, produced and wrote music for TV's
Jeopardy and Wheel Of Fortune. Many of the older musicians had several simultaneous
occupations. Since this study aimed to capture the population of musicians who were
primarily devoted to creating and performing music in pop groups, (many were also
songwriters) those who presented with profiles similar to those just described above were
not included.

Additionally, application of the inclusion criteria was sometimes hindered by another

problem with older musicians - the scarcity of accurate information. Finally, these older
musicians were not part of a popular music culture as we currently understand that culture
today. For example, international travel was much slower and more difficult; the frenetic

13
international touring that is part of the current pop scene was not part of the experience of
musicians from an older generation. Technology for sound recording was more primitive
and the mass production of recordings was not possible in the way that multimedia
reproductions are achieved today. Finally, even the most illustrious older musicians, with a
few exceptions, did not have the pop paparazzi and fan clubs stalking them at concerts or in
cyberspace, or the media frenzy that demands to know all the intricacies of the personal
lives of contemporary pop idols – the boundary between public and private was more firmly
drawn in previous eras. Inclusions of older musicians were, therefore, necessarily
conservative.

Aims and outcomes

This study examined the causes of death in the popular musician population in those
musicians who died between 1950 and 2014. Data on gender, year born, age at birth, age at
death, decade of death, cause of death and music genre membership were compiled for all
musicians who met inclusion criteria. The effects of age of death, sex, music genre and
decade of death on the cause of death were assessed in order to identify vulnerable groups
within this population. Where possible, comparisons were made with age- and sex- matched
data from the US population.

The cause of death was verified, if possible, from at least two independent sources. Sources
included obituaries, death records, pop musician websites, biographies, newspaper or
magazine articles and blogs. A significant number of deaths were listed as “illness”, “short
illness” or “long illness”. Attempts were made to ascertain the nature of illness, but this
proved impossible in many cases. These cases were included in “All other causes” of death
in the analysis. Similarly, deaths listed as due to “natural causes” often could not be
improved upon, but indicated that the death was probably not due to accident, suicide or
homicide. Although it is likely that many of these deaths, particularly in young people (18 –
44 years) were due to substance abuse, overdose, or acute drug toxicity that resulted in
irreversible heart arrhythmias, these cases were also included in “All other illnesses”. It is
often the case that the media are told that the cause of death was “unknown” or “natural”
to hide the actual cause of death, particularly in the event of suicide, overdose, or AIDS.
Gram Parsons is an example. After a prolonged stint of poly-substance and alcohol abuse,

14
Gram Parsons stopped breathing. He was revived by a friend and went to sleep. His
breathing became laboured and despite attempts to revive him a second time, he could not
be resuscitated. The cause of death given to the press at the time was “natural causes”
because his heart stopped beating as he lay sleeping, but the coroner later ruled that the
death had been the result of drug toxicity and long-term poly-drug use. Parsons and other
similar cases were coded as “accidental death” in this study.

In the case of suicide, only those deaths that were specifically designated death by suicide
were coded into this category, that is, only if the word “suicide” had been explicitly listed as
the cause, or in cases where other clear indicators that suicide was the cause of the death
were given, for example, “shot himself”, “hanged himself”, “jumped in front of a train,”
“jumped from a high balcony,” “suicide by overdose” or “death by carbon monoxide
poisoning.” When the cause of death was attributed to “overdose” without elaboration of
the circumstances, these deaths were coded as accidental. There is no doubt that many
suicides by overdose have not been classified as such due to lack of evidence or reluctance
on the part of family and friends to accept that the death was intentional. This coding rule
has no doubt resulted in an underestimation of the suicide rate in this population because
many of the deaths designated “overdose” or “accidental” are highly likely to have
constituted suicidal behaviour (if not conscious suicidal intent).

Michael Hutchence and Amy Winehouse are exemplars of the grey area between suicide
and unintentional death. Both Michael and Amy had been engaging in extremely high risk
(even parasuicidal) behaviour such as drinking very large amounts of alcohol immediately
prior to their deaths, and both had tried unsuccessfully to reach important support people
in the hours before their deaths. Although, according to his wife, Paula Yates, Michael
Hutchence most likely died as a result of auto-erotic strangulation, and not deliberate
suicide, the coroner brought down a verdict of suicide by asphyxiation. On the other hand,
Amy Winehouse had been given a dire warning by her physician on the day of her death
that she was at imminent risk of death from alcohol poisoning if she persisted with her
binge-drinking. This is exactly what she did – she drank herself to death. However, her
family and associates defensively insist that she did not intend to kill herself. In this study, I
have coded her cause of death as liver-related (due to alcohol poisoning).

15
Murder was defined as the intentional act of unlawfully killing another when the act was not
self-defence. Although most of the murder cases in this data set were uncontroversial, some
required special consideration. For example, 28 musicians were killed by police. Coding in
these cases was assessed on a case by case basis. If the musician was shot and killed by
police while unarmed, the case was coded as murder. A sad example is that of the 19-year-
old rock musician, Jaime Paulo Camilo, also known as Max Love, who was killed by a
governor’s guard while on the roof of a lorry working a sound-system as part of election
celebrations in Mozambique (Hanlon, 2013). His case was coded as murder. Don Myrick, a
jazz saxophonist aged 53 years, was shot by police after they knocked at his door to serve a
search warrant during a narcotics investigation. Myrick answered the door with a butane
cigarette lighter in his hand and was fatally shot in the chest at close range by a police
officer. His family successfully defended a wrongful death suit and received $400,000 (Katel,
2010). His death was coded as murder. The three young men killed in action (during war)
were coded as accidental deaths, in view of the fact that, although they were intentionally
killed by others, the act during war is not unlawful and is constituted as a form of self-
defence.

Accidental death was coded for any death by injury or misadventure that was not caused by
self or as a deliberate act of a second party. Three categories were coded – Accidental death
by overdose, accidental death – vehicular, and accidental death – all other causes. These
and other categories for most frequently occurring causes of death are also presented in
Table 1. Categories were designed to be directly comparable with ICD-10 classifications, in
particular those used by the US Center for Disease Control.

Table 1: Cause of death categories and exemplars for each category

Cause of death Includes

*Accidental death - Alcohol poisoning, cocaine, heroin, morphine, pain killers,
overdose prescription drugs, speedball (intravenous cocaine with heroin or
morphine), valium, drug toxicity
*Accidental death – Boat, bus, car, helicopter, hit-and-run, motorbike, plane, taxi, tour
vehicular bus, train, van
*Accidental death – Choking, drowning, falling from height, fall down stairs, house or
other nightclub fire, killed in action (war), lost at sea, Russian roulette,

16
 skiing accident, strangulation
Cancer All malignant neoplasms
Liver-related death Chronic liver disease, cirrhosis
Heart-related death Acute myocardial infarction, atherosclerosis, cardiomyopathy,
cardiovascular disease, congenital heart disease, coronary heart
disease, heart attack, heart disease, heart failure, hypertensive heart
disease, rheumatic heart disease, pulmonary oedema
Respiratory failure Asthma, bronchitis, bronchiectasis, COPD, influenza, pulmonary
embolism, pulmonary fibrosis, pneumonia, traceitis
Cerebrovascular Aneurysm, cerebrovascular disease, cerebral haemorrhage, stroke
All other illnesses Examples include Alzheimer’s disease, Crohn’s disease, cystic fibrosis,
dementia, diabetes, died in childbirth, epilepsy, septicaemia, multiple
sclerosis, motor neurone disease, sudden adult death syndrome,
gastrointestinal disorders (ulcers, gastric haemorrhages, colitis,
dysentery), obesity-related disorders, peritonitis, swine flu, syphilis,
and illnesses (not specified), “natural causes”, “died in sleep”, “found
dead”, “died on stage”
*All accidental deaths in these three groupings were coded as accidental deaths in this study

Music genres were grouped as shown in Table 3. These groupings were based on the
identification of distinctive and dominant musical styles. Earlier derivations of the dominant
style or contemporaneous variations of the dominant style were grouped together. The
groupings were as follows: Blues; Country/Country and Western/Boogie Woogie/Honky
Tonk/Bluegrass; Gospel/Spiritual/Christian; Experimental/Electronic/Techno/Disco/Funk;
Folk/Ballad/Polka; Hip Hop; Jazz/Bebop/Dixieland; Metal; Pop; Punk; Rap; Rhythm and
Blues/ Doo Wop/Soul; Rock/Rockabilly; and World music. Truncated genre styles are
presented in the tables for ease of presentation.

RESULTS
Demographics
Of the total sample of deceased popular musicians (n=12,803); 11,554 (90.3%) were male
and 1,249 (9.7%) were female. The distribution of deaths by decade and sex are shown in
Table 2.

Table 2: Decade of death by sex

Decade of death Male %Male Female %Female Total % Decade

1950 186 1.6% 21 1.7% 207 1.6%

17
 1960 376 3.3% 28 2.2% 404 3.2%

1970 612 5.3% 73 5.9% 685 5.4%

1980 973 8.4% 106 8.5% 1079 8.5%

1990 1506 13.1% 164 13.2% 1670 13.1%

2000 4555 39.5% 457 36.6% 5012 39.3%

2010-Dec 2014 3314 28.8% 398 31.9% 3712 29.1%

Total 11,522 100% 1,247 100% 12,769 100%

One way analysis of variance (ANOVA) indicated that the average age of death for male and
female popular musicians did not differ significantly for the four decades between 1950 and
1980. For the three subsequent decades, male musicians died at significantly younger ages
than female musicians [for 1990, (F (1, 1287)=9.91, p=0.002); for 2000 (F (1, 4318) =19.89, p=0.001);
and for 2010 (F(1, =15.09, p=0.001)]. These sex differences in musician longevity are
3462)

reflected in male and female life expectancies for the US population for the decades 1990,
2000 and 2010 but not for the earlier decades, in which women also had higher longevity
than men.

The frequency distribution of deaths by genre and decade are presented in Table 3, which
also highlights the significant changes in prevalence of the different genres over the seven
decades from 1950 (as reflected in the proportion of deaths by decade for each genre).

18
Table 3: Genre by decade of death
Decade Blues World Country Folk Gospel Hip Hop Jazz Metal Pop Punk R&B Rap Rock Electronic Total
N genre 873 919 835 491 413 258 2044 2010 696 338 925 157 2676 155 12790
% genre 6.8 7.2 6.5 3.8 3.2 2.0 16.0 15.7 5.4 2.6 7.2 1.2 20.9 1.2 100%
Decade 1950 5.5% 0.8% 2.5% 0.4% 2.9% 3.3% 0.3% 2.4% 2.2% 0.3% 1.6%
1960 7.8% 1.0% 4.7% 1.8% 4.1% 6.7% 0.1% 4.2% 3.9% 2.2% 3.2%
1970 13.2% 1.5% 7.3% 3.5% 8.0% 0.4% 6.7% 0.1% 8.1% 1.8% 9.8% 5.6% 1.9% 5.4%
1980 13.3% 3.7% 8.5% 9.2% 7.7% 0.4% 10.1% 3.5% 12.9% 5.6% 13.1% 1.3% 9.6% 8.4% 8.5%
1990 12.6% 9.0% 8.5% 10.2% 6.5% 16.3% 7.2% 18.0% 13.8% 17.2% 15.6% 21.7% 15.7% 18.7% 13.1%
2000 28.9% 40.4% 43.1% 45.2% 43.1% 45.7% 41.6% 40.6% 34.5% 45.7% 33.1% 52.2% 37.8% 35.5% 39.2%
2010 18.8% 43.6% 25.4% 29.7% 27.6% 37.2% 24.3% 37.4% 24.0% 29.7% 22.4% 24.8% 28.9% 35.5% 29.1%
TOTAL 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%

Table 4 presents numbers per genre, average age of birth, average age of death, age range of death, and maximum age to 2014 for male
musicians by music genre. These data are compared with life expectancy for US males who were born in the same year as the average age of
birth for each genre.

Table 4: Number, average age of birth, average age of death, maximum age to 2014 for male musicians and life expectancy (US males)

19
 Music genre Number Av Yr birth Av Age death Age Range Max Av Age to 2014 LE (US Males)*
Blues 752 1930 61.7 21-100 84.0 55.8
Jazz 1769 1931 65.6 17-100 82.7 59.4
Country 716 1934 64.1 19-104 80.4 59.3
Gospel/Spiritual/Christian Rock 306 1935 63.3 13-104 78.9 56.6
R&B/Doo Wop/Soul 796 1938 58.0 18-104 76.0 62.1
Pop 455 1941 55.7 11-100 73.0 64.7
Folk/Ballad/Polka 385 1944 58.3 18-94 69.9 62.4
World music/Reggae 741 1948 56.8 13-100 66.0 64.4
Rock/Rockabilly 2251 1953 48.4 15-93 60.9 66.0
Electronic/Disco/Funk 131 1956 49.9 17-76 58.0 66.7
Punk 279 1964 40.3 18-79 50.0 66.6
Metal 1079 1972 35.5 15-74 42.5 67.4
Rap 139 1975 29.2 16-77 38.9 68.8
Hip Hop 180 1976 29.5 14-78 38.0 69.1
TOTAL 9979

*Ref: http://demog.berkeley.edu/~andrew/1918/figure2.html

20
Figure 1 presents the average age of death for popular musicians by genre and sex
against Life Expectancy (LE) for US males and females born in the same years as the
average year of birth of musicians from each genre.

80
75
70
65
60
55 Male musicians - age of
death
50
45 LE (US Males)*

40 Female musicians-age of
death
35
30 LE (US Females)*

25
s z y l l p k ic k k k l p p
lue Jaz ntr spe Sou Po Fol us Roc Fun Pun eta Ra Ho
B u o p/ m / M ip
Co G o ld isc
o H
o
W or /D
o W ic *Ref: http://demog.berkeley.edu/~andrew/1918/figure2.html
D n
& B/ ctro
R Ele

Figure 1: Average age of death by genre and sex plotted against Life Expectancy (LE) for US
males and females for average year of birth by music genre

Musicians from the older genres – blues, Jazz (includes Bebop and Dixieland), Country
(includes Country and Western, Boogie Woogie, Honky Tonk and Bluegrass), and Gospel
(includes Spiritual and Christian Rock) - enjoyed, on average, a normal lifespan when
compared with the lifespan of the US populations from the same year of birth. The next
group – R&B, pop, folk and world music – have lower life expectancies compared with the
US population, even though they have had the opportunity, on average, to live beyond
the life expectancy of the US population. Thereafter, there is an increasing and
precipitous reduction in the average age of death for the more recent genres – rock,
electronic, punk, metal, rap and hip hop.

These figures reflect, to some extent, a confound in the data – that is, musicians who are
dying youngest belong to newer genres (hip hop, metal, punk, rap) that have not existed

21
as long as genres such as jazz, country, gospel and blues. The average year of birth for the
oldest (i.e., blues) musicians in this sample was 1930; the average year of birth for the
youngest (i.e., hip hop) musicians was 1976. The maximum age in 2014 based on average
age at birth for someone born in 1930 was 84; the maximum age for a hip hop musician
was 38 years. All things being equal, the majority of those born after 1950 should still be
alive. However, we have no way of knowing what proportion of musicians from recent
genres has died, as it has not been possible to assemble a reliable database of living
popular musicians; that is, most researchers in this field have been hampered by
difficulties in estimating or deriving appropriate population denominators.

A second issue making it difficult to assess the differential risk and manner of death in
popular musicians is the possible existence of selection effects that would make the
population of musicians different in some way from the general population with which it
is being compared. An obvious candidate is the relative growth in numbers of popular
musicians over time. If the proportion of popular musicians is growing faster than the
general population over time, and this is likely given the greatly increased rates of death
available in more recent decades, as demonstrated in Table 3 (although this could also
represent an artefact of better record keeping), the sample of musician deaths will
contain more young people and hence average age at death will be younger. In addition,
the deaths of young musicians, particularly if they have received some fame or notoriety,
or died under tragic circumstances such as suicide, homicide or accidental death, are
more likely to be widely reported than deaths of older musicians who may have retired
long ago from the music industry, which would tend to create an impression of pervasive
premature death in the popular music industry. Nonetheless, the data search strategy
identified a significant number of older musicians as indicated by the age ranges
presented in Table 1.

Thirdly, although great care was taken to include all musicians meeting inclusion criteria, I
have no way of knowing which musicians or how many were excluded from the sample
on which this study was based, either because their death statistics were never recorded
or were not found or retrievable.

22
 Comparisons of death rates for male and female musicians with US male and female
age-matched population data
Given that the youngest average age of death was 29.5 years, the sample was divided
into two age groups – those dying before age 30 and those dying after age 30. This
division makes a comparison with population data possible because it reduces to some
extent the confounds and biases in the data described above. The outcome of this
analysis is presented in Table 5 and in Figures 2a and 2b for male musicians.

Table 5: Cause of death for male musicians by age group compared with US males

US males US males
Male musicians 14-
Cause of death 30y 14-30y Male musicians 31=85+ 31-85+
N % % N % %
Accidental death 518 47.3 45.6 890 12.5* 3.59
Suicide 155 14.1 16.0 315 4.4* 1.56
Liver-related death 14 1.3* 0.6 306 4.3* 1.51
Homicide 207 18.9 19.3 250 3.5* 0.75
Heart-related death 48 4.4 3.6 1526 21.4** 35.24
Respiratory diseases 19 1.7* 1.20 350 4.9** 7.79
Cancer 59 5.4 5.60 1936 27.1* 24.69
All other illnesses 68 6.2 7.2 1354 19.0 19.20
Cerebrovascular 8 0.7 0.7 217 3.2** 5.66
Total 1096 100% N=817307 7144 100% N=16764878
*p<0.001 *p<0.001 **rates significantly lower
Source for US males: http://webappa.cdc.gov/sasweb/ncipc/leadcaus9.html than US population

23
 50
45
40
35
30
25
20
% Male musicians 14-30y
15
10
*% US males 14-30y
5
0
h e e s r h s h r
eat icid icid sse nce eat ase eat cula
e
l d m Su illn Ca d d dis d d vas e
ta Ho e e
en
he
r
elat tory elat ebro
ic d t r
t- ra r- er r
Ac lo ar spi ive C
Al e L
H Re

*Ref: http://webappa.cdc.gov/sasweb/ncipc/leadcaus9.html

Figure 2a: Death rates in male musicians 14-30 years and US male population
14-30 years by cause of death

40
35
30
25
20
15 % Males musicians 31-85+
10
5 *% US males 31-85+

0
r s s e e r
n ce eath sse eath ase icid eath icid ula
e c
Ca d d illn al d dise Su d d om vas
e t e H ro
elat ther den tory elat eb
r i r
r t- ll o Acc ira er- Cer
a A sp
He Re Liv

*Ref: http://webappa.cdc.gov/sasweb/ncipc/leadcaus9.html

Figure 2b: Death rates in male musicians 31-85+ years and US male population
31-85+ years by cause of death

Tests of the significance of differences between two independent proportions were

conducted for each cause of death in younger and older male musicians and these were
compared with the US male population. Male musician deaths in the younger age group
closely mirrored the death rates by cause of death found in the same-aged US male

24
population with two exceptions. Young male musicians were more likely to die from liver-
related causes (z=3.55; p=0.0004) and from respiratory illnesses (z=3.85; <.0002). For the
older group of male musicians, there were significant differences between the musicians
and the US male population in death rates by cause of death for all categories of cause of
death except “all other illnesses” in which the proportions were the same (19.0% vs
19.2%) for both groups. The difference in death rate for accidental death between male
musicians and males in the US population (12.6% vs 3.6%) was significant (z=38.9,
p<0.0002, two-tailed). Differences were also significant for homicide (3.4% vs 0.75%);
(z=24.7, p<0.0002, two-tailed); suicide (4.4% vs 1.6%) (z=18.14; p<0.0002, two-tailed),
liver-related deaths (4.17% vs 1.5%) (z=16.16, p<0.0002, two-tailed) and cancer (27.1% vs
24.7%) (z=3.50, p<0.0005, two-tailed) with male musicians between three and four times
more likely to die by accident, homicide, suicide and liver-related death than same-aged
males in the US population. Musicians were significantly less likely to die of heart-related
conditions (20.5% vs 35.2%) (z=-36.12; p<0.0002, two-tailed) or cerebrovascular causes
(3.2% vs 5.7%) (z=-9.41; p<0.0002, two-tailed) compared with age-matched males in the
US population.

The same comparisons for females produced very similar results. In the 14-30 year age-
group, female musicians and same-aged females in the US population showed very
similar death rates for cause of death as the male musicians and the US same-aged male
population. For all four groups, the leading causes of death were accidental death,
homicide and suicide. However, female musicians were significantly more likely to die an
accidental death compared with the US female population (51.3% vs 41%)(z=2.24,
p<0.03, two-tailed). They were also significantly more likely to die of a liver-related death
than their female population counterparts (4.3% vs 0.9%) (z=3.9, p<0.0002, two-tailed). In
the older females (31-85+), female musicians were significantly more likely to die of all of
the identified causes of death compared with the same-aged female population except
for heart-related deaths (14.8% vs 41.2%) (z=-15.96, <.0002) and deaths from
cerebrovascular causes (4.6% vs 10.32%)(z=-5.569, <.0002) from which the population females
were more likely to die.

Sex differences within the popular musician population

There were few sex differences for major causes of death (Figure 4).

25
 35%
30%
25%
20%
15%
10% Male musicians
5% Female musicians

0%
er th th es de cide ases ath age
nc dea dea ss ici i e
Ca
al ted r illn
e
Su
o m dise d d orrh
t H e
en la the ry at em
cid t-re o ato -rel l ha
Ac ear Al
l ir
sp Live ebr
r a
H Re r
Ce

Figure 4: Percent of deaths by sex and cause of death for all male and female musicians

There were no sex differences in proportions of male and female musicians dying of particular
causes of death for the younger age-group (14-30y) (Figure 5).

55%
50%
45%
40%
35%
30%
25%
20%
Male muscians
15%
Female musicians
10%
5%
0%
th ide ide ses cer ath ses ath ar
dea ic uic es a n d e e a de cul
s s
al Hom S
ri
lln C d i
te ry d late rov
d a
ent e la b
cid th re to re re
Ac Al
lo art- pira ver- Ce
He Res Li

Figure 5: Cause of death for male and female popular musicians aged 14-30 years
at age of death

Differences by genre for cause of death in male musicians

Table 6 presents the cause of death by music genre for male musicians (there were too
few female musicians to provide adequate cell sizes in some comparisons).

26
Table 6: Cause of death (%) in male musicians by genre
Table 6: Cause of death (%) in male musicians by genre
Cause of death Music Genre
N in Genre 609 724 610 373 249 222 1405 1391 414 293 669 146 2315 130 9550
MALE
N (Cause death) Blues World Country Folk Gospel Hip Hop Jazz Metal Pop Punk R&B Rap Rock Disco TOTAL
Cancer 2156 23.5% 19.1% 25.1% 31.6% 24.1% 5.9% 29.5% 14.2% 24.2% 18.1% 26.9% 8.2% 23.8% 17.7% 22.6%
Accidental death 1905 9.0% 13.5% 15.7% 16.6% 12.9% 18.5% 11.1% 35.9% 18.8% 29.7% 11.1% 15.8% 25.2% 15.4% 19.9%
Heart-related death 1700 27.9% 18.0% 23.8% 17.4% 17.7% 6.3% 21.6% 11.1% 20.0% 13.3% 23.9% 6.8% 15.5% 18.5% 17.8%
All other illnesses 1530 20.4% 22.2% 15.7% 15.0% 29.3% 7.7% 20.7% 7.5% 18.8% 9.6% 20.9% 7.5% 14.0% 20.0% 16.0%
Suicide 672 1.8% 3.5% 4.6% 5.6% 0.8% 7.2% 2.6% 19.6% 5.6% 11.3% 1.5% 6.2% 7.6% 7.7% 7.0%
Homicide 599 3.6% 10.2% 1.5% 4.6% 4.4% 51.8% 2.1% 5.8% 2.9% 6.8% 5.1% 51.4% 3.8% 8.5% 6.3%
Respiratory diseases 401 7.1% 6.4% 6.2% 3.5% 4.0% 1.4% 5.6% 1.5% 4.8% 2.7% 4.5% 2.7% 3.4% 6.2% 4.2%
Liver-related death 351 4.4% 2.6% 4.9% 2.9% 3.2% 0.5% 3.8% 3.3% 2.9% 5.1% 2.7% 0.7% 4.5% 4.6% 3.7%
Cerebral haemorrhage 236 2.3% 4.6% 2.5% 2.7% 3.6% 0.9% 3.0% 1.1% 1.9% 3.4% 3.4% 0.7% 2.2% 1.5% 2.5%
TOTAL 9550 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%

27
This table highlights the different patterns in cause of death by genre; that is, some
genres had significant risk of death from a particular cause that significantly exceeded the
mean percentage of deaths for each cause across all genres. For example, the mean
percentage of deaths accounted for by cancer was 22.6%. Folk (32%) and jazz (30%)
musicians had higher risk of death from cancer than other genres. Similarly, accidental
death accounted for 20% of all deaths, yet 35% of deaths in metal musicians, 30% in punk
musicians and 25% in rock musicians were caused by accident. Suicide accounted for 7%
of all deaths in the total sample, yet 20% of metal musicians and 11% of punk musicians
died by suicide. Although homicide accounted for 6.3% of deaths across the sample, 52%
of all deaths in hip hop musicians and 51% of all deaths in rap musicians were from
homicide. This is no doubt due to these genres’ strong associations with drug-related
crime. Members of these genres do not live long enough to develop heart- and liver-
related illnesses causing death and consequently had the lowest rates of death in these
categories. In contrast, heart–related deaths accounted for 18% of all deaths, but 28%
blues musicians died of heart-related causes, probably due to the fact that they had the
highest longevity. Gospel musicians had the lowest suicide rate of all the genres studied,
suggesting a protective effect of their religious beliefs.

Discussion

In conducting this study, a number of methodological issues had to be resolved. First,

defining the sample involved a number of crucial decisions. Inclusion and exclusion
criteria had to be established, as did the timeframe for the study and the classification of
popular genres into a manageable number of unique musical styles. Determining the
cause of death was also challenging because early abuse of substances and risk-taking, if
survived in the earlier part of the lifespan, may exert longer term impacts on health in the
form of some cancers, heart disease, cirrhosis and mental health (suicidality) that are not
coded on death certificates, in obituaries or other sources. Some of these impacts can be
directly responsible for early death even if the substance abuse or risky behaviours
reduced or ceased in middle age. This was particularly evident in the Bellis et al (2012)
study that showed that the mortality gap between popular musicians and the general
population increased with increasing years since first becoming famous. A similar effect

28
was noted for morbidity in this study – while the mortality causes in younger popular
musicians mirrored those in the same-aged general population, in the older age group,
there were significantly more deaths from all of the causes examined (see Table 2) when
compared with the general population. Perhaps the most problematic element was the
inability to estimate appropriate population denominators because there were no
repositories of living musicians in the decades under study. Finally, no conclusions can be
drawn about shortened lifespan or the cause of early death in popular musicians. It is
likely to be a combination of factors in the popular music industry described in the
introduction and the vulnerability that many young musicians bring with them into their
profession from early adverse childhood experiences (Bellis et al, 2012).

This study has highlighted the very different health and mortality profiles of musicians
belonging to different genres of popular music. While there were few differences
between the younger male musicians and the same-aged US male population in causes of
death (liver-related death and respiratory diseases were the exceptions), there were very
marked differences in the older musicians compared with the US male population. The
morbidity and mortality of younger musicians appear to reflect population trends that
highlight the increased risk of early death in all young males, not just young musicians at
this vulnerable age in which testosterone, risk-taking, and substance abuse create a
volatile environment to which significant proportions succumb. Of note, also, was the
similarity in profiles of young female musicians with their male counterparts. This
suggests that once a young person joins the popular music industry, effects of sex are no
longer relevant. Both males and females succumb to the stresses equally.

The results for older musicians infer a significant level of psychological vulnerability by
dint of their elevated suicide rates – which were three times higher in musicians older
than 30 years compared with the same-aged US population over the period of study.
These results also highlighted the risky nature of the popular musician workplace – the
proportion of those dying from accidental causes was 3.5 times greater than the US
population over the seven decades of study. (A future study will examine separately the
different causes of accidental death – by overdose, vehicular, and other causes – that
were combined for this analysis).

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The elevated homicide rate was also indicative that all is not well in pop music land. Many
of the homicides coded for this study were drug-related, associated with the commission
of crimes like robberies and home invasions or occurred during so-called “crimes of
passion”, many of which, no doubt, were under the influence of substances.

What aspects of the popular music scene are so pathological as to be associated with
such disturbing patterns in morbidity and mortality, despair so profound as to result in
risk of death by suicide that follows popular musicians into old age, and rage so
uncontainable as to result in either the commission of or becoming a victim of homicide?
Because this was a quantitative study of dead musicians, whose aim was to gather
population data to establish a baseline of the extent and outcome of the occupational
hazards in the pop music world, I can only speculate here about the candidate causes of
these results.

I have already canvassed the usual suspects identified in occupational health research in
the introduction, and indeed, many of these do apply to the high-octane, peripatetic
lifestyle of musicians. A critical destructive aspect of this lifestyle is the ubiquitous
presence of alcohol and substances of addiction, which are rendered accessible by the
increased disposable income that accrues to a chart success, often after months or years
of living in penury and working second and third jobs to pay the rent. Alcohol and
substances also have psychological as well as material and physical valences. These
include their use to facilitate group cohesion and bonding, to celebrate a successful
concert, to wind down after the sustained adrenaline rush of a show, to mask depression,
anxiety and other worries, to manage a psychiatric illness, and to chill out, among others.
These substances and the practices in which they take centre stage (e.g., as pre-show
anxiolytics, at after-parties, as part of sexual encounters, or as morning uppers) become
normative and because pop groups are communities of peers, there is no “adult”
oversight, no boundary-maker to curb behaviour that inevitably gets increasingly out-of-
control. While other professions also experience similar occupational stressors as popular
musicians, no other profession lays claim to the devastation that I have highlighted in this
population in this study.

30
We must therefore turn elsewhere for understanding. An examination of the patterns in
cause of death by music genre is most instructive; in particular, high rates of suicide and
accidental death in metal and punk musicians, and high rates of homicide in hip hop and
rap musicians. One third of jazz musicians in the current study died of cancer. They
accounted for 19.5% of all deaths from cancer (n=2484), and 22.8% of the 335 cases of
death by lung cancer. Most jazz musicians were heavy smokers and spent much of their
professional lives in smoke-filled clubs. This finding is consistent with an earlier study
(Herer, 2000) that also found that cancer was the most frequent cause of death of jazz
musicians, followed by heart-related causes of death. Despite this, both studies observed
that jazz musicians lived a normal life span. These very different patterns among musical
styles indicate that music genre is a lifestyle, not just a type of music.

In addition to mortality patterns in the different genres, the content of the lyrics and the
life stories of some of popular music’s exponents provide a kernel of an explanation that
could be subjected to further scrutiny and research. In many of the artists who met
tragic, untimely deaths, the clues to their psychological anguish are contained in their
songs. For example, Elvis begged an idealized other to “make the world go away, get it off
my shoulders”; to “walk a mile in my shoes…before you abuse, criticise and accuse…;” he
was the “loneliest guy in the crowd”…

Let us return, by way of example, to the genre of Heavy Metal that I discussed in the
introduction. There has been a great deal of contention regarding the naming of this
particular genre (Weinstein, 2013). Notwithstanding, we are left in no doubt as to its
central message, cogently expressed by the erudite music critic, Lester Bangs (1978):

Heavy Metal music in its finest flower had one central, obvious message: There is
no hope. Whatever you do, you can’t win. The world is run by war pigs who have
turned you into human dogs and you must accept your fate as ignominiously as
you possibly can. It was, in America at least, more or less the residue of Vietnam …
but it was really a worldwide sentiment, and in that sense obviously the Heavy
Metal Cassandras of bombast differed from the punks, who may scream of no
future but at least are determined to go out kicking and flailing. Heavy Metal
freaks just wanted to forget the whole fucking mess, man; they were, in a word,
passive [my italics].

Bangs’s entry for “Heavy Metal” in The Rolling Stone Illustrated History of Rock and Roll
ten years after his original scathing critique, states:

31
 …heavy-metal rock is nothing more than a bunch of noise; it is not music, it is
distortion — and that is precisely why its adherents find it appealing. Of all
contemporary rock, it is the genre most closely identified with violence and
aggression, rapine and carnage. Heavy metal orchestrates technological nihilism…
[my italics](p. 332).

Another rock music critic, Mike Saunders (1970), expressed a similar opinion, describing
the music of the band, Humble Pie, as “27 th rate heavy metal crap”. He stated that if the
members of Humble Pie had to listen to themselves “they would probably vomit” and he
exhorted them to spare themselves and others, including God, that “torture.” Alice
Cooper, a hard rock/heavy metal musician crowned the “godfather of shock rock”, whose
stage shows featured guillotines, electric chairs, (fake) blood, boa constrictors and bizarre
makeup and costumes stated:
We were into fun, sex, death and money when everybody was into peace and
love. We wanted to see what was next. It turned out we were next, and we drove
a stake through the heart of the Love Generation” (in Furek, 2008, p. 62).

Did they also drive a stake through their own hearts? Do these nihilistic genres attract
nihilistic young people, many of whom are suffering the ravages of ruptured attachment
experiences in early life (see Kenny, 2013), who are cut adrift from mainstream society,
who don’t fit in, achieve and progress according to normative social expectations? For the
shortest time, they find solace and like-mindedness in these crazy bands that
simultaneously embrace them while inadvertently nurturing the expression of their final
act of self-destruction? Consider a selection of the words of a song (Doornails) intended
as a tribute to dead rockers by the band, NOFX, on their album Wolves in Wolves’
Clothing (2006)3.

…You know, suicide isn't painless

When you leave everyone in pain…

Sedated, flagellated
You were the one most loved and hated…
This bowl is for my mom
For drinking more than I did
For posting bail for me in New York

And in Hollywood that first time

And that joint we smoked was the worst time

3
Released through Fat Wreck Chords, Copyright: Lyrics © OBO APRA/AMCOS
32
Cause doing drugs with parents is just wrong

…. This song is for winning losers

It's for lucky substance abusers
The ones who left their black marks on us all

This song expresses the grief and rage felt at the loss of friends through suicide,
alcoholism and drug overdoses. Many of the lines not quoted here name lost bandmates
and the ways in which they died. The reference to “winning losers” and “lucky substance
abusers” suggests ambivalence about being left behind to experience the pain of another
suicide. I am particularly interested in the songwriter’s ambivalence towards his mother,
who posted bail for him when he was in trouble but who was also an alcoholic who set
him a bad example. He identifies the worst time in his life as the occasion in which he
shared a joint with his mother, which he experienced as abandonment. He recognized
that doing drugs with parents is “just wrong”. Spiralling out of control, he looked to his
mother to contain him, but she colluded, which resulted in an escalation of his dangerous
behaviour.

The ethos of the popular music scene generally is like this songwriter’s mother; it not only
fails to set boundaries and to model and expect acceptable behaviour, it actually does the
reverse – it valorises outrageous behaviour, the acting out of aggressive, sexual and
destructive impulses that most of us dare only live out in fantasy (if at all). A recent
example is the award of “Ultimate Hellraiser” to Ozzy Osbourne in May 2014 by the radio
program Planet Rock, purportedly “where rock lives.” Twenty rockers were honoured on
a top 20 list of hellraisers that included Keith Moon, Jim Morrison, Alice Cooper and Keith
Richards.

There is ample evidence within the pop music industry that indicates that some of the
young men and women who inhabit it are deeply disturbed. Two particularly sad
examples are the R&B singer, Houston (Houston Summers IV) and rapper Christ Bearer. In
2005, Houston gouged out one of his eyes, citing as his explanation that the “devil made
me do it”. He told his body guard that he “had to get the devil off his back” and gouging
his eye was the only way. His publicist issued a statement that Houston “found himself in
the midst of a spiritual battle against the evil that runs rampant in the entertainment
industry” (AAP, 2012). A fellow rapper, Bushwick Bill, sent commiserations, stating “Fame

33
will make you crazy”. He was in a position to know; he had at one time convinced his
girlfriend to assist him in suicide, which she eventually did, shooting him in the eye! Christ
Bearer (Andre Johnson) cut off his penis and leaped off a two-story balcony because he
had been denied access to his two young daughters (Antimusic, 2014). All of these young
men miraculously survived their physical injuries, but I could find no mention of the offer
of psychological assistance to help them manage their profound levels of emotional
distress.

This paper has brought into sharp focus the dysfunction in the popular musician
population as expressed in early death caused, in large part, by elevated rates of
accidental deaths, suicide, homicide and liver-related causes that follow musicians from
the danger years (14 to 30 years) into middle age. The music industry needs to consider
these findings to discover ways of recognizing and assisting young musicians in distress.
At the very least, those who make their livings from these young people need to learn to
recognize early signs of emotional distress, crisis, depression and suicidality, and to put
some support systems into place to provide the necessary assistance and care.

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………………………………….

Acknowledgments: I am indebted to A/Professor Anthony Asher who suggested the analysis

presented in Table 5 and who calculated the comparable US population proportions presented
therein. Sincere thanks to Dr Roger Adams and Dr Robert Heard for their advice and interest, to
A/Professor Leonie Tickle, Professor John Kaldor, and Dr Nic Price for their actuarial and
epidemiological perspectives, and to my research assistant, Maria Katelaris, for her support in
compiling the database on which this study was based.

38