Longevity of screenwriters who win an academy award: longitudinal study

Abstract Objective: To determine whether the link between high success and longevity extends to academy award winning screenwriters. Design: Retrospective cohort analysis. Participants: All screenwriters ever nominated for an academy award. Main outcome measures: Life expectancy and all cause mortality. Results: A total of 850 writers were nominated; the median duration of follow up from birth was 68 years; and 428 writers died. On average, winners were more successful than nominees, as indicated by a 14% longer career (27.7 v 24.2, P=0.004), 34% more total films (23.2 v 17.3, P<0.001), 58% more four star films (4.8 v 3.1, P<0.001), and 62% more nominations (2.1 v 1.3, P<0.001). However, life expectancy was 3.6 years shorter for winners than for nominees (74.1 v 77.7 years, P=0.004), equivalent to a 37% relative increase in death rates (95% confidence interval 10 to 70). After adjustment for year of birth, sex, and other factors, a 35% relative increase in death rates was found (7% to 70%). Additional wins were associated with a 22% relative increase in death rates (3% to 44%). Additional nominations and additional other films in a career otherwise caused no significant increase in death rates. Conclusion: The link between occupational achievement and longevity is reversed in screenwriters who win academy awards. Doubt is cast on simple biological theories for the survival gradients found for other members of society. What is already known on this topic High achievement has been associated with decreased all cause mortality for people in many different occupations Such an association is compatible with behavioural and biological theories for the role of social determinants What this study adds Screenwriters nominated for an academy award show a paradoxical survival pattern, where greater success is associated with a large decrease in life expectancy The paradox is not easily explained by talent, prestige, financial earnings, material conditions, reverse causality, measurement error, or simple demographics It might reflect the unusual lifestyles of writers, where success is not linked to exemplary conduct or control; this underscores the importance of behaviour