tag:theconversation.com,2011:/id/topics/morbidity-and-mortality-30351/articlesMorbidity and mortality – The Conversation2023-07-19T12:22:54Ztag:theconversation.com,2011:article/2000362023-07-19T12:22:54Z2023-07-19T12:22:54ZHip-hop and health – why so many rap artists die young<figure><img src="https://images.theconversation.com/files/537895/original/file-20230717-17-u3sao8.png?ixlib=rb-1.1.0&rect=30%2C38%2C2502%2C2483&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Hip hop artists, from top left, clockwise, DMX, Lexii Alijai, Prince Markie Dee and Trugoy the Dove have all passed away within the past decade. </span> <span class="attribution"><span class="source">Getty Images </span></span></figcaption></figure><p>The song “Be Healthy” from the 2000 album by hip-hop duo dead prez, “<a href="https://pitchfork.com/reviews/albums/dead-prez-lets-get-free/">Let’s Get Free</a>,” is a rare rap anthem dedicated to diet, exercise and temperance:</p>
<p><em>“They say you are what you eat, so I strive to eat healthy / My goal in life is not to be rich or wealthy / ‘Cause true wealth come from good health and wise ways / We got to start taking better care of ourselves”</em> </p>
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<iframe width="440" height="260" src="https://www.youtube.com/embed/47757IZRc5c?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">“Be Healthy,” from the 2000 album “Let’s Get Free”</span></figcaption>
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<p>In what’s widely recognized as <a href="https://www.grammy.com/news/2023-grammys-celebrate-50-years-hip-hop-star-performance-segment">hip-hop’s 50th anniversary</a>, an unfortunate reality is that several of its pioneering artists aren’t here to celebrate. The number of rappers who never live to see much more than 50 years themselves is astounding.</p>
<p>Rappers and rap fans can’t help but take notice that their peers and favorite rappers are dying young. Trugoy the Dove of De La Soul, 53, <a href="https://www.vulture.com/2023/02/de-la-soul-trugoy-the-dove-dead-at-54.html">passed away in February 2023</a> after a <a href="https://www.thedailybeast.com/trugoy-the-dove-member-of-hip-hop-trio-de-la-soul-dies-at-54">battle with congestive heart failure</a>. Gangsta Boo, hailed as the “<a href="https://www.commercialappeal.com/story/entertainment/music/2023/01/14/gangsta-boo-celebration-of-life-memphis-rap-railgarten/69804248007/">Queen of Memphis</a>” and known for her work with Three 6 Mafia, <a href="https://www.billboard.com/music/music-news/gangsta-boo-dead-former-three-6-mafia-rapper-dies-obituary-1235192876/">died at the age of 43</a> of a drug overdose in January 2023. Takeoff, a member of the Atlanta trio Migos, was <a href="https://www.nytimes.com/2022/11/01/arts/music/takeoff-migos-dead.html">killed in November 2022</a>. He was 28 years old. </p>
<p>Rapper <a href="https://www.vibe.com/news/entertainment/jim-jones-stands-on-rappers-have-the-most-dangerous-job-comment-1234672569/">Jim Jones has claimed</a> that rap is the most dangerous profession due to rappers <a href="https://www.theatlantic.com/ideas/archive/2022/11/takeoff-death-hip-hop-rap-violence/672117/">being violently killed so frequently</a>. Similarly, <a href="https://www.complex.com/music/a/backwoodsaltar/fat-joe-rappers-endangeed-species-pnb-rock-death">rapper Fat Joe believes</a> rappers are an endangered species. In the 2022 song “On Faux Nem,” Lupe Fiasco put it more succinctly: “Rappers die too much.”</p>
<p>As a rapper, a fan of hip-hop’s art and artists, and a <a href="https://news.virginia.edu/content/meet-ad-carson-uvas-professor-hip-hop">professor of hip-hop</a>, I agree with Lupe Fiasco: Rappers die too much. Whether it’s from gun violence, heart disease, cancer, self-harm or drugs, the number of rappers whose lives have ended prematurely is alarming.</p>
<figure class="align-center ">
<img alt="Rap star Nipsey Hussle looks out." src="https://images.theconversation.com/files/537537/original/file-20230714-17-t3lnuk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/537537/original/file-20230714-17-t3lnuk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=505&fit=crop&dpr=1 600w, https://images.theconversation.com/files/537537/original/file-20230714-17-t3lnuk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=505&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/537537/original/file-20230714-17-t3lnuk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=505&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/537537/original/file-20230714-17-t3lnuk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=635&fit=crop&dpr=1 754w, https://images.theconversation.com/files/537537/original/file-20230714-17-t3lnuk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=635&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/537537/original/file-20230714-17-t3lnuk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=635&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Rap star Nipsey Hussle was shot and killed in Los Angeles in 2019.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/rapper-nipsey-hussle-attends-a-craft-syndicate-music-news-photo/1080924940?adppopup=true">Prince Williams/WireImage via Getty Images</a></span>
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<h2>The (un)exceptional spectacle of American gun violence</h2>
<p>Stories of rappers who die violently are well known. News media are quick to report on <a href="https://www.mercurynews.com/2022/11/01/gun-violence-has-killed-at-least-1-rapper-every-year-since-2018-2/">violence in hip-hop</a> to <a href="https://theconversation.com/scapegoating-rap-hits-new-low-after-july-fourth-mass-shooting-186443">support their view</a> that the music and the people who make it are exceptionally violent. Violence, death and conflict attract attention. Pair any of those with racial stereotyping and scapegoating and it’s easy to see why the murders of hip-hop stars such as Nipsey Hussle, the Notorious B.I.G., Tupac Shakur and countless other artists garner so much attention.</p>
<p>Though they were all taken by the <a href="https://theconversation.com/rappers-are-victims-of-an-epidemic-of-gun-violence-just-like-all-of-america-194429">very American plague of gun violence</a>, news and historical accounts often amplify the spectacle of violent Black death, even when they claim to honor those who are killed. </p>
<p>I’ve <a href="https://www.npr.org/sections/codeswitch/2021/05/24/173838383/a-letter-to-my-mother-just-in-case">written extensively</a> about the trend of scapegoating rappers. It is also the topic addressed in the song “<a href="https://aydeethegreat.bandcamp.com/track/ankh-featuring-nathaniel-star">ANKH</a>” from my forthcoming mixtap/e/ssay, “<a href="https://aydeethegreat.com/wp-content/uploads/2023/06/Illicit-Press-Release-6-23-pdf-232x300.jpg">V: ILLICIT</a>”:</p>
<p><em>“He died by the gun but they blamed the music. / They said, ‘What he said was evidence.’ And used it. …/ No compassion for the life torn apart when the bullets hit him, / cause he talked about the block in his art, so he’s not a victim. / Cameraman said, ‘They don’t value life too much.’ / He reported here before. Even twice some months. / Somewhere in his mid-twenties was his deadline (dying). / ‘Another N— Killed Here’ was the headline (crying).”</em></p>
<iframe style="border: 0; width: 350px; height: 442px;" src="https://bandcamp.com/EmbeddedPlayer/track=594009146/size=large/bgcol=ffffff/linkcol=de270f/tracklist=false/transparent=true/" seamless="" width="100%" height="400"><a href="https://aydeethegreat.bandcamp.com/track/ankh-featuring-nathaniel-star">ANKH (featuring Nathaniel Star) by A.D. Carson</a></iframe>
<p>An awful byproduct of this culture of consuming carnage is that the kinds of violent gun tragedies people are experiencing <a href="https://www.washingtonpost.com/nation/interactive/2022/gun-deaths-per-year-usa/">all across the U.S.</a> are being spotlighted in hip-hop and used as <a href="https://theconversation.com/scapegoating-rap-hits-new-low-after-july-fourth-mass-shooting-186443">excuses to criminalize and pathologize</a> certain people and the music they enjoy, the art they create, the neighborhoods they live in or the places they grew up.</p>
<p>Another heartbreaking consequence is that some rappers only gain wide popularity and realize financial success <a href="https://www.economist.com/graphic-detail/2020/07/23/posthumous-albums-by-young-rappers-are-topping-the-charts">after they’ve died</a>. Deceased rappers are an unfortunately abundant commodity. Juice WRLD and Pop Smoke are prime examples: They both sold four to five times as much music after their deaths than when they were alive.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/538103/original/file-20230718-21-dohcve.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/538103/original/file-20230718-21-dohcve.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=354&fit=crop&dpr=1 600w, https://images.theconversation.com/files/538103/original/file-20230718-21-dohcve.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=354&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/538103/original/file-20230718-21-dohcve.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=354&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/538103/original/file-20230718-21-dohcve.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=445&fit=crop&dpr=1 754w, https://images.theconversation.com/files/538103/original/file-20230718-21-dohcve.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=445&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/538103/original/file-20230718-21-dohcve.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=445&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Before and after death sales.</span>
<span class="attribution"><span class="source">The Economist</span></span>
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<p>Along with being alarmed by these tragedies, it’s important to examine the conditions that affect mortality and attempt to get to the actual causes rather than scapegoating a musical form.</p>
<h2>Deadly diseases</h2>
<p>While violence brings about headlines, guns are not the only cause for concern. Diseases – many of them preventable – are also a factor.</p>
<p>Heart disease, lung disease, cancer, diabetes, strokes and renal disease are among the top 10 causes of death <a href="https://www.cdc.gov/minorityhealth/lcod/men/2017/nonhispanic-black/index.htm">among Black men</a> and <a href="https://www.cdc.gov/minorityhealth/lcod/men/2018/byrace-hispanic/index.htm">Hispanic men</a>, according to the Centers for Disease Control and Prevention. It makes sense that these causes also prominently figure in the deaths of hip-hop artists. </p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/537899/original/file-20230717-210016-dd9z7i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Rapper Big Pun performs on stage." src="https://images.theconversation.com/files/537899/original/file-20230717-210016-dd9z7i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/537899/original/file-20230717-210016-dd9z7i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/537899/original/file-20230717-210016-dd9z7i.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/537899/original/file-20230717-210016-dd9z7i.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/537899/original/file-20230717-210016-dd9z7i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/537899/original/file-20230717-210016-dd9z7i.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/537899/original/file-20230717-210016-dd9z7i.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Rapper Big Pun, who sold a million albums, died at 28.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/big-pun-and-fat-joe-performing-at-les-poulets-on-may-13-news-photo/547402373?adppopup=true">Hiroyuki Ito/Hulton Archive via Getty Images</a></span>
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<h2>Gone before retirement</h2>
<p><a href="https://www.nytimes.com/2006/02/14/arts/music/james-yancey-producer-known-for-soulful-hiphop-dies-at-32.html">Rapper and producer J-Dilla</a> (32), rappers <a href="https://www.chron.com/entertainment/music/article/houston-rappers-remember-big-moe-dead-at-33-1797262.php">Big Moe (33)</a>, <a href="https://www.complex.com/music/a/complex/black-the-ripper-dead-at-32">Black the Ripper (32)</a> from the U.K., <a href="https://www.vibe.com/news/entertainment/founding-three-6-mafia-member-lord-infamous-dead-40-199175/">Lord Infamous (40)</a>, <a href="https://hiphopdx.com/news/id.20369/title.big-hutch-releases-statement-on-passing-of-above-the-law-member-kmg?utm_source=twitterfeed&utm_medium=twitter#">KMG the Illustrator (43</a> from Above the Law, <a href="https://www.usatoday.com/story/entertainment/celebrities/2021/04/09/dmx-hip-hop-legend-dies-50-after-heart-attack/7074550002/">DMX (50)</a>, <a href="https://www.independent.co.uk/arts-entertainment/music/news/big-t-death-cause-texas-rapper-age-52-wanna-be-a-baller-a8343506.html">Big T (52)</a>, <a href="https://onthisdateinhiphop.com/news/april-3-tweedy-bird-loc-passes-away-2020/">Tweedy Bird Loc (52)</a>, <a href="https://www.rollingstone.com/music/music-news/black-rob-dead-1157364/">Black Rob (52)</a> and <a href="https://www.nytimes.com/2000/02/09/arts/christopher-rios-28-rapper-recorded-under-name-big-pun.html">Big Pun (28)</a> all died from heart attacks. <a href="https://www.hollywoodreporter.com/news/music-news/heavy-d-cause-death-pulmonary-embolism-276405/">Heavy D (44) experienced a pulmonary embolism</a> that led to his death. <a href="https://www.nytimes.com/2021/02/19/arts/music/prince-markie-dee-fat-boys-dead.html">Prince Markie Dee (52) of the Fat Boys</a> passed away from congestive heart failure. <a href="https://www.rollingstone.com/music/music-news/craig-mack-flava-in-ya-ear-rapper-dead-at-47-127656/">Craig Mack (47)</a> died from heart failure. And Brax (21) <a href="https://variety.com/2020/music/news/brax-dead-influencer-rapper-1234823912/#">died from cardiac arrhythmia</a>. </p>
<p><a href="https://ew.com/article/2016/03/23/phife-dawg-dead-dies/#">Phife Dawg (45)</a> of A Tribe Called Quest, <a href="https://www.rollingstone.com/music/music-news/tim-dog-f-k-compton-rapper-dead-at-46-98451/">Tim Dog (46)</a> and <a href="https://www.rollingstone.com/music/music-news/biz-markie-dead-1191772/">Biz Markie (57)</a> all passed away from complications related to diabetes. </p>
<figure class="align-center ">
<img alt="Phife Dawg of A Tribe Called Quest performs at a music festival." src="https://images.theconversation.com/files/537822/original/file-20230717-210447-vwdxnq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/537822/original/file-20230717-210447-vwdxnq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/537822/original/file-20230717-210447-vwdxnq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/537822/original/file-20230717-210447-vwdxnq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/537822/original/file-20230717-210447-vwdxnq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/537822/original/file-20230717-210447-vwdxnq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/537822/original/file-20230717-210447-vwdxnq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">In 2016, Phife Dawg of A Tribe Called Quest died at 45 after a long battle with Type-1 diabetes.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/phife-dawg-of-a-tribe-called-quest-performs-at-2013-h2o-news-photo/176730972?adppopup=true">Rodrigo Vaz/FilmMagic via Getty Images</a></span>
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<p><a href="https://www.nytimes.com/2010/04/21/arts/music/21guru.html">Guru (48) of Gangstarr</a>, <a href="https://www.rollingstone.com/music/music-news/bushwick-bill-geto-boys-rapper-dead-obituary-846047/">Bushwick Bill (52) of the Geto Boys</a>, <a href="https://www.latimes.com/entertainment-arts/story/2022-11-07/hurricane-g-death-rapper-lung-cancer">Hurricane G (52)</a> and <a href="https://www.nytimes.com/2021/12/18/arts/music/kangol-kid-dead.html#">Kangol Kid (55)</a> died from cancer. <a href="https://www.billboard.com/music/rb-hip-hop/dj-kay-slay-55-dead-covid-19-battle-obituary-1235060195/">DJ K Slay passed away at 55</a> from what was described as COVID-19 complications.</p>
<p>Eazy-E <a href="https://deadline.com/2021/07/the-mysterious-death-of-eazy-e-docuseries-wetv-1234793623/">died of AIDS at 30</a>.</p>
<p><a href="https://www.nytimes.com/2011/03/17/arts/music/nate-dogg-hip-hop-collaborator-dies-at-41.html#:%7E:text=He%20was%2041.,on%20the%20songs%20of%20rappers.">Nate Dogg’s death at 41</a> was attributed to a stroke. </p>
<p><a href="https://www.latimes.com/local/la-me-pimpc5feb05-story.html">Pimp C’s death at 33</a> was attributed to sleep apnea and an <a href="https://www.nytimes.com/2008/02/06/arts/06arts-DRUGSKILLEDP_BRF.html">overdose of cough syrup</a>. <a href="https://www.mprnews.org/story/2020/01/28/autopsy-st-paul-rapper-lexii-alijai-died-of-accidental-overdose">Lexii Alijai (21)</a>, <a href="https://www.nbcnews.com/pop-culture/pop-culture-news/philadelphia-rapper-chynna-rogers-dies-25-n1180051">Chynna (25)</a>, and <a href="https://www.billboard.com/music/rb-hip-hop/digital-underground-shock-g-cause-of-death-9585758/">Shock G (57)</a> all reportedly died of accidental drug overdose.</p>
<p><a href="https://ew.com/article/2012/07/19/ms-melodie-rapperdead-at-43/">Ms. Melodie passed away</a> in her sleep at the age of 43. <a href="https://www.latimes.com/entertainment-arts/music/story/2023-06-18/big-pokey-death-houston-rapper-texas#">Big Pokey collapsed onstage</a> and passed away at 48. <a href="https://www.rollingstone.com/music/music-news/whodini-john-fletcher-dead-1107571/">Ecstasy of Whodini died at 56</a>.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/537824/original/file-20230717-243941-wecfnd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Artist Ms. Melodie performs on stage." src="https://images.theconversation.com/files/537824/original/file-20230717-243941-wecfnd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/537824/original/file-20230717-243941-wecfnd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=890&fit=crop&dpr=1 600w, https://images.theconversation.com/files/537824/original/file-20230717-243941-wecfnd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=890&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/537824/original/file-20230717-243941-wecfnd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=890&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/537824/original/file-20230717-243941-wecfnd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1119&fit=crop&dpr=1 754w, https://images.theconversation.com/files/537824/original/file-20230717-243941-wecfnd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1119&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/537824/original/file-20230717-243941-wecfnd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1119&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Ms. Melodie of Boogie Down Productions passed away in 2012.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/late-rapper-ms-melodie-of-boogie-down-productions-performs-news-photo/465938029?adppopup=true">Raymond Boyd/Michael Ochs Archives via Getty Images</a></span>
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<h2>A renewed focus on health</h2>
<p>Unfortunately, this list of tragic lives halted from ages 21 to 57 is not a comprehensive account of all the rappers who have passed away well before the age of retirement.</p>
<p>The occasion of celebrating 50 years of hip-hop provides a moment to reflect and honor some of the artists who contributed to the culture and are not here to celebrate this golden anniversary. It’s also, perhaps, an opportunity to consider some of the outcomes of systemic barriers to health and wellness, such as <a href="https://health.gov/healthypeople/priority-areas/social-determinants-health/literature-summaries/access-health-services">access to affordable health care</a>, varied dietary options and mental wellness resources.</p>
<p>Given the number of rappers and other prominent hip-hop artists who have died young, ultimately it may come down to seriously taking heed to dead prez’s instructions from “Be Healthy”: “We got to start taking better care of ourselves.”</p><img src="https://counter.theconversation.com/content/200036/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>A.D. Carson does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>As hip-hop turns 50, an unfortunate reality is that so many of its pioneering artists never live to see much more than 50 years themselves, a professor of hip-hop writes.A.D. Carson, Associate Professor of Hip-Hop, University of VirginiaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2001532023-02-20T20:11:51Z2023-02-20T20:11:51ZEpigenetic and social factors both predict aging and health – but new research suggests one might be stronger<figure><img src="https://images.theconversation.com/files/510905/original/file-20230217-22-uooeg7.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C3295%2C2549&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Epigenetics is but one of many factors that influence aging, health and disease.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/clock-and-dna-royalty-free-image/1094434840">bestdesigns/iStock via Getty Images</a></span></figcaption></figure><p>Can we objectively tell how fast we are aging? With a good measure, scientists might be able to change our rate of aging to live longer and healthier lives. Researchers know that some people age faster than others and have been trying to concisely measure the internal physiological changes that lead to deteriorating health with age.</p>
<p>For years, researchers have been using <a href="https://doi.org/10.1093/gerona/gls233">clinical factors</a> normally collected at physicals, like hypertension, cholesterol and weight, as indicators to predict aging. The idea was that these measures could determine whether someone is a fast or slow ager at any point in their life cycle. But more recently, researchers have theorized that there are other biological markers that reflect aging at the <a href="https://doi.org/10.1016%2Fj.cell.2013.05.039">molecular and cellular level</a>. This includes modifications to a person’s genetic material itself, or epigenetics.</p>
<p>While each person has a genetic makeup that largely does not change over their lifetime, chemical changes to their genetic material that occur throughout life can change which genes are turned on or off and lead to more rapid aging. These changes typically involve the addition of methyl groups to DNA and are <a href="https://doi.org/10.1016/j.ssmph.2022.101071">influenced by social</a> and <a href="https://doi.org/10.1186/s13148-022-01286-8">environmental exposures</a>, such as adverse childhood experiences, smoking, pollution and depression.</p>
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<iframe width="440" height="260" src="https://www.youtube.com/embed/GASaqPv0t0g?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">The body undergoes many changes as it ages.</span></figcaption>
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<p>But how well do epigenetic markers predict the important health changes that happen with aging? We are <a href="https://scholar.google.com/citations?hl=en&user=xcXH8QcAAAAJ">social</a> <a href="https://scholar.google.com/citations?user=0aj9ZoEAAAAJ&hl=en">scientists</a> who study how social factors predict aging. Our <a href="https://doi.org/10.1016/j.arr.2020.101136">previous research</a> has shown that factors like education, poverty, race, access to medical care and certain health behaviors can influence aging rates. We are incorporating biological measures like epigenetic age in large population studies to understand how social factors get “under the skin” and affect aging. In our <a href="https://www.pnas.org/cgi/doi/10.1073/pnas.2215840120">recently published study</a>, we found that while epigenetic age does predict certain health outcomes later in life, it does little to explain important differences related to social factors.</p>
<h2>What is epigenetic aging?</h2>
<p>In 2013, geneticist and biostatistician <a href="https://scholar.google.com/citations?user=mEM8q5cAAAAJ&hl=en">Steve Horvath</a> introduced the idea that a person’s rate of aging would be captured by the <a href="https://doi.org/10.1186/gb-2013-14-10-r115">level of methylation</a> in their genome. He also developed ways to measure epigenetic age in terms of years and compare this age to one’s chronological age.</p>
<p>Researchers have since developed <a href="https://doi.org/10.18632/aging.101684">several measures</a> that can more reliably predict health outcomes based on epigenetics. Some have suggested that DNA methylation could potentially be used to summarize the amount and rate of aging with a <a href="https://doi.org/10.7554/eLife.54870">few drops of blood</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/510924/original/file-20230217-18-vamim0.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Diagram of DNA methylation" src="https://images.theconversation.com/files/510924/original/file-20230217-18-vamim0.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/510924/original/file-20230217-18-vamim0.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=408&fit=crop&dpr=1 600w, https://images.theconversation.com/files/510924/original/file-20230217-18-vamim0.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=408&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/510924/original/file-20230217-18-vamim0.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=408&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/510924/original/file-20230217-18-vamim0.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=513&fit=crop&dpr=1 754w, https://images.theconversation.com/files/510924/original/file-20230217-18-vamim0.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=513&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/510924/original/file-20230217-18-vamim0.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=513&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Epigenetics can influence health in a number of ways.</span>
<span class="attribution"><a class="source" href="http://commonfund.nih.gov/epigenomics/figure">National Institutes of Health</a></span>
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<h2>Comparing epigenetic and social factors</h2>
<p>It has been unclear how well epigenetic age predicts health outcomes compared to other nongenetic factors like demographics and socioeconomic status. We wanted to see whether epigenetic age, measured by DNA methylation levels in the blood, predicted four aging-related health outcomes: death, chronic disease, physical disability and cognitive dysfunction.</p>
<p>Using data from the <a href="https://hrs.isr.umich.edu/about">Health and Retirement Study</a>, a large, nationally representative sample of Americans over the age of 56, we found that epigenetic age <a href="https://www.pnas.org/cgi/doi/10.1073/pnas.2215840120">predicted all of the health outcomes we examined</a>. Epigentic age most strongly predicted death and morbidity later in life. So overall, people with a higher epigenetic age experienced poorer health.</p>
<p>On the other hand, epigenetic age did not explain why people with certain demographics – such as having less education, smoking, being Black or Hispanic, being obese or having a more difficult childhood – experienced worse health outcomes earlier or more frequently. These social factors were able to predict mortality and morbidity just as well as epigenetics and substantially predicted physical and cognitive functioning better than epigentic age.</p>
<p>Our findings suggest that while DNA methylation is a useful addition to the toolbox to predict health outcomes later in life, other factors such as demographics, socioeconomic status, mental health and health behaviors remain equally, if not more robust, predictors of health.</p>
<h2>Better predicting aging and health</h2>
<p>Epigenetic aging processes like DNA methylation show promise in explaining aging. But there is still a long way to go before researchers fully understand the molecular and cellular mechanisms underlying aging.</p>
<p>Improving our ability to measure both the lifetime social experiences that affect biology and the biological mechanisms that underlie aging could lead not only to better measurements of aging, but to better treatments and disease prevention for those who need it the most.</p><img src="https://counter.theconversation.com/content/200153/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Eileen Crimmins receives funding from the National Institute on Aging .
</span></em></p><p class="fine-print"><em><span>Jessica Faul receives funding from the National Institute on Aging.</span></em></p>People don’t all age at the same rate. Untangling the factors that influence health and disease – such as epigenetics, demographics and behavior – could lead to better care for those who need it most.Eileen Crimmins, Professor of Gerontology, University of Southern CaliforniaJessica Faul, Research Associate Professor of Epidemiology, University of MichiganLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1392012020-05-26T04:36:50Z2020-05-26T04:36:50ZThe poorest Australians are twice as likely to die before age 75 as the richest, and the gap is widening<figure><img src="https://images.theconversation.com/files/337308/original/file-20200525-55437-9grjm1.jpg?ixlib=rb-1.1.0&rect=0%2C99%2C3008%2C1598&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>People living in socially disadvantaged areas and outside major cities are much more likely to die prematurely, our new research shows. The study, <a href="https://www.australianpopulationstudies.org/index.php/aps/article/view/62">published in the journal Australian Population Studies</a>, reveals this gap has widened significantly in recent years, largely because rates of premature death among the least advantaged Australians have stopped improving.</p>
<p>These inequalities were already evident long before the enormous economic and social impacts of the coronavirus pandemic. While Australia (unlike the United States and some European nations) has so far avoided widespread deaths due directly to COVID-19, there may well be longer-term health impacts of the pandemic caused by widespread job losses and societal disruption, particularly among the most vulnerable. </p>
<p>This could well have a flow-on effect in terms of poorer health behaviours and access to health care, leading to adverse health outcomes, including a higher risk of death. Indeed, studies predict the pandemic will <a href="https://theconversation.com/rich-and-poor-dont-recover-equally-from-epidemics-rebuilding-fairly-will-be-a-global-challenge-138935">exacerbate these existing health inequalities</a>. </p>
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Read more:
<a href="https://theconversation.com/rich-and-poor-dont-recover-equally-from-epidemics-rebuilding-fairly-will-be-a-global-challenge-138935">Rich and poor don't recover equally from epidemics. Rebuilding fairly will be a global challenge</a>
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<p>While the longer-term impact of COVID-19 on Australia’s death rate will not be known for some time, we know there were already significant inequalities in our society regarding the risk of premature death.</p>
<p>Our research analysed trends in deaths between ages 35 and 74 years from 2006-16. We found people living in the 20% most socio-economically disadvantaged areas are twice as likely to die prematurely than those in the highest 20%. </p>
<p>More worryingly, this gap in death rates between the most and least well-off sectors of the Australian population grew wider between 2011 and 2016. It widened by 26% for females and 14% for males. </p>
<p>These figures would probably be higher still if we measured the socio-economic status of individuals, rather than the <a href="https://academic.oup.com/ije/advance-article/doi/10.1093/ije/dyz191/5579828">area they live in</a>. People living in outer regional, remote and very remote areas have death rates about 40% higher than those in major cities. In 2006, this gap was smaller, at 30%. </p>
<h2>What’s the cause?</h2>
<p>These growing inequalities are the result of recent stagnation of premature death rates in the lowest socioeconomic areas and outside of major cities. In contrast, rates of premature death have continued to decline in the most affluent areas of major cities.</p>
<p>This is not a new trend. A similar pattern of rising inequality in death rates was <a href="https://academic.oup.com/ije/article/36/1/157/668875">observed from 1986 to 2002</a>. But this time around there is much slower growth in overall average life expectancy, and a stagnation in <a href="https://www.mja.com.au/journal/2019/210/9/slower-increase-life-expectancy-australia-other-high-income-countries">mortality decline among the most disadvantaged population</a>. </p>
<p>One particular concern is the rapid slowdown in improvements to death rates from cardiovascular conditions such as heart disease and stroke. These are Australia’s leading causes of death, and largely explain the <a href="https://academic.oup.com/ije/article-abstract/48/6/1815/5543462?redirectedFrom=fulltext">significant gains in life expectancy</a> in Australia and other high-income countries over the past few decades. Our results suggest these gains may now be drying up among Australia’s most disadvantaged people.</p>
<p>The socio-economic and regional inequalities in rates of early death are likely due to a wide range of factors. Smoking, poor diet and excessive alcohol consumption are more prevalent in lower socioeconomic groups and outside major cities, and are likely to be major contributors to the trend. People in the lowest 20% socio-economically are <a href="https://www.aihw.gov.au/reports-data/health-welfare-overview/australias-health/overview">almost three times more likely to smoke</a> than those in the highest 20%. </p>
<p>The higher rates of premature death outside major cities are also likely to be linked to differences in access to essential health care. People aged 45 years and over and living outside major cities are <a href="https://www.aihw.gov.au/reports/rural-remote-australians/survey-health-care-selected-findings-rural-remote/contents/summary">less likely to have a GP or specialist nearby</a>.</p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/waiting-for-action-on-access-to-gps-in-rural-australia-18471">Waiting for action on access to GPs in rural Australia</a>
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<p>While Australia’s public health leaders are rightly focused on controlling the COVID-19 pandemic, they should not ignore the wide and growing health inequalities that were already entrenched in our society. </p>
<p>Reducing this widening gap in rates of premature death will require a major policy effort. We need to understand and improve the many factors involved – including smoking, diet and alcohol use, education, employment, housing, and access to health care. </p>
<p>We need to ensure policies and information campaigns are targeted to the population groups where death rates are highest and improvements have been slowest. Without a comprehensive approach, the COVID-19 pandemic will likely turn this widening gap into a chasm.</p><img src="https://counter.theconversation.com/content/139201/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Tim Adair receives funding from the Bloomberg Philanthropies Data for Health Initiative. </span></em></p><p class="fine-print"><em><span>Alan Lopez receives funding from the Bloomberg Philanthropies Data for Health Initiative. </span></em></p>There is a large and widening gap between the richest and poorest Australians in terms of risk of dying before the age of 75, according to a study tracking the trend from 2006-16.Tim Adair, Principal Research Fellow, Melbourne School of Population and Global Health, The University of MelbourneAlan Lopez, Professor of Global Health, The University of MelbourneLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/739542017-03-16T19:17:15Z2017-03-16T19:17:15ZThere’s no need to lock older people into nursing homes ‘for their own safety’<figure><img src="https://images.theconversation.com/files/159866/original/image-20170307-14966-q795ez.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Allowing nursing home residents to come and go as they wish may not be so dangerous after all.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/300626660?src=5Rw0qZ805RKmcM8l33Ybxg-4-19&size=huge_jpg">from www.shutterstock.com</a></span></figcaption></figure><p>Older people in nursing homes or aged care facilities are often locked up “for their own safety”. But our review shows there’s <a href="http://www.sciencedirect.com/science/article/pii/S1525861017300385">little justification</a> in most cases for this unfair and unreasonable practice.</p>
<p>In most cases, the chance of older people harming themselves is minimal, so there is no justification for denying them the right to move freely. What can families, facility managers and governments do to give older people back that right?</p>
<h2>Wanderers, absconders and elopers</h2>
<p>We rationalise locking nursing home doors by arguing that residents are old and frail, don’t know what they are doing, and will otherwise get lost and harm themselves. So, walking out of a nursing home unaccompanied and without telling caregivers is seen as a high-risk activity to be prevented at all costs. </p>
<p>Restraining methods include installing <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1467-9566.2009.01221.x/full">alarmed doors</a>, using <a href="https://www.alz.org/national/documents/Fallsrestraints_litereview_II.pdf">physical restraints</a>, as well as <a href="https://www.fightdementia.org.au/files/NATIONAL/documents/Alzheimers-Australia-Numbered-Publication-38.pdf">pharmaceutical</a> and <a href="http://europepmc.org/abstract/med/15597998">non-pharmaceutical</a> interventions.</p>
<p>Residents who try to leave unaccompanied and without telling anyone are called “wanderers”, “absconders” or “elopers”. And if people wander, abscond or elope, this counts as an “unexplained absence”.</p>
<p>Unexplained absences happen more often than we realise, with <a href="http://www.assistedlivingconsult.com/issues/02-05/ALC02-05_Elopement.pdf">11%</a> to <a href="http://www.gnjournal.com/article/S0197-4572(13)00125-0/fulltext">31%</a> of US residents living in assisted living or nursing homes reported missing at some time. There is no published data on the proportion of unexplained absences in Australia.</p>
<p>While these absences might be common, our review suggests they might at best <a href="http://www.sciencedirect.com/science/article/pii/S1525861017300385">not be as dangerous</a> as people think, or at worst, we just don’t have the evidence to tell us how dangerous they are.</p>
<p>Our analysis of nine studies showed most people left by foot, and were found in green vegetation and waterways within 1.6km of the place where they were last seen.</p>
<p>A total of 61 people were injured for every 1000 people with an unexplained absence. And 82 people died for every 1000 people leaving, with extreme temperatures the most common cause of death.</p>
<p>While these figures might sound high, they are likely an overestimate, as unexplained absences from nursing homes were lumped in with those from people living at home in the community.</p>
<p>Also, all of the studies looked at people with dementia, a <a href="https://www.ncbi.nlm.nih.gov/pubmed/10918338">risk factor</a> for unexplained absence, which may have further overestimated the proportion of people who die after an unexplained absence. This means the high number of deaths doesn’t represent all nursing home residents, who have different and varying levels of cognitive and physical impairment.</p>
<h2>Aren’t there really good reasons for protecting vulnerable people?</h2>
<p>There are some <a href="http://www.assistedlivingconsult.com/issues/02-05/ALC02-05_Elopement.pdf">legitimate reasons</a> to confine a very small number of older people in nursing homes, such as those with severe behavioural issues due to mental health problems, who maybe disorientated and delusional. Some residents also feel more secure if doors are locked. </p>
<p>Once outside, some residents, especially those with cognitive and physical impairments, could enter unsafe areas and be harmed.</p>
<p>So, it’s no wonder the issue of “to lock or not” poses challenges for the care provider when trying to balance safety with independence. Another factor is that support staff might need to help residents get out and about, placing time pressures on their already tight schedules.</p>
<p>Nursing homes might not also want to, or be unable to, carry the cost of providing care that supports residents leaving when they want to.</p>
<h2>Balancing risks with benefits</h2>
<p>Which is worse, the psychological impact of being locked in versus the physical risk of leaving? Given we know very little about how many residents die or are injured from an “unexplained absence”, how can we be sure the risk is greater outside the facility?</p>
<p>How much of our concern for safety is for the resident, how much is for the family members and caregivers, and how much of it is for the staff and owners of nursing homes?</p>
<p>People who have family members in a nursing home should be asking whether locking up a person in the final stage of their life is really what is best for them. Family members should be encouraging the nursing home to support their family member to have independence, autonomy and control over their life.</p>
<p>The aged care sector also needs to challenge the ingrained belief its role is to keep residents safe and free from harm. </p>
<p>Nursing homes’ fear of losing their reputation, accreditation and receiving sanctions is real, and so it’s not surprising physical safety takes precedent over freedom of movement. </p>
<p>While nursing home providers are rewarded for running a safe facility, a way forward should be to reward them for how they support residents to be independent.</p>
<h2>A growing concern</h2>
<p>The issue of locking up nursing home residents will become <a href="http://journals.sagepub.com/doi/abs/10.1177/153331750401900602">more acute</a> as the population ages. And living in an aged care facility may become inevitable for many elderly people, especially for those with progressive <a href="http://www.beingblocked.com/wp/wp-content/uploads/2014/02/Characteristics-and-outcomes-of-dementia-residents-in-an-assisted-living-facility.pdf">functional and cognitive diseases</a> such as dementia.</p>
<p>But a nursing home is not a place of incarceration, and for most, it’s people’s final home. We should be less fearful of autonomy and independence. After all, people living in their own home in the community happily practice autonomy every day, even if it brings with it risk.</p>
<p>We worry so much about what can go wrong, we rarely stop to consider how often it turns out OK.</p><img src="https://counter.theconversation.com/content/73954/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Joseph Ibrahim receives funding from the Commonwealth and State of Victoria for research investigating premature deaths in Residential Aged Care Services.</span></em></p><p class="fine-print"><em><span>Marta Woolford does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Older people in nursing homes or aged care facilities are often locked up “for their own safety”, which new research says isn’t usually needed.Marta Woolford, PhD Candidate and Research Officer at the Department of Forensic Medicine, Monash UniversityJoseph Ibrahim, Professor, Health Law and Ageing Research Unit, Department of Forensic Medicine, Monash UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/726942017-02-20T16:38:20Z2017-02-20T16:38:20ZHow to stop your lunch break damaging your health<figure><img src="https://images.theconversation.com/files/157503/original/image-20170220-15908-ubsgux.jpg?ixlib=rb-1.1.0&rect=385%2C114%2C5086%2C3374&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/motion-blurred-people-lunchtime-busy-canteen-319040144?src=Ix1vixuVqoQ5gFMnaELTgw-6-12">Johann Helgason/Shutterstock</a></span></figcaption></figure><p>Eating out is bad for us. <a href="http://www.sciencedirect.com/science/article/pii/S0002822308011723">Studies have shown</a> that food provided outside the home contains more calories and more fat, especially saturated fat. The trouble is, many of us are eating this food every day without really realising what’s in it.</p>
<p>In recent years great efforts have been taken to help us understand the composition of packaged food. The <a href="http://www.nhs.uk/Livewell/Goodfood/Pages/food-labelling.aspx">clear marking</a> of allergens, ingredients lists and “traffic light” indicators on the front of packs show retail customers how much fat, saturated fat, sugar and salt are contained. However, there is an important gap in this admirable trend.</p>
<p>Those of us who eat our lunch in a workplace canteen find it a lot more difficult to access the kind of information that leads to informed choices. And canteens can play a critical role in terms of healthy eating. They are a captive, sometimes subsidised, setting that is often used to provide the main meal of the day. In effect, many of us are eating out five times a week without really acknowledging it.</p>
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<a href="https://images.theconversation.com/files/157493/original/image-20170220-15922-17wg2np.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/157493/original/image-20170220-15922-17wg2np.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/157493/original/image-20170220-15922-17wg2np.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/157493/original/image-20170220-15922-17wg2np.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/157493/original/image-20170220-15922-17wg2np.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/157493/original/image-20170220-15922-17wg2np.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/157493/original/image-20170220-15922-17wg2np.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/157493/original/image-20170220-15922-17wg2np.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Do you go for the healthy option?</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/sandwich-bar-salads-choice-metal-containers-492300403?src=Ukuql3_x9zNN17-pdc4uLQ-3-80">Prostock-studio/Shutterstock</a></span>
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<h2>Right to know</h2>
<p>So how many of us are using these canteens? Well, three quarters of workers in the UK stay at work over lunchtime, <a href="http://academic.mintel.com/display/527011/#">with 31%</a> eating at a workplace canteen. That’s more than 7m of us. While nutritional and allergen labelling is now widespread in our supermarkets, workplace canteens rarely provide such information in an easily accessible format. Influencing dietary behaviour here could be instrumental in reducing employees’ risk of developing chronic diet related diseases such as <a href="https://academic.oup.com/nutritionreviews/article-abstract/70/2/65/1895841/Association-between-eating-out-of-home-and-body">type 2 diabetes or obesity</a>. It should give companies and organisations healthier, happier and more productive employees. </p>
<p>The personal and economic benefits are clear. Health, simply put, can contribute to an <a href="http://psycnet.apa.org/journals/cpb/61/2/122/">organisation’s value</a>. And we have got used to knowing: there is growing consumer interest in information on food eaten out of the home. This includes the nutritional content of dishes, the origin of ingredients and the presence of possible allergens. It could easily be argued that it is a fundamental right to know what we are eating. </p>
<p>New <a href="http://eur-lex.europa.eu/legal-content/EN/ALL/?uri=CELEX%3A32011R1169">EU regulation</a> requires the clear labelling of the presence of 14 allergens for pre-packaged food and food served. The <a href="https://www.google.co.uk/url?sa=t&rct=j&q=&esrc=s&source=web&cd=4&ved=0ahUKEwi_-KuojJfSAhXlJMAKHXf0BhcQFggvMAM&url=https%3A%2F%2Fwww.dpc.senate.gov%2Fhealthreformbill%2Fhealthbill04.pdf&usg=AFQjCNHwPAp4Zuxtw-am0jVX9FwoNnYr7A&sig2=u_7OlPFbvE-9esgmepOmVA">2010 Patient Protection and Affordable Care Act, in the US</a> goes further, requiring nutritional information to be posted in restaurants and large fast food chains. There are similar requirements in <a href="https://www.fsai.ie/">Ireland</a>. However, more can be done in workplace canteens to ensure that diners are able to make informed choices. Where dish information is available, it is often not provided in a consumer-friendly way. Possibly as a consequence of this, <a href="https://www.researchgate.net/publication/278337035_Influencing_eating_behavior_through_food_labeling">studies</a> have found that the increased presence of data is not always having a strong influence on consumer choice. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/157496/original/image-20170220-15917-7bdfsg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/157496/original/image-20170220-15917-7bdfsg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/157496/original/image-20170220-15917-7bdfsg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/157496/original/image-20170220-15917-7bdfsg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/157496/original/image-20170220-15917-7bdfsg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/157496/original/image-20170220-15917-7bdfsg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/157496/original/image-20170220-15917-7bdfsg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/157496/original/image-20170220-15917-7bdfsg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Reviewing the options.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/woman-buying-sandwich-supermarket-330671918?src=5YAwA8AIc5tAeYvppNOxOg-1-21">SpeedKingz/Shutterstock</a></span>
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<h2>On the menu</h2>
<p>So how can we change this? Currently, most information on food offered at work is printed out on a menu card or information board. If you’ve ever eaten in a canteen you will know how cursory the glances are from busy staff to these sources. And if you do take the time to look, the information is normally limited to a description of the dishes with little nutritional or other enhanced information available.</p>
<p>It means that each diner has to work hard to find the information that is relevant to them. After all, the ideal nutritional intake of a manual worker will be quite different than for staff who just push pens or hammer keyboards for a living. What is healthy for one diner might not be so ideal for the next. The need for a personalised approach to providing information is clear, and the solution might lie in our pockets.</p>
<p>Technology, most notably apps on our mobile phones, <a href="http://www.tandfonline.com/doi/abs/10.1080/0267257X.2013.798673">have been shown</a> to have good potential for providing detailed but clear individualised information. People will happily interact with a well-designed bit of software where they wouldn’t hunt down the printed menu. </p>
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<iframe width="440" height="260" src="https://www.youtube.com/embed/roLlNbLvJMA?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
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<p>That is why a pan-European partnership between industry and academia has developed the <a href="http://www.foodsmartproject.net">FoodSMART project</a>. This project is developing a smart phone app, which uses detailed dish data uploaded by the caterer to provide you with personalised information. You can tailor the information to your particular dietary requirements and preferences and it should allow the lunchtime crowd to assess their food intake precisely and efficiently. It can also make individual recommendations to help diners improve their health and well-being. All you have to do is scan a <a href="http://www.whatisaqrcode.co.uk/">QR code</a> with your phone to access the menu and all of this enhanced dish information.</p>
<p>Any initiative encouraging us to eat more “attentively” can help to reduce calorie intake. Enhanced information also allows those with food intolerances and specific dietary needs the freedom to eat away from home with ease. The millions of us who eat at a workplace canteen have been left in the dark while other initiatives help to shape our lifestyle choices. So whether you download an app, hunt down the menu cards or interrogate the canteen staff, it is probably time we did something about a five-day-a-week habit that could be damaging our health.</p><img src="https://counter.theconversation.com/content/72694/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jeff Bray is part of the team working on the EU funded FoodSMART project.</span></em></p><p class="fine-print"><em><span>Heather Hartwell is team lead of the EU funded FoodSMART project</span></em></p>Seven million workers are missing out on information which keep keep them healthier.Jeff Bray, Principal Academic Consumer Behaviour, Bournemouth UniversityHeather Hartwell, Professor, Bournemouth UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/622882016-08-25T20:21:21Z2016-08-25T20:21:21ZWhy males are more likely to die from conception to old age<figure><img src="https://images.theconversation.com/files/134062/original/image-20160815-15267-1t0eiz0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">In the animal kingdom, males are somewhat dispensable, which might explain why males are more likely to die. </span> <span class="attribution"><span class="source">from www.shutterstock.com.au</span></span></figcaption></figure><p>Sexual inequality begins in the womb, but not in the way you might think. In a <a href="http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0158807">study of more than 574,000 births</a> in South Australia between 1981 and 2011, we found boys are more likely to be born preterm and the risk is greater for boys the earlier the birth.</p>
<p>Mothers expecting boys <a href="http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0158807">are also more likely</a> than mothers of girls to suffer pre-eclampsia (a serious disorder of pregnancy characterised by high blood pressure, fluid retention and protein in the urine), gestational high blood pressure or gestational diabetes late in pregnancy.</p>
<p>Many more boys are conceived than girls. Despite this the sex ratio at birth is only slightly in boys’ favour. <a href="http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129554140">For every 100 girls born in Australia</a> 106 boys are born, a statistic that <a href="http://www.cdc.gov/nchs/data/nvsr/nvsr53/nvsr53_20.pdf">holds across most human populations</a>. But males are more likely to die before females at all ages from conception to old age, which we think explains why Australia is around 51% female despite fewer girls being born.</p>
<p>Miscarriages and stillbirths are <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(99)05061-8/fulltext">more likely to involve males</a>. After birth, <a href="http://www.aihw.gov.au/publication-detail/?id=10737423343">male babies are also more likely to die</a> or suffer major illness. <a href="http://www.aihw.gov.au/child-health/health/#chronic">Australian Institute of Health and Welfare</a> data show boys make up 75% of SIDS deaths, 54% of cancer diagnoses, 60% of infant deaths and are more likely to be disabled (often associated with preterm birth).</p>
<p>As males and females age, <a href="http://www.aihw.gov.au/publication-detail/?id=60129556205">disparities in the burden of diseases</a> are prevalent in Australia. Greater numbers of men suffer heart disease (59%), endocrine disorders including type 2 diabetes (57%) and cancer (56%). </p>
<p><a href="http://www.aihw.gov.au/publication-detail/?id=60129556205">Some conditions, however, are more likely in women</a>. These include blood and metabolic disorders (59%), neurological disorders including dementia (58%) and musculoskeletal conditions including arthritis (56%). There is also a female predominance in many auto-immune diseases.</p>
<h2>Why are men more likely to die earlier?</h2>
<p>We don’t know for sure why there are differences in disease prevalence, severity, age of onset and even symptoms between the sexes, but <a href="http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0158807">our research suggests</a> genetic differences between males and females could contribute to differences in the uterus. </p>
<p>Males have XY sex chromosomes and females have XX sex chromosomes. We found 142 genes are expressed differently between normal male and female placentas delivered at term. About a third of the genes are on the sex chromosomes, but two-thirds are on the autosomes (non-sex chromosomes) and <a href="http://molehr.oxfordjournals.org/content/20/8/810.full.pdf+html">only a small number</a> are associated with hormones.</p>
<p>The greatest sex differences are in the brain, specifically in the anterior cingulate cortex, which controls things such as heart rate and blood pressure as well as some emotion and decision-making (1,818 genes), followed by the heart (375 genes), kidney (224 genes), colon (218 genes) and thyroid (163 genes). In other organs, sex differences were mostly confined to genes on the sex chromosomes and those involved in hormone production.</p>
<p>Since defects in how the placenta develops and functions are associated with pregnancy complications, it is likely the placenta is a key contributor to the different outcomes we see between pregnancies carrying boys versus girls. These probably hark back to our evolution. </p>
<h2>Evolution and the battle of the sexes</h2>
<p>In the animal kingdom, males are somewhat dispensable, with the dominant male the most likely to breed with multiple females each season. Thus, in many species, it is only the biggest, strongest and fittest males who reproduce. </p>
<p>Bigger babies are more likely to survive birth and infancy and grow up to reproduce. So maintaining fetal and post-natal growth makes the male more likely to pass on his genes. </p>
<p>Females, conversely, will almost always reproduce and pass on their genes – assuming they survive to adulthood. So the growth strategies of the male and female fetus focus on passing on their genes to the next generation.</p>
<p><a href="http://ac.els-cdn.com.proxy.library.adelaide.edu.au/S0143400409003737/1-s2.0-S0143400409003737-main.pdf?_tid=c5f8de8c-63f8-11e6-9884-00000aacb35e&acdnat=1471383261_e12969438f886b805a73f3e0d72efbf0">Research has found</a> sex differences in how the fetus responds to maternal asthma. Asthma attacks in pregnancy, which are akin to an inflammatory storm, cause the female fetus to taper her growth in response. In so doing, the female fetus is more likely to survive. </p>
<p>However, a maternal asthma exacerbation does not affect the growth of the male fetus. He keeps growing at the same rate but places himself at risk of preterm birth and stillbirth should another asthma attack occur.</p>
<p>The <a href="http://journals.cambridge.org.proxy.library.adelaide.edu.au/download.php?file=%2FDOH%2FDOH1_01%2FS2040174409990171a.pdf&code=078d4b518ca27fa79a5cdd4ecca8b84c">developmental origins of health and disease</a> thesis links the growth and development of the fetus to the health of the infant, child and adult. How well we grow in utero strongly influences our propensity for adult onset diseases. The fetus is said to be programmed in utero for health or disease across the life course.</p>
<p>So how well you grow in the uterus is influenced by your genetics but also by environmental factors. Together these shape your health for life and sex matters.</p><img src="https://counter.theconversation.com/content/62288/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Claire Roberts receives funding from the National Health and Medical Research Council (NHMRC), the Channel 7 Children's Research Council and the University of Adelaide.</span></em></p>Miscarriages and stillbirths are more likely to involve males. After birth, male babies are also more likely to die or suffer major illness.Claire Roberts, Senior Research Fellow, University of AdelaideLicensed as Creative Commons – attribution, no derivatives.