It didn’t take long for Derek Griffith, who grew up in Atlanta, to fall in love with hip-hop. De La Soul. A Tribe Called Quest. He’s always been a music fan, looking up to the men who brought the lyrics alive. So when two members of his favorite groups died premature deaths, his heart broke. David Jolicoeur, who rapped as Trugoy the Dove, died at 54 after suffering from congestive heart problems earlier this year. And Malik Taylor, better known as Phife Dawg, died at 45 due to diabetes complications in 2016.
“It was really heart-wrenching for me,” Griffith said. “They didn’t have to die that young.”
Their deaths are a part of what fuels his work as the director of Georgetown University’s Center for Men’s Health Equity, where he works to combat the health disparities that end Black men’s lives early. He often quotes hip-hop lyrics in professional talks. Tupac. Biggie. It’s a part of him that spills into work.
He’s been thinking about how the fates of his favorite rap legends mirror the grim health trends faced by Black men overall ever since he realized this was the year America would be celebrating five decades of hip-hop. And, as hip-hop’s 50th anniversary comes to a close, it ends with it a sobering reminder that Black men, including many rappers, face a life expectancy that’s among the lowest for any race and ethnicity group across the country, at 70 years old.
When news broke over the summer that Virginia-based rapper Magoo died at 50, it underscored the fragility around health and well-being for Black men. His cause of death has still been undetermined, but the hip-hop community was still in mourning over other deaths. DMX, dead at age 50. Biz Markie, 57. Coolio, just shy of 60. Heavy D, who collapsed outside of his Beverly Hills home at age 44 due to a pulmonary embolism, or a blood clot in the lungs.
Though death by gun violence and drug overdoses often make headlines, what’s missed are the ways Black men are disproportionately vulnerable to death due to cancer, heart disease, stroke and chronic conditions such as diabetes.
“Premature death — often from chronic illnesses that can be prevented — is a reality for Black men whether or not hip-hop is in the room,” said Mark Anthony Neal, who chairs the Department of African & African American Studies at Duke University.
One might assume that high-profile rappers would have the money and means to tap into quality health care and preventive medicine. But the growing list of Black male rap stars who fail to live to old age shows their wealth does not exempt them from illness, and experts say the pressure they face as artists in the spotlight may exacerbate the health conditions among them.
Racism, rap and risk
Black Americans’ life expectancy is compromised not only by disease, but also in large part by the weathering effect of racism — the idea that the constant stress of living in a racist society wears down the body like a rock being worn down by the outdoor elements. Public health advocates say factors such as the lack of healthy food choices in Black neighborhoods and the lack of green spaces that encourage outdoor exercise lower the quality of life and increase daily stress.
The history of medical racism that drives high rates of mistrust among Black folks can lead to delays in people seeking preventative care like screenings, which are key to early diagnosis and treatment. Add to that toxic masculinity, which encourages aggression, toughness and invincibility, and the ability of Black men to reach optimal health and well-being erodes.
Read more: Racism’s Relentless Toll on Black Health in America
“It’s a gumbo mix of risk,” said Dr. Italo Brown, a clinical assistant professor of emergency medicine at Stanford University. For rappers, the health risks are compounded by what it means to create art in the public eye — the punishing schedule of appearances, marketing strategies that highlight gun violence and bragging rights, the 24/7 navigation of social media and the pressure of being slingshotted into the top 1% essentially overnight, he said. Exposure to vices and high risk behavior grows, leaving them even more vulnerable. Brown calls it hip-hop’s silent epidemic.
“This is not by happenstance,” said Brown. The narrative that rappers are dying only due to violence and drugs is not what the data illustrates, he said. “It doesn’t explain the total risk that hip-hop artists face.”
The business structure within hip-hop is not set up for protecting rap artists’ health, experts say.
“With [record] labels, they’re essentially contract laborers. They don’t get health care. They don’t get retirement funds,” said Neal. “Why are we not talking about health plans for hip-hop artists? It shouldn’t surprise us that they are dying early,” he said.
Neal, a New York native who was born and raised in the Bronx and now studies Black masculinity and pop culture, wonders if the language like “manning up” that hip-hop culture lifts up encourages Black men to endure pain and health issues while discouraging them to seek help. DMX, for example, known for his macho persona, said in a 2020 People’s Party interview with Talib Kweli, “I learned that I had to deal with the things that hurt me. I didn’t really have anybody to talk to … in the hood, nobody wants to hear that. Talking about your problems is viewed as a sign of weakness when actually it’s one of the bravest things you can do.”
DMX struggled with addiction throughout his career and died of a cocaine-induced heart attack in 2021, at age 50. Neal would love to see hip-hop culture embrace the idea of artists going to the doctor and seeking support on a regular basis. “Part of hip-hop is this idea that we are invincible. We’re not.”
Read more: Through Meditation and Therapy, Black Men Are Taking Care of Their Mental Health
Neal remembers Jay-Z’s 4:44 album, in which he raps, “my therapist said I relapsed,” and subsequent interviews in 2017 where the rap star revealed how therapy was helping him process a lifetime of suppressed emotions that led him to maintain a hard masculine shell. In a podcast interview on Tidal’s Rap Radar that spring, Jay-Z talked more about wellness in the music industry. “We have to watch our health, our physical health and what we’re doing with our bodies, but also our mental health. A lot of people are going through trauma,” he said. “And you’re too embarrassed to get help for it, especially in these neighborhoods where we grew up.”
The headlines that ran after the album’s shed light on the battles that run parallel to what it means to be a Black man in America and how it can disrupt their mental health.
“Jay-Z Opened Up About Therapy and Masculinity,” Teen Vogue wrote.
Bustle said, “How JAY-Z’s ‘4:44’ May Help Destigmatize Mental Health”.
Earlier this year, a group of hip-hop legends including Fat Joe, Rick Ross, Busta Rhymes, Method Man, French Montana, and Chuck D, joined together in a public service announcement that called for price transparency in health care by hospitals and insurance companies. And, artist Nasir “Nas” Jones launched the Paid In Full Foundation, aimed at providing financial support to hip-hop’s pioneers, which could support quality health care.
Changing what you can
A lot of forces make it difficult for Black men to effectively prioritize their health, said Griffith, from Georgetown. “The only way to understand that is to understand the conditions and context of the lives of Black men. It’s not enough to look at them as just men, and it’s not enough to look at them as just Black,” he said.
It’s important for them to take action on what’s within their control, and not take on too much stress regarding what’s outside of their control, those crushingly large issues of systemic racism that lie outside the scope of individual choices, said Griffith, with Georgetown.
“Black men don’t necessarily go to the doctor for preventative screening,” he said. He recommends folks prioritize routine checkup and blood work, as well as finding ways to celebrate without compromising health. That means limiting alcohol consumption and high sugar and salt diets.
Rappers “are experiencing what so many Black men experience,” said Alford Young Jr., a sociology professor at the University of Michigan.
When some of Young’s favorite rappers started dying, he started accepting that the early guard of the hip-hop generation had suddenly become the old generation. He hopes that the recent deaths help drive a conversation about Black men’s health. He never thought hip-hop could allow for discussions around health care and health disparities.
“Maybe this moment will trigger Black men to think about what is going on,” he said. Rather than spend too much time sad and disappointed, “I hope this can be channeled into an educational opportunity.”
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