We received a substantial amount of attention related to our research, including coverage by Science, Scientific American, Time, People, and late-night talk shows. We also received more than 50 detailed e-mail messages from those in the academic community with comments and questions. Staud and Miskie and colleagues raise two separate points but understate the diversity of the outside perspectives we encountered.

Staud claims that we did not consider undetermined factors that may contribute to both lifespan and personal achievement. We appreciate that cohort studies are prone to subtle biases, yet our analyses tested for many forms of confounding and demonstrated how much confounding was needed to vitiate the results. Moreover, speculation such as that about coping skills and excellent health would have predicted that those nominated should survive longer than those not nominated (contrary to what was observed).

Miskie and colleagues suggest that Nobel Prize–winning scientists live longer than controls. We are intrigued by their observation and agree with the cautions about reverse-causality bias, since the interval between victory and death is short for Nobelists. In contrast, we found that Academy Awards are typically received before an actor gets sick and dies. In addition, we found that particularly early victories conferred even greater survival gains and that the survival benefits were still apparent in analyses that excluded late wins. All of these observations, and others, argue against reverse-causality bias in our study.

Staud and Miskie and colleagues, similar to the authors of many other responses we received, do not reference past research, even though a MEDLINE search yields more than 20 000 publications on the topic of socioeconomic gradients and health. Our study conforms to a large and consistent quantity of scientific data showing that people with lower status are at increased risk for common fatal diseases. We provided one more study showing that social factors are strong predictors of a person's health. We hope clinicians can appreciate and apply this body of evidence in their practice of medicine.