Study Claims Iraq's 'Excess' Death Toll Has Reached 655,000

[Barking_Mad]

Let's see if the media keep on promoting the Ieaq Body Count total of 40,000-50,000. No doubt this will be rubbished also.

Study Claims Iraq's 'Excess' Death Toll Has Reached 655,000

A team of American and Iraqi epidemiologists estimates that 655,000 more people have died in Iraq since coalition forces arrived in March 2003 than would have died if the invasion had not occurred.

The estimate, produced by interviewing residents during a random sampling of households throughout the country, is far higher than ones produced by other groups, including Iraq's government.

It is more than 20 times the estimate of 30,000 civilian deaths that President Bush gave in a speech in December. It is more than 10 times the estimate of roughly 50,000 civilian deaths made by the British-based Iraq Body Count research group.

The surveyors said they found a steady increase in mortality since the invasion, with a steeper rise in the last year that appears to reflect a worsening of violence as reported by the U.S. military, the news media and civilian groups. In the year ending in June, the team calculated Iraq's mortality rate to be roughly four times what it was the year before the war.

Of the total 655,000 estimated "excess deaths," 601,000 resulted from violence and the rest from disease and other causes, according to the study. This is about 500 unexpected violent deaths per day throughout the country.

The survey was done by Iraqi physicians and overseen by epidemiologists at Johns Hopkins University's Bloomberg School of Public Health. The findings are being published online today by the British medical journal the Lancet.

The same group in 2004 published an estimate of roughly 100,000 deaths in the first 18 months after the invasion. That figure was much higher than expected, and was controversial. The new study estimates that about 500,000 more Iraqis, both civilian and military, have died since then -- a finding likely to be equally controversial.

Both this and the earlier study are the only ones to estimate mortality in Iraq using scientific methods. The technique, called "cluster sampling," is used to estimate mortality in famines and after natural disasters.

While acknowledging that the estimate is large, the researchers believe it is sound for numerous reasons. The recent survey got the same estimate for immediate post-invasion deaths as the early survey, which gives the researchers confidence in the methods. The great majority of deaths were also substantiated by death certificates.

"We're very confident with the results," said Gilbert Burnham, a Johns Hopkins physician and epidemiologist.

A Defense Department spokesman did not comment directly on the estimate.

"The Department of Defense always regrets the loss of any innocent life in Iraq or anywhere else," said Lt. Col. Mark Ballesteros. "The coalition takes enormous precautions to prevent civilian deaths and injuries."

 

[Barking_Mad]

BBC report here - http://news.bbc.co.uk/1/hi/world/middle_east/6040054.stm

 

[Jessiedog]

The methodology sounds reasonably robust.

And even if they've overestimated by 100% (or even much more,) then it's still utterly.........



Woof

 

[Donna Ferentes]

And even if they've overestimated by 100% (or even much more,) then it's still utterly.........

Quite.

 

[slaar]

This from the report:

Since March 2003, an additional 2.5% of Iraq’s population have died above what would have occurred without conflict.

And since the level of violence is rising, I wonder how long it will be before it's commonly understood to be a civil war? In the UK 2.5 percent would be well over a million dead. In fact if we look at all deaths in Britain in the second world war, we get 388,000 deaths or 0.8 percent of the population, nowhere near as much as in Iraq.

Juan Cole has some good analysis and finds the results plausible:

http://www.juancole.com/

When you see someone waxing cynical about the study, ask yourself: Does this person know what a chi square is? And, who does this person work for, really?

First of all, Iraqi Muslims don't believe in embalming or open casket funerals days later. They believe that the body should be buried by sunset the day of death, in a plain wooden box. So there is no reason to expect them to take the body to the morgue. Although there are benefits to registering with the government for a death certificate, there are also disadvantages. Many families who have had someone killed believe that the government or the Americans were involved, and will have wanted to avoid drawing further attention to themselves by filling out state forms and giving their address.

Personally, I believe very large numbers of Iraqi families quietly bury their dead without telling the government of all people anything about it. Another large number of those killed is dumped in the Tigris river by their killers. A fisherman on the Tigris looking for lunch recently caught the corpse of a woman. The only remarkable thing about it is that he let it be known to the newspapers. I'm sure the Tigris fishermen throw back unwanted corpses every day.

Not to mention that for substantial periods of time since 2003 it has been dangerous in about half the country just to move around, much less to move around with dead bodies.

There is heavy fighting almost every day at Ramadi in al-Anbar province, among guerrillas, townspeople, tribes, Marines and Iraqi police and army. We almost never get a report of these skirmishes and we almost never are told about Iraqi casualties in Ramadi. Does 1 person a day die there of political violence? Is it more like 4? 10? What about Samarra? Tikrit? No one is saying. Since they aren't, on what basis do we say that the Lancet study is impossible?

 

[slaar]

Well, George doesn't think it is accurate:

http://news.bbc.co.uk/2/hi/middle_east/6040054.stm

"I stand by the figure that a lot of innocent people have lost their life," he said.

"Six-hundred thousand or whatever they guessed at is just... it's not credible."

Does this make any sense?

Do you think he has any idea what a chi square is?

You decide...

 

[Fruitloop]

Someone needs to tell Georgie that 'a lot' is not a figure.

 

[Donna Ferentes]

I personally have some doubts about the methodology - and I say that understanding what it was, I know how much crap has been spoken about it by people who don't. I do wonder that while the sampling techniques they used are perfectly valid, whether in these particular circumstances they may not have led to slightly distorted results.

But they'd have to be distorted to the most incredible degree for it to really matter, as the poster observed above.

 

[Barking_Mad]

the problem is that the situation is so violent that reporters can't even get to some of the places that are the most violent, ie Al Anbar Province. Most US troops have died there, but when do people see reports of violence from there? The media chooses to report on what's easiest to report, which is more often than not Baghdad.

The BBC's own reporting doesn't go to the lengths it should to report daily deaths. If you study the media reports gathered by icasualties on a daily basis and compare them to the ones reported on the BBC then its obvious that the reports are massively understated. iCasualties has 522 deaths for the first 10 days of this month and that's just the ones reported.

You can only imagine the shocking state of Iraq's hospitals and the pressure all these extra deaths and injuries are placing on them, so its bound to raise the number of people who are dying of problems that might otherwise been treated, albeit factoring in theat they were already under sanctions before the invasion.

 

[editor]

Whatever the fucking figure is, it's horrendous, unacceptable and utterly shocking.

 

[snorbury]

is it still shocking though, people in the west seem numb almost bored with it, maybe that's just symptoms of shock

 

[dylanredefined]

I dont have the maths to understand how they come up with the figures.And
an estimate which could be 300,000-900,000 just seems pointless Is it going to change anything how
ever many have died? Sadly I think there will be a row and then carry on as before just like the last estimate.

 

[Divisive Cotton]

 

[Divisive Cotton]

the above is one of many many examples of hacking both during and after the invasion of iraq

 

[FridgeMagnet]

This has been a little misreported - the idea is that the 95% confidence interval ranges for deaths ranges from about 400K to about 800K. So it could be higher or lower. It's still, clearly, an immense amount of people, and the Lancet isn't known for letting through statistically flawed studies. I mean, that's the point of peer review; they have a reputation to maintain.

Of course, the US right-wing blogosphere and press machine is busy rubbishing the figures, but, well, they would, wouldn't they? Amazing how many statistical experts suddenly appear under such circumstances.

 

[ska invita]

What was the figure put by the lancet a couple of years back now? Was it 100,000?

 

[slaar]

What was the figure put by the lancet a couple of years back now? Was it 100,000?

About that. This study is from the same team, in part to check the former study's accuracy.

I wonder what it would take to shut the propaganda machines up; a full census? Probably even that wouldn't do it.

 

[Fruitloop]

Remember, they are no longer part of the reality-based community.

 

[Kid_Eternity]

Of course, the US right-wing blogosphere and press machine is busy rubbishing the figures, but, well, they would, wouldn't they? Amazing how many statistical experts suddenly appear under such circumstances.

And their pro war lefty lackeys over here are doing the same. I note the aim seems to be to muddy the waters, I wonder how many have actually put a study together to credibly refute these finding?

 

[slaar]

Really good piece on Comment is Free:

http://commentisfree.guardian.co.uk/daniel_davies/2006/10/how_to_not_lie_with_statistics.html

The results speak for themselves. There was a sample of 12,801 individuals in 1,849 households, in 47 geographical locations. That is a big sample, not a small one. The opinion polls from Mori and such which measure political support use a sample size of about 2,000 individuals, and they have a margin of error of +/- 3%. If Margaret Beckett looks at the Labour party's rating in the polls, she presumably considers this to be reasonably reliable, so she should not contribute to public ignorance by allowing her department to disparage "small samples extrapolated to the whole country". The Iraq Body Count website and the Iraqi government statistics are not better measures than the survey results, because one of the things we know about war zones is that casualties are under-reported, usually by a factor of more than five.

And the results were shocking. In the 18 months before the invasion, the sample reported 82 deaths, two of them from violence. In the 39 months since the invasion, the sample households had seen 547 deaths, 300 of them from violence. The death rate expressed as deaths per 1,000 per year had gone up from 5.5 to 13.3.

Talk of confidence intervals becomes frankly irrelevant at this point. If you want to pick a figure for the precise number of excess deaths, then (1.33% - 0.55%) x 26,000,000 x 3.25 = 659,000 is as good as any, multiplying out the difference between the death rates by the population of Iraq and the time since the invasion. But we're interested in the qualitative conclusion here.

That qualitative conclusion is this: things have got worse, and they have got a lot worse, not a little bit worse. Whatever detailed criticisms one might make of the methodology of the study (and I have searched assiduously for the last two years, with the assistance of a lot of partisans of the Iraq war who have tried to pick holes in the study, and not found any), the numbers are too big. If you go out and ask 12,000 people whether a family member has died and get reports of 300 deaths from violence, then that is not consistent with there being only 60,000 deaths from violence in a country of 26 million. It is not even nearly consistent.

 

[TeeJay]

The last figure of 100,000 was variously mis-quoted by many people as supposedly being the number of people killed by US/UK forces, the number of people killed and so forth. In reality the figure was none of these things: it was deaths from all causes in excess of the "baseline figure". The biggest flaw with the first study was not the sampling method (although most of the debate focusses on this) it was the numbers used for the 'baseline' - a small change in these figures gave a massive change in the 'excess' figures. An even bigger problem wasn't within the Lancet study itself but that people didn't actually read it or understand what the figure was meant to represent.

I haven't looked at this latest study but I will again wait until I have seen it for myself rather than relying on the shit-for-brains mass media to "tell me" what it says. The vast majority of the media completely misrepresented it last time so I have no cofidence that they either understand (or care?) this time either.

I'll come back and make a post about it once I have seen it or myself, looked at the methodology used (both sampling and statistical - including how the 'baseline' was calculated). I will also have a careful look at the various categories of deaths. There may well be far less discrepancy between this figure and other figures (eg Iraq Bodycount) in reality - there wasn't last time once you looked at the details. However I will only be able to come to a judgement about this once I have seen it for myself.

Out of interest, has anyone here actually read the original report yet (and if so maybe they could post a link if one exists, or otherwise tell us where we can see a copy).

 

[slaar]

Yeah, it's here:

http://www.thelancet.com/webfiles/images/journals/lancet/s0140673606694919.pdf

To measure mortality we did a national cross-sectional cohort study of deaths from January, 2002, through July, 2006. Household information was gathered about deaths that occurred between January 1, 2002, and the invasion of March 18, 2003, in all households and these data were compared with deaths that occurred from the time of the invasion through to the date of survey.

A sample size of 12 000 was calculated to be adequate to identify a doubling of an estimated pre-invasion crude mortality rate of 5·0 per 1000 people per year with 95% confidence and a power of 80%, and was chosen to balance the need for robust data with the level of risk acceptable to field teams.

Our estimate of the pre-invasion crude or all-cause mortality rate is in close agreement with other sources.

Also there was a

striking similarity between the 2004 and 2006 estimates of pre-war mortality

So the baseline was 01/02/02 to 18/03/03 and the post-invasion results are compared to that. Sounds solid enough.

The crude mortality rate in the pre-invasion period was 5·5 per 1000 people per year (95% CI 4·3–7·1) and for the overall post-invasion period was 13·3 per 1000 people per year (10·9–16·1; table 3). A four-fold increase in the
crude mortality rate was recorded during the study period, with a high of 19·8 per 1000 people per year between June, 2005, and June, 2006

Chart 2 is particularly damning.

Post-invasion excess mortality rates showed much the same escalating trend, rising from 2·6 per 1000 people per year (0·6–4·7) above the baseline rate in 2003 to 14·2 per 1000 people per year (8·6–21·5) in 2006 (figure 2 and table 3). Excess mortality is attributed mainly to an increase in the violent death rate;

The study also pre-empts criticisms that the figure is inconsistent with Iraq Body Count surveys etc.

The increasing number of violent deaths follows trends of bodies counted by mortuaries, as well as those reported in the media and by the Iraq Body Count.

Aside from Bosnia,21 we can find no conflict situation where passive surveillance recorded more than 20% of the deaths measured by population based methods. In several outbreaks, disease and death recorded by facility-based methods underestimated events by a factor of ten or more when compared with populationbased estimates.11,22–25 Between 1960 and 1990, newspaper accounts of political deaths in Guatemala correctly reported over 50% of deaths in years of low violence but less than 5% in years of highest violence.26 Nevertheless, surveillance tallies are important in monitoring trends over time and in the provision of individual data, and these data track closely with our own findings (

It also suggests strongly that Iraq before the invasion wasn't exactly a hell-hole for its citizens:

From January, 2002, until the invasion in 2003, virtually all deaths in Iraq were from non-violent causes.

and, worse, that non-violent deaths are on a steadily increasing trend, i.e. the humanitarian situation is steadily worsening, not getting better even not counting violent deaths:

Death rates from non-violent causes remained essentially unchanged from pre-invasion levels until 2006, when they rose by 2·0 deaths per 1000 per year above the pre-invasion baseline, an increase that was not significant.

 

[dylanredefined]

Anyone else thinks they really need to learn some more maths to understand how this survey works?

 

[slaar]

Anyone else thinks they really need to learn some more maths to understand how this survey works?

I knew I sat through all those mind-numbing undergrad stats lectures for something.

 

[TeeJay]

I might as well copy the post I made on this thread:

Hour Silence for the 40,000 dead in Iraq

+++++++++++++++++++++++++++++++++++
It is interesting to see that the overall figure - once violent deaths in Fallujah have been excluded - is extrapolated from 46 deaths pre-invasion versus 90 deaths post-invasion, reported from 988 households with about 7,500 people.

Excluding the Fallujah figures, the entire survey is based on the following pre and post invasion figures.
Number deaths .......... 46 > 90
Accidents ............... 4 > 13
Heart attack/stroke .... 11 > 18
Chronic disorders ...... 11 > 11
Infectious diseases ..... 1 > 5
Neonatal/infant ......... 6 > 10
Other .................. 12 > 12
Violence ................ 1 > 21


If someone presented numbers like this in the UK people would dismiss them out of hand for being far too small a sample and having a very lax interview method.

The 21 deaths due to violence (excl Fallujah) include people killed by criminals and by insurgents and insurgents and combatants killed, as well as people killed by US/UK bombs. In fact of the deaths only 4 for them were during the period of allied bombing, with at least half of them occuring a year or more after the invasion.

If you look at all violent deaths, including Fallujah, the report says the following:

Despite widespread Iraqi casualties, household interview data do not show evidence of widespread wrongdoing on the part of individual soldiers on the ground. To the contrary, only three of 61 incidents (5%) involved coalition soldiers (all reported to be American by the respondents) killing Iraqis with small arms fire. In one of the three cases, the 56-year-old man killed might have been a combatant. In a second case, a 72-year-old man was shot at a checkpoint. In the third, an armed guard was mistaken for a combatant and shot during a skirmish. In the latter two cases, American soldiers apologised to the families of the decedents for the killings, indicating a clear understanding of the adverse consequences of their use of force. The remaining 58 killings (all attributed to US forces by interviewees) were caused by helicopter gunships, rockets, or other forms of aerial weaponry. Many of the Iraqis reportedly killed by US forces could have been combatants. 28 of 61 killings (46%) attributed to US forces involved men age 15–60 years, 28 (46%) were children younger than 15 years, four (7%) were women, and one was an elderly man. It is not clear if the greater number of male deaths was attributable to legitimate targeting of combatants who may have been disproportionately male, or if this was because men are more often in public and more likely to be exposed to danger. For example, seven of 12 (58%) vehicle accident related fatalities involved men between 15 and 60 years
of age.

All-in-all, actually reading the report completely undermines the claim that is frequently heard about "100,000 dead" innocent civilians being killed by US/UK forces. Even if you accept the Lancet methodology and 'best guess' they produce, they aren't even claiming this themselves.

++++++++

...and in response to someone claiming that they were sure that the 100,000 figure was an underestimate and accusing me of wanting to claim a low figure because I supported the US/UK invasion:

Why are you "sure" 100,000 is an underestimation? On what basis? They were not counting numbers killed - they did a survey with 7 interviewers and have extrapolated from 90 deaths (of which 21 were 'violent'), leading them to give an estimate for a country of c. 25 million people.

My aim isn't to argue that 20,000 , 100,000 or 1,000,000 is "acceptable" or not - my point is to show people that they should actually look at these figiures with a criticial mind - just as they would look at government figures with a critical mind. It is pathetic if people are only careful and critical when looking at facts and figures presented by the government, but will simply accept and parrot stuff that they think supports their own arguments.

Whatever Butchers says about noone having made the claim that 100,000 innocent Iraqis being killed by US/UK troops I have seen this repeated many times both on urban75 and elsewhere, again and again.

Maybe I will be able to refer people to this thread the next time I see it stated?

Which is exactly what I am doing here. If anyone wants to argue about the 100,000 figure, how reliable it is and what it actuall represented, if anything, they would do well to go and read that thread - but best of all they should go and read the original report for themselves. They might be surprised what they find.

 

[slaar]

Teejay I don't see how that is relevant. Nobody on this thread is claiming any of those things, and the Lancet paper takes account of all of them, breaking down figures into US/UK kills, insurgency, natural death etc and by gunfire, car bombing etc.

There's an appalling Guardian article here:

http://commentisfree.guardian.co.uk/michael_white/2006/10/post_501.html

I have two problems. Firstly, the figures offered by the study range from 392,976 to 942,636, so the 655,000 estimate splits the difference. This is both strikingly imprecise (not necessarily avoidable), and also at variance with other estimates, both governmental and more disinterested. The Observer's Peter Beaumont, who explained the horrifying murder campaign against professional Iraqi women on Sunday, sets out the numbers in today's Guardian: 98,000 (US researchers), 128,000 (Iraqi NGOs).

*Bangs head against desk and starts weeping*

 

[TeeJay]

That post was about the first Lancet report. I will have a read of this new report (hopefully over the next few days) and get back to you about this new figure...

I will also try to dig up the exact sources that I remember reading that called into question the reliability of the 'baseline' mortality figures used in the first Lancet report, how they were at variance with other estimates and why even small changes in this baseline would produce massive changes in the final figure (as you can see for example, when comparing 1 pre-invasion death from 'infectious disease' to 5 'post invasion' and then extrapolating this across a country of 25 million people will large changes in the final estimate of 'excess deaths').

All researchers will argue passionately in favour of their own techniques but ultimately you shouldn't rely on 'single study' reports - you need to take all the available evidence and put it all through a 'plausibility test'. You need to understand what people are measuring, how they collected the data, where their baselines come from, how they go about projecting the small samples onto a far larger population, how the results tie in with a whole range of other evidence - and of course you need to think carefully about the whole "counterfactual" argument - the whole "these things were caused directly by the invasion" claim that many seem to automatically make.

We don't apply the same kind of logic to public health and mortality figures in the UK so why be so sloppy and brain-dead just because we are dealing with a political football like the Iraq war?

Anyway I will take the time to read the report (and other comments and analysis of it) and come back when I have done so.

 

[slaar]

That post was about the first Lancet report. I will have a read of this new report (hopefully over the next few days) and get back to you about this new figure...

I will also try to dig up the exact sources that I remember reading that called into question the reliability of the 'baseline' mortality figures used in the first Lancet report, how they were at variance with other estimates and why even small changes in this baseline would produce massive changes in the final figure (as you can see for example, when comparing 1 pre-invasion death from 'infectious disease' to 5 'post invasion' and then extrapolating this across a country of 25 million people will large changes in the final estimate of 'excess deaths').

All researchers will argue passionately in favour of their own techniques but ultimately you shouldn't rely on 'single study' reports - you need to take all the available evidence and put it all through a 'plausibility test'. You need to understand what people are measuring, how they collected the data, where their baselines come from, how they go about projecting the small samples onto a far larger population, how the results tie in with a whole range of other evidence - and of course you need to think carefully about the whole "counterfactual" argument - the whole "these things were caused directly by the invasion" claim that many seem to automatically make.

We don't apply the same kind of logic to public health and mortality figures in the UK so why be so sloppy and brain-dead just because we are dealing with a political football like the Iraq war?

Anyway I will take the time to read the report (and other comments and analysis of it) and come back when I have done so.

I quite agree. The level of understanding in the media about these issues is pathetic.

 

[TeeJay]

Teejay I don't see how that is relevant. Nobody on this thread is claiming any of those things, and the Lancet paper takes account of all of them, breaking down figures into US/UK kills, insurgency, natural death etc and by gunfire, car bombing etc.

I have seen many people, in many places - including u75 - claiming that 100,000 people have been killed as a result of the invasion of Iraq. The figure is often said to have been arrived at scientifically by the Lancet researchers.

It might be the case that you can see this for the utter crap that it is, but it has to be said again and again, as often as people come out with it, which they do all the time, and have already started to with this new number as well.

 

[slaar]

Sure, but you can see from the above article how unbelievably bad understanding is in the media. The guy is trying to discredit the study by picking the 5 percent and 95 percent confidence levels, saying that a point estimate is the average of the two and that therefore this makes the study inaccurate.

I mean really...