Tim Lambert (deltoidblog AT gmail.com) is a computer scientist at the University of New South Wales.
A new study of violent deaths in Iraq has been published in the NEJM. You can read it here. Here's the abstract:
Background Estimates of the death toll in Iraq from the time of the U.S.-led invasion in March 2003 until June 2006 have ranged from 47,668 (from the Iraq Body Count) to 601,027 (from a national survey). Results from the Iraq Family Health Survey (IFHS), which was conducted in 2006 and 2007, provide new evidence on mortality in Iraq.
Methods The IFHS is a nationally representative survey of 9345 households that collected information on deaths in the household since June 2001. We used multiple methods for estimating the level of underreporting and compared reported rates of death with those from other sources.
Results Interviewers visited 89.4% of 1086 household clusters during the study period; the household response rate was 96.2%. From January 2002 through June 2006, there were 1325 reported deaths. After adjustment for missing clusters, the overall rate of death per 1000 person-years was 5.31 (95% confidence interval [CI], 4.89 to 5.77); the estimated rate of violence-related death was 1.09 (95% CI, 0.81 to 1.50). When underreporting was taken into account, the rate of violence-related death was estimated to be 1.67 (95% uncertainty range, 1.24 to 2.30). This rate translates into an estimated number of violent deaths of 151,000 (95% uncertainty range, 104,000 to 223,000) from March 2003 through June 2006.
Conclusions Violence is a leading cause of death for Iraqi adults and was the main cause of death in men between the ages of 15 and 59 years during the first 3 years after the 2003 invasion. Although the estimated range is substantially lower than a recent survey-based estimate, it nonetheless points to a massive death toll, only one of the many health and human consequences of an ongoing humanitarian crisis.
I'll put my comments in a separate post, but here are some comments from Les Roberts:
1) There is more in common in the results than appears at first glance.
The NEJM article found a doubling of mortality after the invasion, we found a tripling. The big difference is that we found almost all the increase from violence, they found 1/2 the increase from violence.
IBC adds to their estimate for months after a given date; back at the end of June 2006, IBC estimated 41,000 deaths (my notes suggest 38,475 to 42,889 on June 24, 2006). This new estimate is 4 times the "widely accepted" number of that moment, our estimate was 12 times higher. Both studies suggest things are far worse than our leaders have reported.
2) There are reasons to suspect that the NEJM data had an under-reporting of violent deaths.
The death rate they recorded for before the invasion (and after) was very low....lower than neighboring countries and 1/3 of what WHO said the death rate was for Iraq back in 2002.
The last time this group (COSIT) did a mortality survey like this they also found a very low crude death rate and when they revisited the exact same homes a second time and just asked about child deaths, they recorded almost twice as many. Thus, the past record suggests people do not want to report deaths to these government employees.
We confirmed our deaths with death certificates, they did not. As the NEJM study's interviewers worked for one side in this conflict, it is likely that people would be unwilling to admit violent deaths to the study workers.
They roughly found a steady rate of violence from 2003 - 2006. Baghdad morgue data, Najaf burial data, and our data all show a dramatic increase over 2005 and 2006.
Finally, their data suggests 1/4 of deaths over the occupation through 6/06 were from violence. Our data suggest a majority of deaths were from violence. All graveyard reports I have heard are consistent with our results.
Medicine & Health
Comments
I'm putting on my David Kane hat here:
FRAUD!!! Where is the data!?
They haven't revealed their methods of adjustment! It's a trick! FRAUD!
That's way too low for any country! My god, it's lower than the Great US of A!! We can't take this study seriously!
That confidence interval isn't symmetric! They used a cunning statistical trick I don't understand to hide their real findings, which were that people were resurrected! I can't trust this study till I see the data and all the programming, and get to interview all the recruiting personnel myself!!
Posted by: SG | January 10, 2008 3:37 AM
SG, you missed this:
Kane will be along to accuse them of fraud any second now.
Posted by: Tim Lambert | January 10, 2008 3:59 AM
only 0.4%? I bet those interviewers fabricated data - I demand to see the record of interviews! Not the names mind you, just cluster-level data which they are forbidden from revealing for privacy purposes. And if they don't give it to me straightaway... FRAUD!
Posted by: SG | January 10, 2008 4:19 AM
You will notice that this study is getting a far wider (and very different) response to the Lancet Study. Why could this be, do we think? Here's a hint (in the increasingly right wing New Scientist).
'Iraqi war death toll slashed by three quarters. The number of dead since the US invasion may be far lower than previously claimed, say a team working for the Iraqi Ministry of Health.'
Is how they reported it.
The Guardian is also going strong on the 'You see? It was a humanitarian intervention after all!' line.
Posted by: Hidari | January 10, 2008 5:10 AM
SG, if the Lancet study had never been undertaken, making the NEJM study the highest estimate of Iraqi deaths that's pretty much exactly the response it would have received.
As it is, of course, the NEJM study will be praised to the high heavens by people who up until now were trying to claim the IBC figures weren't a serious undercount.
Posted by: Ian Gould | January 10, 2008 5:20 AM
"2) There are reasons to suspect that the NEJM data had an under-reporting of violent deaths.
The death rate they recorded for before the invasion (and after) was very low....lower than neighboring countries and 1/3 of what WHO said the death rate was for Iraq back in 2002."
Does that make any sense? Using a lower pre-war death rate would attribute a greater proportion of the current death rate to the post-invasion environment.
How could it make sense to suggest that this could contribute to an undercounting of deaths attributable to post-invasion factors?
Personally I always assumed the problem with Roberts' Lancet estimates was due to them using a too-low pre-war death rate and hence you get a lot more dead bodies estimated than anyone knows anything about.
Posted by: Mako | January 10, 2008 5:40 AM
Surely the bottom line is that this study has a greater number of samples and therefore is more likely to have an estimate of mortality closer to the real figure (which we will never know). I'm sure even Les Roberts would have been pleased when he was undertaking his study, if he had been told he could have had ten times more sampling clusters.
No one study can be considered to be the truth. They are estimates. There are examples of epidemiological work in other areas which has been later found to have been less likely after further studies have been carried out.
There is a danger that in defending the Lancet study, one can end up making it the "truth". For example, are people who consider this new study to be a more reliable because of its numbers "denialists"?
All the studies published need to be looked at as a whole. Setting up a particular study, which happens to have the highest estimate, as the truth, and seeing the others as attacks on it is not a sensible way of looking at this.
Even if you accept the IFHS figure, I don't think critics of the war need to be concerned that it can be used as a stick to beat them with. As the authors state "Although this number is substantially lower than that estimated by Burnham et al. it nonetheless points to a massive death toll in the wake of the 2003 invasion - and represent only one of the many health and human consequences of an ongoing humanitarian crisis". It is notable that even one of the authors is also listed as deceased, having been killed on his way to work in August of last year.
It would be regrettable if this study was merely seen as another attack on The Lancet study akin to that of the Kane or The National Journal article you link to in the previous post.
Posted by: Anthony | January 10, 2008 5:41 AM
"Kane will be along to accuse them of fraud any second now." Posted by: Tim Lambert | January 10, 2008 3:59 AM
And I hope you will be along shortly to defend or criticise this estimate with the same vigour you did for the Lancet estimates, solely on the basis of whether their methodology was sound.
Posted by: Mako | January 10, 2008 5:43 AM
[I'm sure even Les Roberts would have been pleased when he was undertaking his study, if he had been told he could have had ten times more sampling clusters]
Not necessarily if he was then told that 11% of his clusters would be too dangerous to visit and would have to have their results inferred on the basis of IBC data. That's the definition of "informative censoring" and I don't understand why the authors seem to downplay the effect of this. It looks like a reasonably good survey and it has similar qualitative conclusions to the Roberts et. al one (ie, that the hypothesis that the Iraq invasion wasn't a disaster can be rejected with high degree of confidence) but I don't think it's grounds for completely throwing out Roberts et al and Burnham et al - I think Les Roberts' point that this group did have a big undercount in their child mortality data is a good one.
Posted by: dsquared | January 10, 2008 6:02 AM
You agree then that this estimate is probably, in the balance of things, a more reliable estimate of the number of deaths - since it does not influence your own, or Les Roberts', "qualitative conclusion" from his quantitative study that the Iraq war was a disaster?
Posted by: Anthony | January 10, 2008 6:13 AM
SG said: "I'm putting on my David Kane hat here"
You mean your "dunce cap"?
Go sit in the corner, SG, and don't come out until you have written "Just because I can't calculate pre- and post-invasion CMR's for Iraq doesn't mean no one else can" 100 times.
Posted by: JB | January 10, 2008 6:27 AM
So can we at least bury the IBC? I think the scientific debate will be interesting to watch. At least now there are published results to work with.
Posted by: Deech56 | January 10, 2008 6:41 AM
You agree then that this estimate is probably, in the balance of things, a more reliable estimate of the number of deaths - since it does not influence your own, or Les Roberts', "qualitative conclusion" from his quantitative study that the Iraq war was a disaster?
No and no. I don't necessarily agree it's a more reliable estimate of the deaths, because I don't understand the way in which they've dealt with the censored clusters and I think Roberts' point about past undercounts makes sense. And my assessment of whether it is reliable or not would be a cause, not a consequence, of my conclusion that the Iraq war was a disaster.
Posted by: dsquared | January 10, 2008 6:46 AM
Why bury the IBC? You just need to be aware of the nature of the data they have collected. I really do not understand this desire to bury things. The same goes for dsquared's comment about not completely throwing out Roberts et al and Burnham et al. He is right, you don't have to. The better option is too judge each thing on its merits and potential weaknesses and make a judgment about which is the more likely to provide the best estimate. Obviously the IBC then becomes one of the less likely estimates.
The good thing (or rather bad thing in reality) about this debate in comparison to other scientific issues, is that the conclusion is pretty much clear from an overview of published data we have. A large number of people have died and it has been a tragedy for the Iraqi people and their civil society. You don't have to start being a partisan for the IFHS study or the Lancet study to make this point.
The point that Hidari makes in comment four about this new study being seen by some as vindication, which it is not, is a natural result of the politicisation of The Lancet article by all sides - including, rather unfortunately in my own opinion, the editor of the Lancet. Given the nature of study, it is hard to say that this was avoidable. However, I think the best thing to do now is deal with the data and the methods.
Posted by: Anthony | January 10, 2008 7:00 AM
my assessment of whether it is reliable or not would be a cause, not a consequence, of my conclusion that the Iraq war was a disaster.
Glad to hear it, I expected nothing less. I was somewhat surprised by the hypothesis you put forward though in comment 9, as though there might be a threshold of deaths you hold below which Iraq might not have been a disaster.
Anyway, it would be a shame, would it not, if this study was judged as an attacks on the Lancet study similar to those that Tim has highlighted on his blog. I suspect that some are who highly attached to a figure of 650,000, in a less dispassionate way than you no doubt are.
Posted by: Anthony | January 10, 2008 7:17 AM
"You agree then that this estimate is probably, in the balance of things, a more reliable estimate of the number of deaths - since it does not influence your own, or Les Roberts', "qualitative conclusion" from his quantitative study that the Iraq war was a disaster?"
Anthony, even if the IBC figures were correct- and clearly now they are not - the Iraq War would have been a disaster.
I can't speak for others but my concern throughout the debate on the Lancet studies has been to defend the reputation of reputable scientist from unreasonable attack and to defend what appeared to be valid scientific work.
Posted by: Ian Gould | January 10, 2008 7:59 AM
On a brief look I think it seems like a decent effort. My main concerns about it would be that:
1) adjustment for missing clusters was based on IBC, which is assuming a lot, especially since they then use their results to conclude IBC gives a reliable measure of trends.
2) it's going to be very vulnerable to claims of trickery from the wingnut world, because the final result is based on Monte Carlo simulations to find the most likely death rate given the many uncertainties. Everyone knows that simulations are just a way of massaging figures! My God, global warming science is based on simulations, and look how wrong that is!
3) the authors make repeatedly the point that their death counts are massively underreported
I also note that the authors of this paper had access to what they describe as "microdata" from the Lancet studies. Yet they don't have any fraud accusations to make ... it's a conspiracy, I tell you!! All them epidemiomoliogolists are protecting each other!
Posted by: SG | January 10, 2008 8:13 AM
[I was somewhat surprised by the hypothesis you put forward though in comment 9, as though there might be a threshold of deaths you hold below which Iraq might not have been a disaster]
A negative number of excess deaths would obviously and unambiguously have been a triumph - in utilitarian terms I would be tempted to say that even a positive excess deaths figure similar in scale to the Northern Ireland casualty count could be a reasonable trade-off for the introduction of democratic institutions and removing the risk of some future Saddam massacre. But as Ian says, even at the IBC level, there are far too many broken eggs given the quality of the omelette delivered.
Posted by: dsquared | January 10, 2008 8:18 AM
Anthony, even if the IBC figures were correct- and clearly now they are not - the Iraq War would have been a disaster.
Ian, my point in comment ten was to note that whether 150,000 died or 650,000 died dsquared's view of the war in Iraq will be that it was a disaster. Which is precisely the same point you are making with regard to your own views. Therefore, political considerations should be cast aside in judging this new study, since the point is well made that the consequences of the Iraq war have been appalling for Iraqi civil society regardless of which study gives the most reliable estimate of deaths.
Posted by: Anthony | January 10, 2008 8:29 AM
"even if the IBC figures were correct- and clearly now they are not"
Why do people keep saying things like this, as though there has ever been a question raised as to what the IBC figures represent?
Even if the freaking IBC didn't explain to you clearly what their figures were, you could realise just by looking at it it that they are tabulating media reports of deaths.
Do you read your own newspaper and feel the need to tell people that the sport scores in it don't represent all the sport that was played that weekend? More than once? Continually for years on end?
Posted by: Mako | January 10, 2008 8:32 AM
But as Ian says, even at the IBC level, there are far too many broken eggs given the quality of the omelette delivered.
This is, of course, an entirely rational position to take. However, it is judgment, not a scientific conclusion. The main point for my posts in this thread is to suggest that the WHO report does not need to be attacked in politicized and partisan manner, and nor does it need to be undermined to protect The Lancet paper or emotional energy expended in defending it, in order to support any thesis that the war in Iraq was a disaster (in your terms).
Present company excluded, I suspect many may find that hard. Especially people who rant at anti-war protests about the "axis of Anglo-American imperialism".
Posted by: Anthony | January 10, 2008 8:47 AM
Anthony says: "Surely the bottom line is that this study has a greater number of samples and therefore is more likely to have an estimate of mortality closer to the real figure (which we will never know)"
Not necessarily. If Saddam Hussein himself had done a survey asking Iraqis whether they liked having him as their leader, how many people do you suppose would have answered "No"?
...which, of course, is the point Les Roberts is making when he says
I'd have to say that is a very serious criticism -- perhaps the most serious of all.
Posted by: JB | January 10, 2008 8:50 AM
We now have another apparently competently conducted study to add to the mix. There certainly are issues to be explored, as their are with the Lancet studies.
One point on Les Roberts' claim that:
I raised this issue with Jon Pedersen when I spoke with him after Lancet 2. He felt that there was no relevance of the undercount in child mortality estimates to adult mortality. He stated that demographers are well aware that child mortality is often underreported in such surveys, which, if I remember correctly, was exactly why they examined the figures in time to resurvey. I'm certainly not an expert here, but do feel that this point should be rebutted before using the undercount of child mortality to discount the ILCS estimates of adult mortality.
That said, let the examination of the new study proceed!
BTW, does anyone know what happened to the ORB survey's new sampling, that was to be reported in early October and never was? And did they ever put out any methodological detains that can be examined?
Posted by: Stephen Soldz | January 10, 2008 8:51 AM
Yes the number of deaths remains huge and yes Ian Gould you were just defending 'what appeared to be valid scientific work' but you were wrong and so was Deltoid on a scale.
The IBC estimates, whatever their faults, were closer to the best estimates now available than Lancet.
Posted by: hc | January 10, 2008 8:55 AM
On the matter of missing clusters, I notice that the authors of this NEJM article compared the proportion of deaths in Baghdad for their paper with Lancet 2. For them it was about 50%, for Lancet 2 26%. Which makes me think that a much higher rate of death for the Lancet 2 paper occurred in exactly the areas which the NEJM under-sampled for security reasons. They then adjusted their death rate for the missing clusters using the IBC data, which also had about 50% of deaths in Baghdad. This would have introduced a bias towards the null compared to the Lancet paper.
I suspect that adjusting the missing clusters using Lancet 2 data would have given marginally higher death rates, but they didn't want to do this because Lancet 2 was a cluster survey too, so presumably risked the same biasses. It's a shame they didn't do a sensitivity analysis for some of their assumptions, though, or include estimates using Lancet 2 mortality distributions (which they didn't as far as I can see).
Posted by: SG | January 10, 2008 9:00 AM
You guys are so funny!
1) I have been told that the data and code from IFHS will be made available. If it isn't, you will hear many complaints from me. But if it is made available, can we all agree that the behavior by the L1 authors is ridiculous?
2) I tried to get the data for L1 out of Roberts for a year before accusing anyone of anything. Science takes time.
3) Response rates! Indeed, this will be a fun topic. For background, see endless discussions here. The short version is that response rates are made up of two parts: contact rates and participation rates. The participation rates in L2, while extremely high, have been in, at least, the realm of the possible. Once you are talking to someone in Iraq, they seem willing to answer your questions. The contact rates in L2 were always the key red flag, especially since L2 required talking to either the head of household or the spouse and L2 only made one contact attempt at each dwelling. I have not studied this new paper closely (and I do not think that it reports all the data that we need), but we will return to this topic in due course. If we see similar response rates between L2 and this, I will retract my criticisms. If L2 rates are much higher than here, will you join me in my suspicions?
More to come.
And, just to be clear, isn't Roberts a bit misleading above? IBC measures only civilian deaths. So, assume that IFHS is correct and 150,000 violent deaths occured in a period in which IBC reported 40,000 civilian deaths. Isn't it plausible that the 110,000 violent deaths that IBC does not report are combatant (soldiers, police, insurgent and so on)? In other words, IBC and IFHS match up pretty darn well, depending on what you think the ratio of civilian/combatant deaths would be.
Posted by: David Kane | January 10, 2008 9:19 AM
HC: "The IBC estimates, whatever their faults, were closer to the best estimates now available than Lancet."
At this point, I'd withhold judgment on whether the NEJM represents the best estimates under discussion over issues such as the missing clusters sort themselves out.
Furthermore the IBC count, IIRC was around 40,000 for this.
The median value for Lancet 2 was 151,000 and the Lancet 2 median value was ca, 600,000.
So IBC was under by a factor of 4, Lancet 2 was over by a factor of 4 - assuming as I say that NEJM is validated.
Posted by: Ian Gould | January 10, 2008 9:19 AM
Actually, we don't know that yet. We know that a new paper CLAIMS this to be true. Perhaps you should wait until the paper's been scrutinized a bit more closely before leaping to your conclusion?
Or do you only demand scrutiny when you don't like the numbers a study delivers?
Posted by: dhogaza | January 10, 2008 9:21 AM
The IBC estimates, whatever their faults, were closer to the best estimates now available than Lancet.
what do you mean with "closer"? who decides what the "best" estimate is?
the paper is good, and it is another proof of the amount of death and chaos that the invasion brought to Iraq. i have three points that worry me a little:
1. the use of the paper to contradict the lancet paper. big parts of the paper actually support the lancet paper. in many places, the authors mention a potential bias towards the estimates being too small. they should have made this more clear. instead, by constantly mentioning the IBC count and by not attributing the increase of non-violent death clearly to the war in situation in iraq, they provide ammunition to those who prefer to belittle the effect.
2. stable number of violent death. this is simply unbelievable. look at fig 1 on page 490. even the US army noticed the increase in violence. if a survey doesn t show it, serious questions need to be asked!
3. displacement while it looks as if they included displacement numbers into the popuplation count, i don t think that a survey for martality in Iraq can be done now, without taking a very close look at this issue. it most likely is the explanation for the lower violent death rate found in this survey.
Posted by: sod | January 10, 2008 9:31 AM
And, just to be clear, isn't Roberts a bit misleading above? IBC measures only civilian deaths. So, assume that IFHS is correct and 150,000 violent deaths occured in a period in which IBC reported 40,000 civilian deaths. Isn't it plausible that the 110,000 violent deaths that IBC does not report are combatant (soldiers, police, insurgent and so on)? In other words, IBC and IFHS match up pretty darn well, depending on what you think the ratio of civilian/combatant deaths would be.
a pretty wild guess for someone who claims to be doing statistics.
let me just state this clearly: you just made the assumption that EVERY SINGLE violent civilian deathcase in Iraq is reported in the newspapers?!?
sorry David, but even for you that is an idiotic claim.
Posted by: sod | January 10, 2008 9:37 AM
David, we will not agree about the behaviour of the L1 authors until you accept the possibility that they have honest, privacy reasons for not releasing that data.
Also, given the L2 authors appear to have given "microdata" to the NEJM authors, who apparently were satisfied with it, perhaps it's time you recognised that the problem in this little dialogue was the chap standing around screaming FRAUD. Which, from memory, you did very early on.
Given that the response rate for this paper was 96.2%, and 0.4% of those contacted refused to participate, doesn't that make the contact rate up around 97% of households? And wasn't your issue with L2 that its contact rate was 98%?
Have you checked all the RRs in this new paper against the count data, to see that they don't contradict? Presumably your radical new theory about ratios of normal distributions applies equally to this paper...? And aren't you a little bit concerned about that non-symmetric confidence interval? Surely there's a trick there...
Posted by: SG | January 10, 2008 9:37 AM
"Why bury the IBC? You just need to be aware of the nature of the data they have collected."
Probably most people agree with that, but if you were around here or at medialens for the Lancet/IBC wars, you'd have found that IBC representatives were usually extremely reluctant to acknowledge an undercount of more than a factor of two, despite the lip service they pay to limitations of their data on their webpage. Sloboda did acknowledge the outside possibility of a factor of 4 once, but in the anti-Lancet debates they generally weren't that generous in their concessions, or they wouldn't have tried so hard to discredit Lancet1.
I've provided a link to one page of the IBC response to Lancet2, which gives you some idea of their perspective. They cite the Iraq MOH statistic of 60,000 wounded in the period from mid 2004 to mid 2006 and they argue that this is likely to be a fairly complete count, since hospitals would want to be accurate on how many people they've treated. It's a little hard to believe that 150,000 people died from March 2003 until mid 2006, but only 60,000 were seriously wounded from mid 2004 to mid 2006.
http://www.iraqbodycount.org/analysis/beyond/reality-checks/4
Posted by: Donald Johnson | January 10, 2008 10:03 AM
David thinks most of the 150,000 dead are non-civilians.
As for the number of non-civilian deaths, the US claims to have killed 19,000 insurgents from June 2003 through the summer of 2007--
http://www.usatoday.com/news/world/iraq/2007-09-26-insurgents_N.htm
As for police, etc, I'm not sure, but IBC may include police as civilians and count their deaths. I haven't looked for the number of Iraqi soldiers killed, but would they show up in a household survey?
Posted by: Donald Johnson | January 10, 2008 10:12 AM
Off the top of my head I would make the following propositions:
The IBC represents the absolute floor for deaths in Iraq. It is overwhelmingly likely that it seriously under reports the number of deaths.
The most dangerous areas in Iraq are likely to be the ones where the violent death rate is highest.
The NEJM did not survey the most dangerous 11% of areas in Iraq, but instead used IBC data.
The NEJM is therefore substituting data which likely seriously undercounts the violent deaths in the very areas where we would expect them to be highest.
Posted by: McKingford | January 10, 2008 10:44 AM
Let's suppose David's clearly ridiculously low estimate of 40,000 civilian deaths in Iraq 2003-2006 was accurate. How would this translate to the United States, if it had been invaded and occupied by another country? If we are measuring death toll in terms of proportionately comparing the Iraq and US populations, this would translate to about 500,000 dead US civilians. Half a million. In other words, total carnage.
Moreover, David appears to suggest that the death of those non-civilians in Iraq opposed to the US occupation - people he calls 'soldiers, police, insurgent and so on' is legitimate. How utterly convenient of him.
Posted by: Jeff Harvey | January 10, 2008 11:01 AM
Well, they used IBC data to compare ratios, which is not an unreasonable method. But it does have a possible downward bias, as they note:
I would say that this isn't a good assumption since areas that are too violent for researchers would probably be too violent for journalists as well.
Posted by: Boris | January 10, 2008 11:39 AM
BTW, I would refer to #36 as the "No way am I going down that f*ing street" bias. :)
Posted by: Boris | January 10, 2008 11:41 AM
"Let's suppose David's clearly ridiculously low estimate of 40,000 civilian deaths in Iraq 2003-2006 was accurate. How would this translate to the United States, if it had been invaded and occupied by another country? If we are measuring death toll in terms of proportionately comparing the Iraq and US populations, this would translate to about 500,000 dead US civilians. Half a million. In other words, total carnage."
In my opinion, it beats living under a brutal dictatorship for the rest of ones life. The Iraqi's had no chance on their own to get out from under Saddam's thumb. I'd rather be dead than live under a dictatorship such as that.
Posted by: ben | January 10, 2008 12:15 PM
ben, actually, if it came down to it...I'm betting you would rather actually be alive than dead, no matter what your government.
Speaking personally, I wish that Saddam had been removed in the first Gulf War. There was a good case for doing so, which got ignored largely because many Western governments felt they would get more profit out of having his secular government (which still owed a lot of Western arms dealers a lot of money) in place. However, this doesn't (any of it) nullify the fact that then the US (and UK, to be fair) invaded another country which had not performed an act of aggression towards us, on marginally legal [ok, legal if you squint and flop one ear back and look at it in dim light] grounds, and that said invasion was incompetently planned for and incompetently handled and has resulted in the complete disintegration of the invaded country into a morass of internecine warfare.
And whether you say 150,000 or 655,000 casualties, I think any way you cut it that translates to too damn many. And no, I don't have any suggestions at this point on how they might sort it out. Some things just don't have a good answer. However, I think that many Iraqis have a good point in stating that their chances for survival were probably greater under Saddam, and I don't blame them for being pissed off at how this has been handled.
Posted by: Luna_the_cat | January 10, 2008 12:37 PM
But ... Ben! Just a moment! You're a LIBERTARIAN.
Don't you think that you ought to be able to decide that for yourself, rather than have GOVERNMENT, a foreign one at that, make that decision for you?
Gotta love these freedom-loving libertarians who don't want government to impose the people's will on them, but are happy to see their government impose their will on the citizens of another country entirely.
Posted by: dhogaza | January 10, 2008 12:37 PM
Thanks, dhogaza -- I was thinking that too, but I couldn't think how to say it.
Posted by: Luna_the_cat | January 10, 2008 12:40 PM
Let's be clear, we're talking DEATHS, not casualties. Casualties include those who are injured but not killed, and that figure is surely much, much higher.
Posted by: dhogaza | January 10, 2008 12:45 PM
True, and noted. Apologies for my imprecision.
Posted by: Luna_the_cat | January 10, 2008 12:55 PM
The 150,000 figure is for violent deaths only. Excess mortality for the period, according to this study, is about 400,000. This is the number that matters - it hardly matters to an Iraqi if the invasion caused him to be shot, blown up, or die of disease through breakdown of critical infrastructure and social arrangements. Western corporate media, of course, choose to play up the lower number.
[The fact that all excess mortality was attributable to violence was a serious problem with the findings of Lancet 2. It seems likely that some problem with Lancet 2 caused a large number of the non-violent deaths to be counted as violent.]
Posted by: Sortition | January 10, 2008 1:01 PM
I wonder how long it will take the RW blogosphere, the WSJ and all the rest that are so quickly and eagerly piling on "this debunks the study published in the Lancet" to realize that they are endorsing an excess mortality figure of 400,000 rather than 600,000+?
This really destroys the argument that the Lancet figure was exaggerating many times over the "real" figure.
Posted by: dhogaza | January 10, 2008 1:19 PM
This is from the new report--
"Recall of deaths in household surveys with very few exceptions suffer from underreporting of deaths. None of the methods to assess the level of underreporting provide a clear indication of the numbers of deaths missed in the IFHS. All methods presented here have shortcomings and can suggest only that as many as 50% of violent deaths may have gone unreported. Household migration affects not only the reporting of deaths but also the accuracy of sampling and computation of national rates of death."
If I understand them correctly, does this mean their own violent death count might be too low by a factor of two?
If so, for those of us who aren't experts, there's something misleading about citing the CI as though it represents the likely range in which the true value could be found. Of course the same criticism could possibly be made of Lancet2. Maybe the truth is somewhere in-between the ranges given by the two studies.
Posted by: Donald Johnson | January 10, 2008 1:43 PM
I don't think the IFHS authors will endorse an estimate of excess deaths. They will argue, not completely inappropriately, that the prewar mortality estimate is clearly way too low. Again to refer to Jon Pedersen's [I don't know if he was involved in this -- his name isn't on the list, but he was lead on the ILCS] comments to me, he expressed skepticism about the ability to retroactively assess prewar mortality rates, feeling that anything much beyond 6-months to a year was bound to be low. That was, again if I recall our conversation correctly, the reason he focussed upon violent deaths -- you don't need an accurate prewar estimate.
So we know that there's underreporting here. We don't know how much. But we do know that it is likely severe for the prewar period. Thus, all the estimates are exactly that, estimates. But an estimate of "excess deaths" from this data is bound to be flawed, more flawed than the estimates of violent deaths.
I think there are a number of concerns here. The 11% of clusters not visited, method of estimating missing data, the likely prewar mortality undercount, the extent of mortality from Baghdad [I believe the survey that asked about deaths in one's household could be used to estimate the geographic distribution -- my recollection is that it had a much lower rate from Baghdad, consistent with L2], and the fact that this was conducted by the Iraqi government, with possible difficulties in data collection. On the other hand, the sample is large and its not as if L2 was flawless.
Alas, as scientists, and as concerned citizens, we may never know the true figures, given the mass exodus in recent years. This whole episodes is a complex case study in how to use imperfect data on important policy questions. The only thing I suspect we know pretty well is that enormous numbers of Iraqis have died, probably at least 200,000 [given the last violent years]. This shows that the invasion has been a humanitarian disaster.
Posted by: Stephen Soldz | January 10, 2008 1:54 PM
Playing coy is not an option - like the IBC numbers, the IFHS numbers are going to be interpreted as indicating the cost of the invasion in human lives. 400,000 may not be a very reliable number, but it is a much more realistic reference point than 150,000.
It is also important to remember that the 400,000 deaths estimate covers only 3/03-6/06.
Posted by: Sortition | January 10, 2008 2:24 PM
"I'd rather be dead than live under a dictatorship such as that."
Yeah, its real easy to decide other people would be better off dead.
Personally I think Americans would be better off dead than continue to struggle on without universal health care.
Incidentally, while nominally elected, the current Iraqi government is every bit as bad a Saddam's in various measurable ways - violence and discrimination against women and gays have both increased; torture by the security forces is worse now than it was in the 1990's.
Posted by: Ian Gould | January 10, 2008 2:33 PM
"IBC measures only civilian deaths."
IBC TRIES to measure only civilian deaths.
When groups of bodies of adult males are dumped showing signs of torture and murder by death squads or when hundreds of adult male bodies are reported to have turned up in a morgue over a period of months dead from bullet wounds it's a reasonable inference that some of them are in fact insurgents.
Similarly there are a LOT of suicide bombings where their minimum and maximum casualty figures vary by one, the simplest explanation for that is that some of the media sources they rely upon include the bombers in the figures.
Furthermore there are some incidents in the database which just seem blatantly to contradict their "civilian deaths" criterion such as reports of Iraqi troops or police being killed by car bombs.
Posted by: Ian Gould | January 10, 2008 2:40 PM
"In other words, IBC and IFHS match up pretty darn well, depending on what you think the ratio of civilian/combatant deaths would be."
So do IBC and Lancet "depending on what you think the ratio of civilian/combatant deaths would be".
Posted by: Ian Gould | January 10, 2008 2:44 PM
I think that for practical purposes (arguing for or against the war), a vague but undoubtedly correct claim that the war has caused hundreds of thousands of excess deaths is good enough. We may never know if the excess (for 2003-2006) is in the low hundreds or high hundreds of thousands. I'd like to know how solid the numbers are for the claims given for Saddam's killing--HRW claimed 300,000 dead from his security forces, and then sometimes people throw in hundreds of thousands for the war with Iran and then (for people who ignore the Western responsibility) there are the sanction deaths (with estimates for those varying all over the place), so you end up with people blaming a million or more deaths on Saddam, with no one expected to produce strong evidence for any of these numbers.
Going back to David Kane's statement
"Isn't it plausible that the 110,000 violent deaths that IBC does not report are combatant (soldiers, police, insurgent and so on)? "
I take it we're supposed to assume IBC is counting most or all the noncombatants. The US claims to have killed 15,000 insurgents from June 2003 to the end of 2006 (see the link I provided in # 33). That still leaves nearly 100,000. So if David is right, Iraqi combatants are killing each other at a rate many times greater than the US military has managed and not in death squad activities or car bomb attacks, because those are included in IBC's data. This is surprising--one gets the impression that most of the killing in Iraq is of civilians, but actually, as David now informs us, most of it must be occurring in pitched battles that have completely escaped the attention of the press.
Posted by: Donald Johnson | January 10, 2008 3:03 PM
44: Where did you find that the excess mortality from this new study was around 400.000? I couldn't find it in the paper itself, but it would be really interesting if it was true...
If you derived this figure from data in the paper, would you mind unpacking your reasoning a little bit for the lay people amongst us (myself included)?
Posted by: dalazal | January 10, 2008 3:15 PM
The BRussells Tribunal presented recently a new important survey: "Deterioration of Women's rights and Living Conditions Under Occupation", written by Iraqi scientist Dr. Souad N. Al-Azzawi, specialist on the subject of depleted uranium and member of our Advisory Committee: (http://www.brusselstribunal.org/pdf/WomenUnderOccupation.pdf)
The conclusions of that study confirm earlier studies, polls and surveys like the Lancet survey and ORB's poll. (http://www.justforeignpolicy.org/iraq/iraqdeaths.html) And even worse: the survey concludes that the total number of deaths amongst the 4.5 million internally displaced or forced migrated people both inside and outside the country is estimated to be 868,500.
The survey composed of 21 questions was distributed in two major cities:
Inside Baghdad, Iraq in the Karada District, and Kudsiya area in Damascus, Syria where more than 200,000 Iraqi refugees live.
The questionnaire was distributed in the selected areas by two teams. Each team consisted of a PhD, MS, and a B.Sc. holders who work, or used to work with the author in Baghdad University.
The 150 women who answered the survey were a part of 150 families or households composed of a total of 502 Iraqis.
Further indications that the WHO figures are way too low:
"A study of 13 war affected countries presented at a recent Harvard conference found over 80% of violent deaths in conflicts go unreported by the press and governments. City officials in the Iraqi city of Najaf were recently quoted on Middle East Online stating that 40,000 unidentified bodies have been buried in that city since the start of the conflict. When speaking to the Rotarians in a speech covered on C-SPAN on September 5th, H.E. Samir Sumaida'ie, the Iraqi Ambassador to the US, stated that there were 500,000 new widows in Iraq . The Baker-Hamilton Commission similarly found that the Pentagon under-counted violent incidents by a factor of 10. Finally, a week ago the respected British polling firm ORB released the results of a poll estimating that 22% of households had lost a member to violence during the occupation of Iraq, equating to 1.2 million deaths. This finding roughly verifies a less precisely worded BBC poll last February that reported 17% of Iraqis had a household member who was a victim of violence.
There are now two polls and three scientific surveys all suggesting the official figures and media-based estimates in Iraq have missed 70-95% of all deaths. The evidence suggests that the extent of under-reporting by the media is only increasing with time." (Les Roberts, 20 Sep 2007 - http://www.globalresearch.ca/index.php?context=viewArticle&code=ROB20070922&articleId=6848)
Posted by: DIRK ADRIAENSENS | January 10, 2008 3:20 PM
Can we please have a criticism of this study's methodology by David Kane, preferably pointing out where they made the same errors as Roberts and where they have got it better, and why this study is more reliable than IBC whereas Roberts' ones weren't? I've been really looking forward to it and we're already 50 posts in.
J
Posted by: jodyaberdein | January 10, 2008 4:06 PM
If you derived this figure from data in the paper, would you mind unpacking your reasoning a little bit for the lay people amongst us (myself included)?
the table on page 489 lists death rates. before war, all causes (all ages): 3.17 after invasion, all causes (all ages): 6.01
before war, violent (all ages): 0.10 after invasion, violent (all ages): 1.09
so the missing approx. 2.0 increase in death rate should be from non-violent causes. if an 1.0 increase transfers into about 150000 (violent) additional dead, the 2.0 increase should give about another 300000.
(pretty crude calculation, but i think you can do the exact math with the data provided)
Posted by: sod | January 10, 2008 4:43 PM