Posted by: Lister | January 10, 2008

New Iraq Survey

New study says 151,000 Iraqi dead. That’s from March 2003 until June 2006.

The result is based on interviews with over 9,000 families across Iraq carried out by the health ministry for the WHO.

[…] Difficulties facing those leading the survey included:

–no central records are kept
–some areas are too dangerous to visit
–more people leave their homes in times of conflict
–many people have left Iraq altogether

“The survey results indicate a massive death toll since the beginning of the conflict,” said Iraqi health minister Salih Motlab al-Hasanawi.

The NYTimes said:

The surveyors largely conducted their work in August and September 2006.

[…] one co-author, Louay Hakki Rasheed, was killed on his way to work on Aug. 2, 2007. The extraordinarily dangerous security situation prevented surveyors from visiting about 11 percent of the areas that the researchers had intended to visit.

Most of the places that were off-limits to the researchers were in Anbar Province, the Sunni-dominated region of western Iraq. While there have been significant security improvements in Anbar in the past year — after Sunni tribal leaders joined with United States troops to drive out extremist militants — in 2006 the province was a lawless haven dominated by insurgents.

[…] At the same time, Iraqi officials have asserted that they made improvements in their ability to track fatalities using morgue counts and other means. One shortcoming has always been that the corpses of many victims, if they are identifiable, are taken by family members straight to the cemetery, bypassing the morgue and hospital. Yet Iraqi authorities say that relatives still have an incentive to obtain a death certificate because it is required for inheritance, for government compensation, and for other purposes.

That last answers one of the questions I asked before regarding burial.

The report is available from the New England Journal of Medicine, which also provides a link to a pdf file.

This was a bigger survey involving 9345 households, compared to 1849 households (12,801 people) in Lancet-2. This post isn’t about debunking the new survey in support of the old. I’m happy for new data and relieved that the death toll is probably lower than given by the previous best study.

The report makes its own comparison with Lancet-2, stating:

…the IFHS data indicate that every day 128 persons died from violence from March 2003 through April 2004, 115 from May 2004 through May 2005, and 126 from June 2005 through June 2006.

The Iraq Body Count numbers were 43, 32, and 55 civilian deaths per day for the same periods.

In the study by Burnham et al., there was a much higher rate of death from violence and a sharp increase during the 3-year period, with 231, 491, and 925 deaths per day, respectively (Figure 1B).

There was greater agreement regarding mortality from nonviolent causes between the IFHS study (372 deaths per day) and the study by Burnham et al. (416 deaths per day)

So the WHO study doesn’t report an increase in number of deaths over the period ending mid-2006.

Some comparisons:
WHO: 151,000 violent deaths due to the war.
Lancet-2: 601,000 violent deaths due to the war.

The WHO report: (table 3)
crude death rates, after invasion: 6.01 per 1000 per year
crude death rates, before invasion: 3.17 per 1000 per year
Excess death rate: 6.01-3.17=2.84 per 1000 per year

violent death rates, after invasion: 1.09 per 1000 per year
violent death rates, before invasion: 0.10 per 1000 per year
Excess violent deaths: 0.99 per 1000 per year

Lancet-2:
crude death rates, after invasion: 13.3 per 1000 per year
crude death rates, before invasion: 5.5 per 1000 per year
Excess death rate: 13.3-5.5=7.8 per 1000 per year

violent death rates, after invasion: 7.2 per 1000 per year
violent death rates, before invasion: 0.1 per 1000 per year
Excess violent deaths: 7.1 per 1000 per year

Which implies an average population of about 25 million for the 40 months (3.3 years) the data applies to.

Figure 1 of the pdf shows the distribution of deaths according to province. Lancet-2 had a higher proportion of deaths from “high mortality provinces”. While this new report and IBC roughly agree on the propotions. Which is interesting, because the WHO report says this (in an earlier section):

Of the 1086 originally selected clusters, 115 (10.6%) were not visited because of problems with security. These clusters were located in Anbar (61.7% of the unvisited clusters), Baghdad (26.9%), Nineveh (10.4%), and Wasit (0.8%).

Since past mortality is likely to be higher in these clusters than in those that were visited during the IFHS, we imputed mortality figures for the missing clusters in Anbar and Baghdad with the use of information from the Iraq Body Count on the distribution of deaths among provinces to estimate the ratio of rates of death in these areas to those in other provinces with high death rates. Data from the Iraq Body Count were used to compute ratios for death rates in Anbar and Baghdad, as compared with the three provinces that contributed more than 4% each to the total number of deaths reported for the period from March 2003 through June 2006.

And the report reminds us to refer back to this when figure 1 is printed.

The WHO report also addresses the possibility of under-reporting of deaths:

The underreporting of deaths was expected to be lower for more recent years.

[…] 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.

And finally:
If the IBC was out by a factor of 3 in 2006, then why not say it is still out by a factor of 3 today? That makes for about 250,000 deaths.

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Responses

  1. Some comparisons between NEJM and Lancet-1 from Tim Lambert’s site:

    According to Table 4 from the Supplementary Materials (NEMJ):

    Mortality Rate All causes Pre-Invasion = 3.17

    Mortality Rate All causes for Mar03 to Dec04 = 5.92

    The excess death for Mar03 to Sep04 period (=L1):

    (5.92-3.17)/1000 * (17.8/12) * 24400000 = 99531

    Lancet-1 estimated 100,000 deaths for that period. Another comment suggests the two reports agree on violent deaths. But I haven’t checked that yet.

    Also, Sortition points out in, post to that blog, that the NEJM report implies a total excess death of 400,000 for the period Lancet-2 estimates 650,000. But this time there is a definite disagreement about the ratio of violent/non-violent deaths.

    Crooked Timber lists some of the stats, such as 1.67 violent deaths per 1000 per year post invasion. That is an adjusted estimate which the report uses to get its 151,000 final figure for violent deaths over the 3.5 year-ish period. (ie: not the 1.09 given in my main post).

    Finally, a round up of non-apology from Crooked Timber’s — Mea Culpa, Mea maxima ahhhstickitupyerjacksie.

  2. Jousting with the Lancet, by Diane Farsetta, discussing some of the articles written about the Lancet studies and the responses of the authors.

    (via Deltoid).


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