War & Health

On January 9th a new Iraq War mortality study was released by the New England Journal of Medicine. This study represents the third major attempt to count Iraqi deaths since the start of the war. Iraq Body Count was the first attempt, counting the number of deaths published in news reports. The operators of Iraq Body Count freely admit the real number is likely much higher and that their value (47,668) represents at best a minimum value. The second attempt was the now infamous “Lancet” and “Lancet II” studies whose validity was blasted this week in a National Journal article (good read). The last of the Lancet survey-based studies found 601,027 Iraqi deaths since 2003. The National Journal article eloquently puts the magnitude of that number into perspective:

“The February 2006 bombing of the Golden Mosque is widely credited with plunging Iraq into civil war, yet the Lancet II report posits the equivalent of five to 10 bombings of this magnitude in Iraq every day for three years.”

This latest study from the Iraq Family Health Survey Study Group is based off 9345 household surveys and estimated 151,000 violent deaths from March 2003 through June 2006:

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.

One finding which is consistent across all three studies is that violence was a leading cause of death amongst Iraqi adults. This is contrary to what we find in wars historically. Infectious disease typically far outnumbers violent deaths. This historic discrepancy might be caused by Iraq’s relatively (compared to previous wars and even the modern states) high levels of pre-war education and quality healthcare.