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.
If the Hopkins survey is right, it could be the case that the last three years of mayhem in Iraq has claimed twice as many lives as died violently during the odious, 23-year regime of Saddam Hussein. Most experts looking at the Saddam years say that lives lost by internal repression and genocide against Kurds and Shia probably killed about 300,000 people.
You can’t blame the righties for being skeptical, however, because I suspect much of the news reporting about the study is sloppy. I’m making some assumptions here because I haven’t seen the study itself, but if it’s similar to an earlier study from 2004 by Les Roberts of Johns Hopkins, the study did not just add up Iraqi civilians known to have been killed by violence, and I doubt the researchers claim to have completely separated “civilian” deaths from “combatant” deaths — in the middle of an insurgency/civil war, that would be pretty much impossible.
Instead (and I’m relying mostly on the Washington Post’s account of this) as I understand it the study looks at mortality rates before and after the invasion and publishes the difference. The mortality rates include all Iraqis who died of anything, including malnutrition and disease. Historically disease has caused more deaths among both soldiers and civilians in war than battle itself, for a lot of reasons. That’s less true now than it used to be, for soldiers. But if war destroys infrastructure that delivers safe water to a population, or damages hospitals, or runs off the doctors, or cuts off supplies to medicines, then a lot of people die from war who might not have died otherwise. And that’s what the Johns Hopkins study counts — people who died who would not have died otherwise.
However, Johns Hopkins reports now that about 600,000 of the 655,000 deaths were from violence, which is startling.
Per Doug Ireland at CommonDreams, much of the rejection of Johns Hopkins’s earlier study came from people who assumed the study counted deaths from violence, or only counted civilians killed by coalition forces, without actually reading what the study said.
Guterman’s article dissects the U.S. mass media’s attempts to dismiss the study’s findings while European newspapers front-paged the story. The results of Guterman’s interviews with the “experts” American newspapers relied upon to discredit the Lancet study should cause red faces at some of our national dailies. For example, “The Washington Post, perhaps most damagingly to the study’s reputation, quoted Marc E. Garlasco, a senior military analyst at Human Rights Watch, as saying, ‘These numbers seem to be inflated.’ “Mr. Garlasco says now that he had not read the paper at the time and calls his quote in the Post ‘really unfortunate.’He says he told the reporter, “I haven’t read it. I haven’t seen it. I don’t know anything about it, so I shouldn’t comment on it.’ But, Mr. Garlasco continues, ‘like any good journalist, he got me to.’
“Mr. Garlasco says he misunderstood the reporter’s description of the paper’s results. He did not understand that the paper’s estimate includes deaths caused not only directly by violence but also by its offshoots: chaos leading to lack of sanitation and medical care.”
The article cited in the quote above, by Lila Guterman, is here. Writing for the Chronicle of Higher Education, Guterman documented that American news media blew off the earlier study because (1) they didn’t bother to read it and (2) they don’t understand how statistics and statistical sampling work. (I admit I am in the latter category myself, but then so is just about everybody else.) For example, Fred Kaplan of Slate — someone I link to from time to time — complained that the wide range in the study of possible deaths, 8,000 to 194,000, was not an estimate, but a “dartboard.” Guterman explained that the researchers
… acknowledged that the true number of deaths could fall anywhere within a range of 8,000 to 194,000, a function of the researchers’ having extrapolated their survey to a country of 25 million.
But the statistics do point to a number in the middle of that range. And the raw numbers upon which the researchers’ extrapolation was based are undeniable: Since the invasion, the No. 1 cause of death among households surveyed was violence. The risk of death due to violence had increased 58-fold since before the war. And more than half of the people who had died from violence and its aftermath since the invasion began were women and children.
Because the initial reporting of the 2004 report was riddled with errors, many people to this day believe it was “debunked” by “experts,” when in fact the real experts who read the study praised it. But the real experts didn’t get quoted in American media. Back to Guterman:
Public-health professionals have uniformly praised the paper for its correct methods and notable results.
“Les has used, and consistently uses, the best possible methodology,” says Bradley A. Woodruff, a medical epidemiologist at the U.S. Centers for Disease Control and Prevention.
Indeed, the United Nations and the State Department have cited mortality numbers compiled by Mr. Roberts on previous conflicts as fact — and have acted on those results. …
… Mr. Roberts’s first survey in Congo, in 2000, estimated that 1.7 million people had died over 22 months of armed conflict. The response was dramatic. Within a month, the U.N. Security Council passed a resolution that all foreign armies must leave Congo, and later that year, the United Nations called for $140-million in aid to that country, more than doubling its previous annual request. Later, citing the study, the State Department announced a pledge of an additional $10-million for emergency programs in Congo.
(I recall that the Columbia Journalism Review also published a post-mortem of reporting on the 2004 report and concluded journalists screwed the story because they don’t understand statistics. However, this article is not online and I’m not sure what issue it was in — probably early 2005, but I don’t have it handy.)
A big reason the 2004 report was bashed was that The Lancet rushed to publish it before the 2004 election. (Contrary to rumor, the article did go through peer review before publication.) The VRWC Media Machine used that fact to bash the study as “political” and get it discredited (by people who either didn’t understand statistics or who hadn’t read the report, or both). And now they’re gearing up to “debunk” the new study the same way.
This time, however, the Washington Post is a little more careful about the experts it quotes. From today’s story by David Brown:
Ronald Waldman, an epidemiologist at Columbia University who worked at the Centers for Disease Control and Prevention for many years, called the survey method “tried and true,” and added that “this is the best estimate of mortality we have.”
This viewed was echoed by Sarah Leah Whitson, an official of Human Rights Watch in New York, who said, “We have no reason to question the findings or the accuracy” of the survey.
“I expect that people will be surprised by these figures,” she said. “I think it is very important that, rather than questioning them, people realize there is very, very little reliable data coming out of Iraq.”
Of those deaths, Brown reports,
A little more than 75 percent of the dead were men, with a greater male preponderance after the invasion. For violent post-invasion deaths, the male-to-female ratio was 10-to-1, with most victims between 15 and 44 years old.
Gunshot wounds caused 56 percent of violent deaths, with car bombs and other explosions causing 14 percent, according to the survey results. Of the violent deaths that occurred after the invasion, 31 percent were caused by coalition forces or airstrikes, the respondents said.
The percentage of Iraqis killed by coalition forces is declining, because Iraqis have stepped up and are killing each other at more robust rates.
Juan Cole comments (emphasis added):
This study is going to have a hard ride. In part it is because many of us in the information business are not statistically literate enough to judge the sampling techniques. Many will tend to dismiss the findings as implausible without a full appreciation of how low the margin of error is this time. Second, it is a projection, and all projections are subject to possible error, and journalists, being hardnosed people, are wary of them.
The New York Times report has already made a serious error, saying that deaths in the Saddam period were covered up. The families interviewed knew whether their loved ones were disappearing in 2001 and 2002 and had no reason to cover it up if they were. The survey established the baseline with a contemporary questionnaire. It wasn’t depending on Iraqi government statistics.
Another reason for the hard ride is that the Republican Party and a significant fraction of the business elite in this country is very invested in the Iraq War, and they will try to discredit the study. Can you imagine the profits being made by the military-industrial complex on all this? Do they really want the US public to know the truth about what the weapons they produce have done to Iraqis? 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?
Then Anthony Cordesmann told AP that the timing and content of the study were political. But is he saying that 18,000 households from all over Iraq conspired to lie to Johns Hopkins University researchers for the purpose of defeating Republicans in US elections this November? Does that make any sense? And, if Cordesmann has evidence that the authors and editor set their timetable for completion and publication according to the US political calendar, he should provide it. If he cannot, he should retract.
Ironically enough, the same journalists who will question this study will accept without query the estimates for deaths in Darfur, e.g., which are generated by exactly the same techniques, and which are almost certainly not as solid.
Awhile back I was production editor of some scholarly scientific and sociology journals, and the damn things were ridden with chi squares and p-values and all manner of Greek letters, and I never did understand any of the statistical stuff. So, full disclosure, I’m not one to criticize ignorance of chi squares. But the people who do understand chi squares are saying the Johns Hopkins methodology is sound. Don’t let the righties tell you otherwise.
Update: Glenn Greenwald checks out some rightie sites and notes (sarcasm alert) that “Bush followers have become overnight expert statisticians.” But as Glenn explains in an update, these and other righties who dismiss the study out of hand “do not actually understand what the study is examining.”
They (and other of the above-linked Bush followers) seem to be laboring under the misunderstanding that the 650,000 death toll is the number of Iraqis who have died violent deaths since our invasion. That is not what the study is purporting to measure. The study is comparing the mortality rate of Iraqis during the time of our occupation (including deaths by any cause, such as disease, famine, or anything else) to the mortality rate prior to the occupation, and based on the post-invasion increased mortality rate (13.1 deaths per 1,000 persons post-invasion versus the pre-war 5.5 figure), calculates that more than 650,000 Iraqis have died during the occupation than would have died during the same time frame in the absence of the invasion.