Mortality after the 2003 invasion of Iraq: a cross-sectional cluster sample survey

President Bush answered a question about this study in his press conference yesterday:

source: whitehouse.gov

Q [Suzanne Malveaux CNN] Thank you, Mr. President. Back on Iraq. A group of American and Iraqi health officials today released a report saying that 655,000 Iraqis have died since the Iraq war. That figure is 20 times the figure that you cited in December, at 30,000. Do you care to amend or update your figure, and do you consider this a credible report?

THE PRESIDENT: No, I don't consider it a credible report. Neither does General Casey and neither do Iraqi officials. I do know that a lot of innocent people have died, and that troubles me and it grieves me. And I applaud the Iraqis for their courage in the face of violence. I am amazed that this is a society which so wants to be free that they're willing to -- that there's a level of violence that they tolerate. And it's now time for the Iraqi government to work hard to bring security in neighborhoods so people can feel at peace.

No question, it's violent, but this report is one -- they put it out before, it was pretty well -- the methodology was pretty well discredited (*). But I talk to people like General Casey and, of course, the Iraqi government put out a statement talking about the report.

Q -- the 30,000, Mr. President? Do you stand by your figure, 30,000?

THE PRESIDENT: You know, I stand by the figure. A lot of innocent people have lost their life -- 600,000, or whatever they guessed at, is just -- it's not credible. Thank you.

(*) This statement was untrue.

The peer reviewed survey refered to above 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.

source: A group of American and Iraqi health officials

An excess mortality of nearly 100 000 deaths was reported in Iraq for the period March, 2003 September, 2004, attributed to the invasion of Iraq. Our aim was to update this estimate.
...

In Iraq, as with other conflicts, civilians bear the consequences of warfare. In the Vietnam war, 3 million civilians died; in the Democratic Republic of the Congo, conflict has been responsible for 3

Comments

Seth says
(con credibility) some pertinant discussion at nationalreview.com.

Seth says

(?) An interview with Les Roberts (one of the authors).

Seth says

M 2006-10-12 10:07:52 [item 4649]

Who paid for it is a valid question. Follow the money is the question asked by Bob Woodward coached by deep throat in Watergate.

...

source: from page 3 of the report

...

Seth says
Some discussion here. Not enough time to evaluate it yet.

Seth says

source: The numbers do add up
In the context of the 2004 study, I was prepared to countenance another explanation: that the Iraqis were lying and systematically exaggerating the number of deaths. But in the 2006 study, death certificates were checked and found in 92% of cases.

Note that Lancet Study Methodology Gives Validation Test qutes the certificates checked as 80%. Why is there is a discrepency?

Seth says

M 2006-10-12 10:06:29 4649

Why is that not credible? It is an average over 43 months (since March 2003) of 15,232 . That's a lot of dead bodies to be hanging around. I'm sure someone would have noticed by now & pointed it out to the press without having to wait for a study.

There is a bit more deapth to this question discussed at the BBC here.

Seth says

M 2006-10-12 11:32:12 4649

... I wonder if they tried extrapolating the number of deaths in household samples say in the Bronx & South Central LA & extrapolated from there how many deaths per year happened by violence in the US what they would get?

I agree, that would be a good method of calibrating the accuracy of the method. On would need to find where census type interviews were used to determine counts where the results were also available by more accurate measurements.

Seth says
url http://www.alertnet.org/thefacts/reliefresources/116066724942.htm

Seth says

M 2006-10-12 12:21:26 4649

seth 2006-10-12 11:51:41 4649

M 2006-10-12 11:25:22 4649

Why not just count the bodies ?

Good question. Me thinks it is easily answered, but i will try to find a more definitive answer than the one i got on the top of my head.

Well, I suspect that with that many estimated dead bodies happening the researches probably didn't want to be there on the ground.

This is a count done after the fact. The bodies were not present. They would have been long ago buried or otherwise disposed of; consequently they could not have been counted directly.

source: The study in question.
Methods: Between May and July, 2006, we did a national cross-sectional cluster sample survey of mortality in Iraq. 50 clusters were randomly selected from 16 Governorates, with every cluster consisting of 40 households. Information on deaths from these households was gathered.

Read in the introduction about how the surveys were taken. My take on the serveys is that they were very similar to the way a US census is taken.

Seth says
url http://www.knoxnews.com/kns/world/article/0,1406,KNS_351_5061318,00.html

Seth says
* url http://www.csmonitor.com/2006/1013/p01s04-woiq.html

Seth says
review of press coverage url http://newsbusters.org/node/8261

Seth says
lancet comment url http://www.thelancet.com/journals/lancet/article/PIIS0140673606694920/fulltext free registration required

Seth says

source: Lancet Study Methodology Gives Validation Test
The Lancet authors report that they attempted to confirm the death reports given to them by their interview subjects. They report being able to confirm 80% of the death reports by finding official death certificates filed by local and provincial governments. This augments the credibility of this part of their methodology - if, in a war zone, 80% of your self-reports are verified by government records, the reporting you

Seth says
contains some mentions of experts agreeing with the study url http://www.mediainfo.com/eandp/columns/pressingissues_display.jsp?vnu_content_id=1003251404

Seth says

source: The numbers do add up

There will be a concerted attempt to persuade people that the statistical issues involved in this study are difficult. They aren't. The correct way to think about this is as follows:

First, don't concentrate on the number 600,000 (or 655,000, depending on where you read). This is a point estimate of the number of excess Iraqi deaths - it's basically equal to the change in the death rate since the invasion, multiplied by the population of Iraq, multiplied by three-and-a-quarter years. Point estimates are almost never the important results of statistical studies and I wish the statistics profession would stop printing them as headlines. ......

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. ... 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. ....

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.

The rest of this excellent article is well worth a read. I quote the passage above only because it gives us a good way to understand the statistics.

Seth says

source: Brian MacQuarrie of THE BOSTON GLOBE

The latest study received $90,000 from the Center for International Studies at MIT. John Tirman, the center

Seth says

"Experts" From Across Political Spectrum Pound Partisan Study on Iraqi Civilian Deaths Posted by Mark Finkelstein. Other experts will be posted later or in the findings.

Seth says

Logic in this washington post article needs to be carefully checked.

Seth says
very interesting url http://healingiraq.blogspot.com/archives/2006_10_01_healingiraq_archive.html#116071590494473034

Seth says
url http://www.stats.org/stories/how_media_lancet_iraq_oct13_06.htm

Seth says
Iraqi Fatalities: Truth and Consequences

Seth says

source: IRAQ BODY COUNT
Reality checks: some responses to the latest Lancet estimates
Hamit Dardagan, John Sloboda, and Josh Dougherty

...

Seth says

source: Why is the New York Times silent on massive Iraq death toll?
There is no legitimate, scientific basis for rejecting the findings of this survey carried out under the auspices of Johns Hopkins, one of the leading US universities. Under the direction of epidemiologists at the college

Seth says

source: ... Part II: Iraqi Death Rate May Top Our Civil War
But Will the Press Confirm It?
The press, after its initial coverage, has turned away from the shocking Johns Hopkins study which estimated 400,000 to 800,000 deaths in the Iraq war since 2003. One of the authors of the study has issued a challenge: Check out their findings in the field -- and then confirm or debunk it.

Mark de LA says

seth 2006-10-17 12:12:47 4644

Here is one article written by Tom Edsall who is refered to above ...

source: Washington Post
Grover Norquist, president of Americans for Tax Reform, said the grant-making is "corrupting."

"The danger is that any group that gets money from the government will end up serving the interests of the state rather than the constituencies they are trying to serve," he said. "The guy who writes the check writes the rules."

Seth says

source: www.sitnews.us
"The sampling is solid. The methodology is as good as it gets," said John Zogby, whose Utica, N.Y.-based polling agency, Zogby International, has done several surveys in Iraq since the war began. "It is what people in the statistics business do."

Zogby said similar survey methods have been used to estimate casualty figures in other conflicts, such as Darfur and the Democratic People's Republic of Congo.

Seth says
Finally a legitimate criticism ...

source: opinion journal
With so few cluster points, it is highly unlikely the Johns Hopkins survey is representative of the population in Iraq. However, there is a definitive method of establishing if it is. Recording the gender, age, education and other demographic characteristics of the respondents allows a researcher to compare his survey results to a known demographic instrument, such as a census.

Dr. Roberts said that his team's surveyors did not ask demographic questions. I was so surprised to hear this that I emailed him later in the day to ask a second time if his team asked demographic questions and compared the results to the 1997 Iraqi census. Dr. Roberts replied that he had not even looked at the Iraqi census.

And so, while the gender and the age of the deceased were recorded in the 2006 Johns Hopkins study, nobody, according to Dr. Roberts, recorded demographic information for the living survey respondents. This would be the first survey I have looked at in my 15 years of looking that did not ask demographic questions of its respondents. But don't take my word for it--try using Google to find a survey that does not ask demographic questions.

Iow, include questions of known results to calibrate the study. Why was this not done?

Seth says
This is not strikly on topic because it does not shed any light on the truth of the study. However it does put the figures in a human perspective ...

source: neurotic Iraqui wife: The Smile of Victory...

... read the whole article. Iraqui lives are important. The cost of this excursion in Iraqui lives should be accurately tallied. There is too much difference between 30,000 and 600,000 to ignore. If the sample size was not sufficeint, then the US government should pay to increase it. If the methadology was flawed, then the best methodology should be found. But we need to know. Not for the election, but for our own conscience.

Sorry, i find your dismissal of this report as just "not credible", Mr President, insufficient.

Mark de LA says
If you are interested in getting to the truth of the matter look for some useful questions in this article, presumably an interview with Gilbert Burnham on the study. Lots of questions are raised in the comments on the article - both pro & con. Personally I don't think you can do this kind of study accurately in a war zone in a time of war where chaos reigns. Furthermore, the number is meaningless without some demographics on the people killed & the people who killed them.

Mark de LA says

seth 2006-10-21 09:46:11 4649

M 2006-10-21 09:37:56 4649

Your statement

source: ... I realize that Star Trek's Prime Directive is fiction. But me thinks US foreign policy should become advised of its wisdom.

... pretty much defines you as an isolationist - which you previously claimed you weren't. If you just count dead bodies (which this study did NOT do) you probably would have said that the 214,000 deaths in Hiroshima & Nagasaki to end the Pacific war with Japan was a bad idea.

Your consistent refusal to be interested in the demographics of the victims & the victimizers destroys any belief that I would have in your interest in getting to the truth of this matter.

Mark, i have anwsered every single point you raise above in previous comments ... yet your thinking does not start from that point ... it remains where it was before i said anything. It is as my comments in dialogue to you are totaly ignored. Well then this is not dialogue. This is shouting at each other. It is talking past each other. For me it has no value.

Yep, ditto. That's why I am going to move on to something more fruitful!

Seth says

M 2006-10-21 09:37:56 4649

Your statement

source: ... I realize that Star Trek's Prime Directive is fiction. But me thinks US foreign policy should become advised of its wisdom.

Seth says
Yes this article sheds light on the study. The science of accessing costs of policy as measured in human lifes is a science that needs to be developed. We need this kind of accessment, and if it is done scientifically, and always done using the same methodology, then, in the future, we could be comparing apples to apples. As it happens the American people really do not know what the overall cost in human lifes our Iraq policy has entailed.

And, again, it does not matter to this study who killed who. This assessment does not measure that. It is to access the effect in lives of our involvement. I can understand that those who look on the war as a score card ... did America win a war ... can we chalk another one up for the Gipper ... did we get victory ... did we spread Freedom ... would care whether those who died were gooks or blue bloods. Sorry i do not share that view. That Bush sacrificed hundreds of thousands of Iraqi lives on the altar of American supremacy, is a shame that he will take to his grave.

I realize that Star Trek's Prime Directive is fiction. But me thinks US foreign policy should become advised of its wisdom.

Seth says

Mark 2006-10-21 09:53:23 4649

Yep, ditto. That's why I am going to move on to something more fruitful!

Good, please do.

Seth says
url http://slate.com/id/2151926 presents argument about baseline too low.

OneMo Fer d'road says
In case you missed it here is a nice piece by Victor Davis Hanson to help you get a perspective on the media circus (now with their heads firmly inserted up their election orofices) on headlines & stuff about Iraq: uri http://victorhanson.com/articles/hanson041206.html, enjoy!
(;-))

Mark de LA says

Apparently someone does keep count here. I recommend you test your self by guessing what the numbers were/are for American casualties last year (in the war) & other such numbers. Then follow the link & see how your opinions have been distorted by the mainstream media.

Seth says

M 2007-01-28 07:17:31 4649

It has been reported over and over in the media that we have just surpassed 3,000 casualties for the 4 year warin the enire war ... so averaging that out we get 750 per year. Your site reports 821 for last year. No gross distortion there.

The Iraq casualties get a bit murkey. Me thinks the Lancet report is a an overestimate probably because they used a underestimate for the starting base line. My own perceptions from the midea reports are that there are about 50 Iraqi deaths/day ... which is about 1500 per month ... wich agrees well with the icasualties.org figures. No gross distortion there.

In any case this site a good find ... i have been looking for something like this ... in particular the detailed database poiniting to the actual news reports.

Thanks.

Seth says

M 2007-01-28 07:17:31 4649

It has been reported over and over in the media that we have just surpassed 3,000 casualties for the entire war ... so averaging that out we get 750 per year. Your site reports 821 for last year. No gross distortion there.

The Iraqi casualties get a bit murkey. Me thinks the Lancet report is a an overestimates because they used a underestimate for the starting base line. My own perceptions from the media reports are that there are about 50 Iraqi deaths/day ... which is about 1500 per month ... wich agrees well with the icasualties.org figures. No gross distortion there.

In any case this site a good find ... i have been looking for something like this ... in particular the detailed database poiniting to the actual news reports.

Thanks.

Mark de LA says

Mostly the media focuses on the 3000 number rather than the average each year. In fact it may be safer to go to Iraq instead of some cities in the US. That is an average of ~800/year/150,000 troops or a rate of 533/100,000 troops. That rate is interesting compared to the abortion rate of 1600/100,000 child bearing women. Which can be interpreted that you have a greater chance of dying when coming into the world in the US than you do of dying as a soldier in Iraq. Said another way: soldiers die in Iraq at a lesser rate than mothers kill their unborn children in the US!

Seth says

M 2007-01-28 17:24:55 4649

soldiers die in Iraq at a lesser rate than mothers kill their unborn children in the US!

A better comparison is the number of innocent people who died in the twin towers. Bush's war is starting to make that tradagy look pretty small ... especially if you also count the innocent Iraqi. Iraq is a terrible place to have to live compared to say Seattle. Listen to what some of the people who must live there say about how they feel ... here is one place to start. Trying to minimize the pain is just a way to make more of it possible. If some of this pain was touching closer to home, i would hazzard a guess that you would not have such a bullshit attitude twards it.

Mark de LA says

seth 2007-01-28 18:57:31 4649

M 2007-01-28 17:24:55 4649

soldiers die in Iraq at a lesser rate than mothers kill their unborn children in the US!

Well maybe some day you or some asshole who has participated in an abortion will get the chance to feel the pain of being aborted!

Seth says

M 2007-01-29 05:55:59 4649
"Every story, if continued long enough, ends in death."
--Ernest Hemingway

Read this for a better perspective.

Mark de LA says

I have no fear of an alien ideology at ALL! What I am concerned with is a mass hypnotism of a population to the point that they can no longer think for themselves - who daily blow themselves up & those who are not hypnotized their way. I am concerned that that mass-hypnotized population is now daily threatening to wipe out an entire country (Israel) AND the West in the name of their Radicalizing-hypnotizing god.

... is there anyone that can still think for themselves out there ?

Seth says

M 2007-01-29 16:55:37 4649

It takes no guts to be a pacifist. You really don't have to do anything except open your mouth, run around & scream & shout! (Armchair liberals need not do even that.) Anyone can oppose that has no responsibility for the outcome; no authority to change it; nothing but Rodney King ideas; and no stakes in the game. You still missed comments & probably did not read [Capitulation: item 5871] - it puts things in perspective.

Yep, 5871 puts the war in the perspective of your fear of alien ideology. What's frightening is you right wingers, who have no responsibility and no authority to effect the outcome, and continue to sit in your armchirs and jerk off about killing Muslems under the red white and blue banner of "the war on terror". What's frightening is that you are being played by the war profiteers and don't even know it. Which takes more guts ? ... to jack off over a dream of Victory ... or to shout that this is a BULL SHIT WAR !!!

Seth says

M 2007-01-29 09:40:18 4649

, is killing people all that bad? If you have no religion and no ethics (mostly derived from religious perspective) & are a materialist as long as you survived you probably would say no.

You don't need to believe in religion to choose that murder is a crime. That ethos is based upon empathy and the golden rule. I do not want to live in a world where human life is devalued such that people casually propose that " killing people is not all that bad".

the left want the US to lose!

... not true. People opposing a continuation of our Iraq incursion do so because we should never have started it, and should stop it at the earliest possible time. There is no hard evidence that redeploying our troops will not deescalate the violence. Once you have coded the strategic choices in terms of win-and-lose, you have already defined a zero-sum Right-Wrong game.

I wonder what it will be like when the suicide bombers come to our shores or, already being here, begin preparations for the 12th Imam. Remember, as you ponder how nice Ahmadinejad is, that it is OK in his mind at least to lie to infidels.

This thought really needs to be completely seaprated from the Iraq incursion. Otherwise you are implying that our incursion in Iraq has something to do with preventing future 9-11 type attacks. That assumption has been pretty well debunked. But if you are conserned about preventing radiological attacks on our soil you should take the idea and dialogue presented in 4909 seriously. Invading soverign countries, making enemies all over the world, and being a global bulley is just making such attacks more probable.

Mark de LA says

I guess (using your crude words) it takes more guts to jack-off your lost dreams of the glory days of your 60's radical, Hanoi-Jane, US-hating, leftist ideology.

. For a pacifist, you seem to escalate to hate rhetoric rather fast.

(Hitler?)

Seth says

M 2007-01-30 06:47:52 4649

I don't see how that is thinking for yourself ... i call that parroting the neocon party line.

Seth says

104 die from sectarian violence in Iraq on the last day of Ashura ... mostly Shia against Sunni. Perhaps there would have been more had the US not defeated the "Soldiers of Heaven" who were planning to attack worshipers in in Najaf. Or at least that is the official story ... the problem is we do not know if is true or not ...

source: UPI

But the authoritative Baghdad daily Azzaman and an Iraq website report that the story is a cover up for an unpremeditated massacre.

Patrick Cockburn of the London Independent writing from Baghdad called the official account "a fabrication."

The official version of the incident says Iraqi soldiers battled members of the messianic cult who were planning to disrupt the Shiite holy festival of Ashura. However, independent reports indicate the fighting occurred when members of the Hawatim tribe, on their way to the celebrations in Najaf, were attacked by Iraqi soldiers.

The report from Baghdad says a clash broke out between the Shiite tribe members on a pilgrimage to Najaf and an Iraqi army checkpoint, when Iraqi soldiers fired on a car killing the tribe's chief, his wife and their driver.

The tribesmen are reported to have retaliated by attacking the Iraqi military checkpoint. The Iraqis, claiming they were under attack from al-Qaida called for U.S. support.

... This has not been getting a lot of press that i have seen. At this point i don't know what to believe. Perhaps i will make a item and track it.

Seth says
There is more analysis re the Azzaman interpertation of the Najaf battle here. Apparently Azzaman is a Sunni dominated news outlet. If i were to have to guess now, i would guess that the official versions is a better truth than the Azzman version. Here is some more information from the LA Times. Nobody else is even talking about the Azzman version.

Mark de LA says

& yet another sobering statistic on deaths ~1200 people die of cigarette caused illnesses each day in the United States -EACH DAY according to the American Cancer Society. That eclipses the average number of deaths to American soldiers each year of the war so far in Iraq! That IS preventable.

Why is not Congress upset at that ? Oh! that's because they get lots of taxes & legal fees from law suits .

Seth says

seth 2007-02-01 00:34:39 4649

your stastics don't do it for me ... your wasting your time.

Let me be a bit more specific. My current interest in civilian deaths in Iraq is so that i will be aware of the effect to the Kegan plan and General Petrais's implementation of that plan ... these stastics need to be looked at over a period of years ... there were 43 yesterday. Your posting about cigarette deaths does not inform my study, that is the sense in which you are wasting your time.

Mark de LA says

Of course not, you are looking for the "statistical lies" that support your Bush is wrong argument (in your terms "script"). Proportonality is not in your script. The leftist, anti-war crowd is not interested in "death" per se, nor human misery. If they were interested in deaths they would look at war deaths in proportion to all deaths. If they were interested in human misery they would look at all human misery (look at Africa for example). I realize why you are not interested.

I just wonder if you know why you are not interested.

Seth says

M 2007-02-01 08:01:42 4649

Of course not, you are looking for the "statistical lies" that support your Bush is wrong argument (in your terms "script").

Actually that is not true. I'm looking for an extensionl method of measureing the violence in Iraq. I have no idea whether in two years those casualities will go down or not. If they go down, then the Kegan plan will have been vindicated.

Proportonality is not in your script.

Proportonality should always be in any script. This study is not writing a script ... it is tracking a script that has been put in progress.

The leftist, anti-war crowd is not interested in "death" per se, nor human misery. If they were interested in deaths they would look at war deaths in proportion to all deaths. If they were interested in human misery they would look at all human misery (look at Africa for example). I realize why you are not interested.

I just wonder if you know why you are not interested.

Why do you always think the worst of my motives?

Seth says
Alexandra Zavis of the Los Angeles Times reported to the Assyrian International News Agency reported that "At least 2,067 Iraqis were killed in insurgent and sectarian violence in January, according to figures compiled by the ministries of Defense and Health." This is about half of the Iraquis casualties reported here. Why?

Seth says

Here is a chart of all the people killed in Iraq in January. One wonders what the escalation of violence in January after the announcement of the plan fortells? There is some analysis of it here.

Seth says

source: The Independent
British government officials have backed the methods used by scientists who concluded that more than 600,000 Iraqis have been killed since the invasion, the BBC reported yesterday.

The biggest question i have with the Lancet study is the base line.

Mortality after the 2003 invasion of Iraq: a cross-sectional cluster sample survey

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