The Lancet report

At first glance, the Lancet report extrapolating more than 600,000 violent deaths in Iraq as a result of the 2003 invasion (and about 650,000 total) seems to me incredible. At second and third glance, it still seems incredible.

This isn’t to deny there has been a terrible loss of life in Iraq in recent years– partly due to coalition actions, mostly due to vicious attacks by insurgents and militias. But (putting aside the question of methodology for a moment) the figure of 600,000 is simply not believable to me.

Is this because of a political predilection to disbelieve it? Perhaps. If the Lancet did another study matching people’s views on Iraq with their degree of belief in the 600,000 figure, I suppose there would be very few surprises.

But consider this account in Medical News Today:

In this new paper, Gilbert Burnham, John Hopkins Bloomberg University, USA, and team came to the 654,965 figure by calculating total deaths between March 2003 to June 2006, and comparing them with total deaths during January 2002 to March 2003 (before the invasion).

47 sites throughout the country were selected, each containing between 1849 households and 12,801 household members. Each household was asked about births, deaths, in-migration and out-migration between May and June 2006. When a death had occurred in a household death certificates were produced 92% of the times. The researchers did not ask household members whether the dead household members were civilians or combatants.

Of the 629 deaths reported, 87% (547) of them had happened after the invasion. This compared to 13% (82) before the invasion. The researchers concluded that the mortality rate before the invasion was 5.5 per 1000 people annually, compared to 13.3 per 1000 people after the invasion.

Then consider two comments at the end of a reasonably balanced article on the study in The New York Times.

Robert Blendon, director of the Harvard Program on Public Opinion and Health and Social Policy, said interviewing urban dwellers chosen at random was “the best of what you can expect in a war zone.”

But he said the number of deaths in the families interviewed — 547 in the post-invasion period versus 82 in a similar period before the invasion — was too few to extrapolate up to more than 600,000 deaths across the country.

Donald Berry, chairman of biostatistics at M. D. Anderson Cancer Center in Houston, was even more troubled by the study, which he said had “a tone of accuracy that’s just inappropriate.”

You don’t have to be the director of the Harvard Program on Public Opinion and Health and Social Policy to be skeptical of a report that surveys 1,849 families, tallies 547 deaths in a 39-month post-invasion period, compares it to 82 reported deaths in a 14-month pre-invasion period, and concludes that 650,000 have died who otherwise wouldn’t have. Do you?

(It would be refreshing to get some informed, thoughtful, nonideological comments on the study itself from people who know what they’re talking about.)

wardytron adds:

I’ve been wearing out my calculator trying to understand these sums. If you take the 5.5 deaths per 1,000 rate quoted in the report, then according to the figures in the CIA’s World Factbook pre-invasion Iraq had a death rate more than 2 points lower than Canada (at 7.8/1000), and just over half the rates in Germany and Sweden (10.62, 10.31). But then according to the same figures the post-invasion rate is only 5.37, which is less than half the rate for the Isle of Man, of all places, so something seems odd.

And if you take the 500,000 deaths supposedly caused by UN sanctions – which amounts to about 38,500 a year over 13 years – then based on a population of 26m that alone is 1.48 per 1,000 of population. So deduct that from 5.5 per 1,000 and it seems that Iraq pre-invasion was one of the safest places in the world, beaten only by the likes of the Gaza Strip, (of all places). With 3.8 deaths per 1,000 Gaza is more than twice as safe as Canada, and nearly three times as safe as the Isle of Man. But then, again according to World Factbook (by way of Wikipedia), life expectancy in Gaza is 71.79 compared to 80.22 in Canada. Boffins, does any of this make sense?

Update: Recommended reading: mettaculture’s comment of October 12, 1:48 pm.