Psyche, Science, and Society

Les Roberts on new Iraq mortality study

January 10th, 2008

Les Roberts, an author of the two previous Lancet studies of Iraq mortality,  sends the following comments on the new Iraq mortality study, the Iraq Family Health Survey, that I blogged about last night:

I think that this new article in the NEJM is a good addition to the discussion. It is good for Iraqis, it is good for science, it is good for promoting peace.

1) There is far more in common in the results than appears at first glance.

The NEJM article found a doubling of mortality after the invasion, we found a 2.4 fold increase. They found a CMR of 3/1000/yr. before and 6 after but thought they were missing almost 1/2 the deaths. We found a CMR of 5 before and 13 after….thus we actually agree roughly on the number of excess deaths. The big difference is that we found almost all the increase from violence, they found 1/3 the increase from violence.

The other odd items (family size, refusal rates, absentee household rates, fraction of deaths from infectous diseases and car accidents…) are strikingly similar.

IBC adds to their estimate for months after a given date; back at the end of June 2006, IBC estimated 41,000 deaths (my notes suggest 38,475 to 42,889 on June 24, 2006). This new estimate is 4 times the “widely accepted” number of that moment, our estimate was 12 times higher. Both studies suggest things are far worse than our leaders have reported.

2) There are reasons to suspect that the NEJM data had an under-reporting of violent deaths.

The death rate they recorded for before the invasion (and after) was very low….lower than neighboring countries and 1/3 of what WHO said the death rate was for Iraq back in 2002.

The last time this group (COSIT) did a mortality survey like this they also found a very low crude death rate and when they revisited the exact same homes a second time and just asked about child deaths, they recorded almost twice as many. Thus, the past record suggests people do not want to report deaths to these government employees.

We confirmed our deaths with death certificates, they did not. As the NEJM study’s interviewers worked for one side in this conflict, it is likely that people would be unwilling to admit violent deaths to the study workers.

They roughly found a steady rate of violence from 2003 - 2006. Baghdad morgue data, Najaf burial data, Pentagon attack data, and our data all show a dramatic increase over 2005 and 2006.

Finally, their data suggests 1/6th of deaths over the occupation through 6/06 were from violence. Our data suggest a majority of deaths were from violence. All graveyard reports I have heard are consistent with our results.

I hope these comments are helpful. I hope people in the press will visit a few  graveyards/morgues/hospitals and decide if 1/6th or over 1/2 of the deaths during the period 2003-06.

Best regards,

Les Roberts

Entry Filed under: Iraq, Mortality, Public Health, Research Methods