LONDON Oct 28, 2004 — A
survey of deaths in Iraqi households estimates that as many as 100,000
more people may have died throughout the country in the 18 months after
the U.S. invasion than would be expected based on the death rate before
There is no official figure for the number of Iraqis
killed since the conflict began, but some non-governmental estimates
range from 10,000 to 30,000. As of Wednesday, 1,081 U.S. servicemen
had been killed, according to the U.S. Defense Department.
The researchers of The Lancet report concede that the
data they based their projections on were of "limited precision," because
the quality of the information depends on the accuracy of the household
interviews used for the study. The interviewers were Iraqi, most of
The study, conducted by researchers at Johns Hopkins
University, Columbia University and the Al-Mustansiriya University
in Baghdad, is being published Thursday on the Web site of The Lancet
The survey indicated violence accounted for most of the
extra deaths seen since the invasion, and air strikes from coalition
forces caused most of the violent deaths, the researchers wrote in
the British-based journal.
"Most individuals reportedly killed
by coalition forces were women and children," they said.
To conduct the survey, investigators visited 33 neighborhoods
spread evenly across the country in September, randomly selecting clusters
of 30 households to sample. Of the 988 households visited, 808, consisting
of 7,868 people, agreed to participate in the survey. At each one they
asked how many people lived in the home and how many births and deaths
there had been since January 2002.
The scientists then compared death rates in the 15 months
before the invasion with those that occurred during the 18 months after
the attack and adjusted those numbers to account for the different
Even though the sample size appears small, this type
of survey is considered accurate and acceptable by scientists and was
used to calculate war deaths in Kosovo in the late 1990s.
The investigators worked in teams of three. Five of the
six Iraqi interviewers were doctors and all six were fluent in English
In the households reporting deaths, the person who died
had to be living there at the time of the death and for more than two
months before to be counted. In an attempt at firmer confirmation,
the interviewers asked for death certificates in 78 households and
were provided them 63 times.
There were 46 deaths in the surveyed households before
the war. After the invasion, there were 142 deaths. That is an increase
from 5 deaths per 1,000 people per year to 12.3 per 1,000 people per
year more than double.
However, more than a third of the post-invasion deaths
were reported in one cluster of households in the city Falluja, where
fighting has been most intense recently. Because the fighting was so
severe there, the numbers from that location may have exaggerated the
When the researchers recalculated the effect of the war
without the statistics from Falluja, the deaths end up at 7.9 per 1,000
people per year still 1.5 times higher than before the war.
Even with Falluja factored out, the survey "indicates
that the death toll associated with the invasion and occupation of
Iraq is more likely than not about 100,000 people, and may be much
higher," the report said.
The most common causes of death before the invasion of
Iraq were heart attacks, strokes and other chronic diseases. However,
after the invasion, violence was recorded as the primary cause of death
and was mainly attributed to coalition forces with about 95 percent
of those deaths caused by bombs or fire from helicopter gunships.
Violent deaths defined as those brought about by the
intentional act of others were reported in 15 of the 33 clusters. The
chances of a violent death were 58 times higher after the invasion
than before it, the researchers said.
Twelve of the 73 violent deaths were not attributed to
coalition forces. The researchers said 28 children were killed by coalition
forces in the survey households. Infant mortality rose from 29 deaths
per 1,000 live births before the war to 57 deaths per 1,000 afterward.
The researchers estimated the nationwide death toll due
to the conflict by subtracting the preinvasion death rate from the
post-invasion death rate and multiplying that number by the estimated
population of Iraq 24.4 million at the start of the war. Then that
number was converted to a total number of deaths by dividing by 1,000
and adjusting for the 18 months since the invasion.
"We estimate that there were 98,000 extra deaths during
the postwar period in the 97 percent of Iraq represented by all the
clusters except Falluja," the researchers said in the journal.
They called for further confirmation by an independent
body such as the International Committee of the Red Cross, or the World
The study was funded by the Center for International
Emergency Disaster and Refugee Studies at Johns Hopkins University
and by the Small Arms Survey in Geneva, Switzerland, a research project
based at the Graduate Institute of International Studies in Geneva.