The New England Journal of Medicine has published an estimate of the number of deaths of Iraqi since its invasion by the U. S. in 2003:
On the basis of direct reporting of deaths by households respondents that were adjusted for missing clusters, it was estimated that the violence-related rate of death from March 2003 through June 2006 was 1.09 per 1000 person-years (95% CI, 0.81 to 1.50). About half of the violent deaths were estimated to have occurred in Baghdad, and virtually all such deaths occurred in the southern and central regions.
Overall mortality from nonviolent causes was about 60% as high in the post-invasion period as in the pre-invasion period. Although recall bias may contribute to the increase, since deaths before 2003 were less likely to be reported than more recent deaths, this finding warrants further analysis.
During the same period, the Iraq Body Count registered 47,668 civilian deaths from violence. A much smaller mortality survey (1849 households in 47 clusters) by Burnham et al. came up with a best estimate of 601,027 violent deaths. The best estimate on the number of deaths from March 2003 through June 2006 based on the IFHS data analysis and comparisons with other sources is three times as high as that reported by the Iraq Body Count but only one fourth of that reported by Burnham et al. On the basis of simulations that took into account survey sampling errors and estimated probable uncertainty in the adjustment factors for missing clusters, in the level of underreporting, and in projected population figures, we estimated that there were 151,000 violent deaths in Iraq during this period (95% uncertainty range, 104,000 to 223,000). Although this number is substantially lower than that estimated by Burnham et al., it nonetheless points to a massive death toll in the wake of the 2003 invasion — and represents only one of the many health and human consequences of an ongoing humanitarian crisis.
The number at which this study arrives is double that of Iraq Body Count and a quarter of that produced by the much-discussed Lancet study. Judging by the description of the methodology used to prepare this estimate, I think it’s best understood as a refinement of the number provided by Iraq Body Count or, more specifically, if Iraq Body Count is wrong in its geographic distribution of deaths, then this study may overestimate or underestimate the actual casualty count.
To place the numbers in perspective the overall death rate from all causes in Iraq during the period studied is roughly 6.01 per 1,000. The overall death rate in neighboring countries is 2.6 per 1,000 in Jordan, 4.9 per 1,000 in Syria, and 5.5 deaths per 1,000 in Iran.
Although 6.01 per 1,000 is significantly lower than the number found in the Lancet study the death rate in Iraq is still high. It would be interesting to see a disaggregation of the death rate directly due to American forces from the rate at which Iraqis are killing each other but I doubt that reliable numbers will ever be determined.
Other than the deaths themselves the worst thing (at least to me) is that even though it’s pretty clear that the Lancet study, which estimated the number of deaths directly attributable to U. S. forces as greater than the total number of violent deaths found in this new study, was flat wrong, its results will be taken as canonical, particularly in the Middle East. The harm has already been done; there’s no way to undo it.