Seattle Researchers: Death Toll for Iraq War Likely Near Half Million

Oct 15, 2013

Seattle researchers led an effort that has produced a new estimate of war-related deaths in Iraq, finding 461,000 Iraqis have died. The study is the first of its kind to cover the entire span of the Iraq War, from 2003 to 2011.

About 60 percent died from violence, but a full 40 percent died from secondary causes that that might seem unrelated, such as heart disease and cancer. But lead author Amy Hagopian of the University of Washington’s Department of Global Health says the mayhem of war has ripple effects.

“When we invade a country, we destroy infrastructure that protects housing and water and transportation. We cause death even if we don’t shoot people,” Hagopian said.

Medical and public health systems also get degraded during wartime, and can be too overwhelmed with victims of violence to treat, say, someone’s diabetes. The team estimated those secondary deaths by calculating the expected death rate before the war and comparing it to the actual rate.

Door-to-Door in a Warzone

Hagopian collaborated with researchers from the UW’s Institute for Health Metrics and Evaluation, Johns Hopkins University, Simon Fraser University, and Al-Mustansiriya University in Baghdad.

Their data comes from a survey of 2,000 households collected by two teams of Iraqi doctors who took on the challenging door-to-door assignment in 2011.

“We made sure to have local contacts so that we were alerted to dangers. We did have a team that was shot at. There was one cluster that we skipped because of security concerns,” she said.

Still, more than 98 percent of the households agreed to participate.

An Inexact Science

The estimate comes with some statistical uncertainty, with an uncertainty interval of 48,000 to 751,000. Still, Hagopian says 500,000 is probably about right, if a bit low since many of the hardest-hit families have left Iraq and therefore weren’t there to answer the survey. The study makes what Hagopian calls a “conservative” adjustment for that out-migration.  

In any case, Hagopian says it’s crucial to get a reliable estimate of war’s human cost, in part to keep policymakers honest.

“[Politicians] don’t ever need to estimate in advance how many people they think they're going to kill. And when they don’t have to do that, they don’t have to acknowledge the real cost of deciding to invade and occupy countries,” she said.

The estimate from Hagopian’s team is higher than some previous studies that used similar methods, but lower than a few others. Estimates based on survey data tend to be significantly higher than those that use press and eyewitness accounts, such as Iraq Body Count.

The study was published in the journal PLOS Medicine.