George W. Bush made news last year when he said that 30,000 Iraqis -- "more or less" -- have died as a result of the U.S. war and ongoing violence in Iraq.
Try "more."
A study conducted by the Johns Hopkins Bloomberg School of Public Health and published in the British medical journal the Lancet concludes that 655,000 more Iraqis have died since March 2003 than would have died if the United States had not invaded their country. The researchers, working with funding from MIT's Center for International Studies, say that about 600,000 of these deaths were the result of violence. The remaining 55,000 were the result of disease or other nonviolent causes.
How large a number is 655,000? It's equal to about 2.5 percent of Iraq's total population. If 2.5 percent of Americans were killed in a war here, the death toll would be an unimaginable 7.4 million.
The study's results will be controversial. The researchers didn't count 655,000 bodies or death certificates to get to their numbers. They used a method called "cluster sampling." They interviewed people in a sampling of 1,849 households across Iraq, and they extrapolated their results from information they gathered on the 629 Iraqi deaths about which they learned in those interviews. Critics will inevitably claim that you can't base such huge numbers on such small ones -- and we're sure to hear almost immediately (what time does Rush Limbaugh's show start?) that John Hopkins, MIT and the Lancet somehow conspired with Democrats to release this information less than a month before the midterm congressional elections.
The researchers acknowledge that their estimates are "far higher" than those derived through what they call "passive surveillance measures." They argue, however, that "passive surveillance measures" have proved, over time, to be less accurate than the "cluster sampling" method. "Data from passive surveillance are rarely complete, even in stable circumstances, and are even less complete during conflict, when access is restricted and fatal events could be intentionally hidden," they write. "Aside from Bosnia, we can find no conflict situation where passive surveillance recorded more than 20 percent of the deaths measured by population-based methods. In several outbreaks, disease and death recorded by facility-based methods underestimated events by a factor of ten or more when compared with population-based estimates."
Moreover, the researchers say, their results conform to the estimate of 100,000 deaths they made after a similar study in 2003 and 2004 and with news reports and government tallies showing that the Iraqi death toll has increased dramatically over the course of the past year. Boston University researcher Paul Bolton, who has reviewed the study, tells the Wall Street Journal that the researchers' methodology was "excellent" and represents the standard procedure for such work. "You can't be sure of the exact number," Bolton says, "but you can be quite sure that you are in the right ballpark."
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