As many as 654,965 more Iraqis may have died since
hostilities began in Iraq in March 2003 than would have
been expected under pre-war conditions, according to a
survey conducted by researchers at the
Johns Hopkins Bloomberg
School of Public Health and Al Mustansiriya University
The deaths from all causes — violent and
nonviolent — are over and above the estimated 143,000
deaths per year that occurred from all causes prior to the
March 2003 invasion.
The estimates were derived from a nationwide survey of
1,849 households throughout Iraq conducted between May and
July 2006. The results are consistent with the findings of
an October 2004 study of Iraq mortality conducted by the
Johns Hopkins researchers. Also, the findings closely
reflect the increased mortality trends reported by other
organizations that utilized passive methods of counting
mortality, such as counting bodies in morgues or deaths
reported by the news media. The study is published in the
Oct. 12 online edition of the peer-reviewed scientific
journal The Lancet.
"As we found with our previous survey, the majority of
deaths in Iraq are due to violence, although we also saw a
small increase in deaths from nonviolent causes such as
heart disease, cancer and chronic illness. Gunshots were
the primary cause of violent deaths. To put these numbers
in context, deaths are occurring in Iraq now at a rate more
than three times that from before the invasion of March
2003," said Gilbert Burnham, lead author of the study and
co-director of the Bloomberg School's
Refugee and Disaster Response.
"Our total estimate is much higher than other
mortality estimates because we used a population-based,
active method for collecting mortality information rather
than passive methods that depend on counting bodies or
tabulated media reports of violent deaths," he said.
"Though the numbers differ, the trend in increasing numbers
of deaths closely follows that measured by the U.S. Defense
Department and the Iraq Body Count group."
Key points of the study include the following:
An estimated 654,965 additional
people died in Iraq between March 2003 and July 2006.
A majority of the additional
deaths (91.8 percent) were caused by violence.
Males aged 15 to 44 years
accounted for 59 percent of post-invasion violent
About half the households surveyed
were uncertain who was responsible for the death of a
The proportion of deaths
attributed to coalition forces diminished in 2006 to 26
Between March 2003 and July 2006,
households attributed 31 percent of deaths to the
Mortality data from the 2006 study
reaffirms 2004 estimates by Johns Hopkins researchers and
mirrors upward trends measured by other organizations.
establishment of an international body to calculate
mortality and monitor health of people living in all
regions affected by conflict.
The mortality survey used well-established and
scientifically proven methods for measuring mortality and
disease in populations. These same survey methods were used
to measure mortality during conflicts in the Congo, Kosovo,
Sudan and other regions.
For the Iraq study, data were collected from 47
randomly selected clusters of 40 households each. At each
household selected, trained Iraqi surveyors collected data
on the number of births and deaths that occurred in the
household between Jan. 1, 2002, and June 30, 2006. To be
considered a household member, the deceased had to have
lived in the home at least three months prior to death.
When interviewers asked to see a death certificate at
households reporting a death, it was presented in 92
percent of instances. The survey recorded 1,474 births and
629 deaths among 12,801 people surveyed. The data were then
applied to the 26.1 million Iraqis living in the survey
While the survey collected information on the manner
of death, the study did not examine the circumstances of
the death, such as whether the deceased was actively
involved in armed combat, terrorism or criminal activity or
was caught in the middle of the conflict. The study
outlines other limitations of the survey method, including
the hazards of collecting data during a conflict.
The results from the new study closely match the
finding of the group's October 2004 mortality survey. The
earlier study, also published in The Lancet, estimated that
more than 100,000 additional deaths from all causes had
occurred in Iraq from March 2003 to August 2004. When data
from the new study were examined, 112,000 deaths were
estimated for the same time period of the 2004 study.
The new survey also found that the number of deaths
attributed to coalition forces had declined in 2006, though
overall households attributed 31 percent of deaths to the
coalition. Responsibility could not be attributed in 45
percent of the violent deaths.
According to the researchers, the overall rate of
mortality in Iraq since March 2003 is 13.3 deaths per 1,000
persons per year, compared to 5.5 deaths per 1,000 persons
per year prior to March 2003. This amounts to about 2.5
percent of Iraq's population having died as a consequence
of the war. To put the 654,695 deaths in context with other
conflicts, the authors note that during the Vietnam War an
estimated 3 million civilians died overall, the Congo
conflict was responsible for 3.8 million deaths, and recent
estimates are that 200,000 have died in Darfur over the
past 31 months.
The study was written by Burnham, Riyadh Lafta,
Shannon Doocy and Les Roberts. Funding was provided by the
Massachusetts Institute of Technology and the Johns Hopkins
Center for Refugee and Disaster Response.