Death rates and death certificates

by Daniel on October 12, 2006

Look, can we knock these two on the head, please, gang? I realise that we have no chance of stamping out these fallacies all over the internet – it’s almost as if there were a whole network of right-wing talking points sites out there all taking in each other’s washing! – but we can at least stop regurgitating them ourselves.

1. Iraq is a young country. Therefore, it has a low “crude” death rate. “Crude” in this case means “not adjusted for demographic structure and therefore not meaningfully comparable across countries”. Therefore, it is not surprising that pre-war Iraq had a crude death rate similar to that of Denmark, any more than it is surprising that any other two completely non-comparable statistics might happen to be the same number.

2. When someone dies, you get a death certificate from the hospital, morgue or coroner, in your hand. This bit of the death infrastructure is still working in Iraq. Then the person who issued the death certificate is meant to send a copy to the central government records office where they collate them, tabulate them and collect the overall mortality statistics. This bit of the death infrastructure is not still working in Iraq. (It was never great before the war, broke down entirely during the year after the invasion when there was no government to send them to and has never really recovered; statistics agencies are often bottom of the queue after essential infrastructure, law and order and electricity). Therefore, there is no inconsistency between the fact that 92% of people with a dead relative could produce the certificate when asked, and the fact that Iraq has no remotely reliable mortality statistics and quite likely undercounts the rate of violent death by a factor of ten.

Go on and sin no more, or at least not on our Lancet comments threads.

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1

Donald Johnson 10.12.06 at 2:52 pm

Some of us had the death certificate inconsistency (or “inconsistency”) in good faith. It’s the one obvious point to make if you sit down and try to imagine reasons why this study might be wrong. (I then tried to figure out how the inconsistency could arise and fraud seemed to be the only answer.)

But anyway, it’s just another armchair objection.
People who don’t believe this study should be demanding that the government support an independent investigation by human rights groups and statisticians to finally settle the matter. Oddly enough, I haven’t seen any of the rightwing objectors urging this, but I’ve no doubt this is an oversight on their part that will soon be corrected.

2

Donald Johnson 10.12.06 at 2:54 pm

Death certificate inconsistency objection in good faith, that is. Preview is my friend, but I treat him so badly.

3

Jane Galt 10.12.06 at 2:56 pm

Daniel, my impression is that the UN goes to the other hospitals and asks them for their death certificates. Do you have information to the contrary, or is this “Theoretically, this is how the Lancet study could be right?”

4

John Emerson 10.12.06 at 2:57 pm

Awhile back I read about a case in India where a man had been declared dead by his inlaws, and had to spend several years in court proving that he wasn’t.

The dead Iraqis are unlikely to get lawyers to get included in the stats. Perhaps we should set up a fund for them to do that.

5

P O'Neill 10.12.06 at 3:04 pm

statistics agencies are often bottom of the queue after essential infrastructure, law and order and electricity)

Which makes it especially insane that aid agencies and donor countries all try to flood into post-conflict countries with grand plans for reconstruction, all based on no bleedin’ data! Is there any other field where so much is spent based on so little information? (obviously there are areas where much is spent despite information that the spender has chosen to ignore). But it never sounds good for someone to pipe up at the donor conference and say “how about a few quid for the central statistics agency?”

6

soubzriquet 10.12.06 at 3:09 pm

Wasn’t the UN study based on Iraqi health ministry numbers? Jane seems to be suggesting that the UN did an exhaustive survey of hospitals in Iraq, but I don’t remember a survey with that methodology (not that I’ve been watching it as carefully as I probably should… quite plausible I missed it). Even this would obviously give an undercount, but I don’t know how well the error could be estimated.

7

Jane Galt 10.12.06 at 3:16 pm

Even the numbers in Baghdad, which should be reliable since the death certificates are right there! in the building where they were issued! show the Lancet grossly overcounting deaths.

8

Sven 10.12.06 at 3:21 pm

grossly overcounting deaths

Come again?

9

MQ 10.12.06 at 3:26 pm

“Jane Galt” seems to be trying to set some kind of propaganda record for a single comments thread. Here’s the reply by the Lancet authors (from this paper: http://web.mit.edu/CIS/pdf/Human_Cost_of_War.pdf) to the various attempts to obfuscate their findings using the hopelessly incomplete numbers from the Iraqi health ministry:

The Ministry of Health in Iraq has published some numbers from time to time, but these are generally considered to be unreliable. The registration of deaths in Iraq has been an organized process for many years. Death certificates have traditionally been obtained for the deaths of all adults and older children. Death certificates are required for insurance claims, compensation, payment of benefits, and for burial. Cemeteries do not take bodies for burial without certificates. If deaths occurred outside of hospital, the bodies would be transported to the general hospital for the certificate to be issued. If there were doubts about the cause of death, a post-mortem examination would be carried out before issuing a certificate. Copies of the death certificates would go to the national offices managing vital registration. This process has continued through the current conflict, with death certificates being required for burial, and with information from certificates being duly recorded. However, the tabulation of data from registration of deaths in Iraq has suffered from the chaos of the current conflict. Beyond this, there is also a suspicion that records of death, particularly related to violent deaths, is being manipulated and only partially being released for various political reasons. Even with the death certificate system, only about one-third of deaths were captured by the government’s surveillance system in the years before the current war, according to informed sources in Iraq. At a death rate of 5/1,000/year, in a population of 24 million, the government should have reported 120,000 deaths annually. In 2002, the government documented less than 40,000 from all sources. The ministry’s numbers are not likely to be more complete or accurate today.”

10

Sebastian Holsclaw 10.12.06 at 3:40 pm

So wouldn’t it be better technique to collect the data from the hospitals directly?

11

Steve 10.12.06 at 3:51 pm

Note that Juan Cole apparently doesn’t agree with you.

“Where are the bodies?”

This is a good question but according to Juan Cole, there’s a good answer: there are two major reasons that most bodies never pass through a morgue: (i): Muslim tradition demands that bodies are buried the day of the death in a simple wooden box, so there’s natural resistance and, (ii) while there are incentives for taking bodies to the morque to counteract this, they’re overwhelmed by the fact that the government is so infiltrated with death-dealing militias at this point that nobody wants to put their name on any sort of government form if they can help it.

http://www.juancole.com/2006/10/655000-dead-in-iraq-since-bush.html

Juan says there are no bodies because people are afraid to take bodies to the authorities.
Daniel says, Juan is wrong-there are bodies-and local government knows all about it-but the federal government doesn’t.

“When someone dies, you get a death certificate from the hospital, morgue or coroner, in your hand. This bit of the death infrastructure is still working in Iraq. Then the person who issued the death certificate is meant to send a copy to the central government records office where they collate them, tabulate them and collect the overall mortality statistics. This bit of the death infrastructure is not still working in Iraq.”

How do you know all this?

Sk

12

JR 10.12.06 at 3:53 pm

Sebastian-

13

Daniel 10.12.06 at 3:54 pm

my impression is that the UN goes to the other hospitals and asks them for their death certificates

the numbers in Baghdad, which should be reliable since the death certificates are right there! in the building where they were issued!

So wouldn’t it be better technique to collect the data from the hospitals directly?

I think that people may be misunderstanding the issues here. Iraq is in a state of complete anarchy. It is not a place where you can just rock up to the hospitals, smile at the receptionist and pick up a neat manila folder full of the week’s death certificates. Even if anyone had the resources and armed guard necessary to carry out this little fantasy, they would use them for something else.

14

stostosto 10.12.06 at 3:57 pm

Regarding crude death rates, the World Bank posts some numbers at its web site. Iraq´s is put at 9 for 1990; 10 for 1995; n.a. for 2000; and 9 (italicised, presumably to indicate uncertainty) for 2004.

This compares to an average for the Middle East and North Africa of 8 (1990) and 6 (2004).

But if we look at Iraq’s immediate neighbours, we get (for 2004):

Turkey: 6
Syria: 3
Jordan: 4
Saudi Arabia: 4
Kuwait: 2
Iran: 5
It would appear that the Lancet estimate of 5.5 for 2002 is quite different from the World Bank’s estimates — but at the same time it is much closer to the general level of the region in which Iraq is located.

(Btw, I checked Brazil and Mexico as well, and this source differs from the numbers given by poster sebastian holsclaw — they’re much lower, at 7 and 5 than what he reports (around 10 for both, as should be expected for countries with younger populations)).

15

John Emerson 10.12.06 at 3:57 pm

I’ll just continue to make be an asshole on this thread.

I understand that many here make their livings in some area of the the social science biz or the data biz, and this is how you like to talk about things. In the same way, I imagine that classical musical world knows what’s going on with the Baghdad symphony today, and the zoo people have the word on the Baghdad zoo. Great. So if statistics is your thing, this has been another chance to show your stuff.

Nonetheless, are the numbers decisive in any way? We seem to be arguing about a factor of four, maybe six (except for Soru, who believes that the Iraquis are actially better off now.) Granted that statistics, symphonies, and zoos are always important to people in concerned with them, is the difference between 100,000 and 600,000 at all important from our point of view ? Is there some kind of thershold between the two numbers?

Sure, 600,000 is a Quantitative Fact, but does having that fact tell us anything we couldn’t already know without the Fact?

Everyone paying moderately close attention has a lot of scattered, mostly qualitative information informing them that a LOT of people are getting killed in Iraq. There’s other information telling us that many normal functions (e.g. electricity) have been distrupted for years. We know since Rice’s visit that planes can’t routinely land safely in the airport. Reporters keep coming back and telling us that it’s much worse than we think. And so on.

None of the plausible interpretations or suggested revisions of the study really change the qualitative reality of what’s happening in Iraq.

16

Sebastian Holsclaw 10.12.06 at 4:05 pm

“I think that people may be misunderstanding the issues here. Iraq is in a state of complete anarchy. It is not a place where you can just rock up to the hospitals, smile at the receptionist and pick up a neat manila folder full of the week’s death certificates. Even if anyone had the resources and armed guard necessary to carry out this little fantasy, they would use them for something else.”

Ok, this is where I have a problem. It is too chaotic for people to go to hospitals (which have a discrete small number) but they can do a household survey? That is the kind of thing that makes me skeptical.

17

JR 10.12.06 at 4:05 pm

Sebastian- A sample of hospitals is not useful in determining death rate that can be scaled up to the total population – even assuming that they have good records and that the officials in charge would let you see them – because you have no idea how many people use a given hospital. So you would have to collect the data from every single hospital in the country. With households, you can determine the average number of deaths per household, and the average number of people per household, and scale up to the size of the population. Read the study, especially the section on study design – it’s not that hard to understand.
http://web.mit.edu/cis/pdf/Human_Cost_of_War.pdf

18

Sebastian Holsclaw 10.12.06 at 4:07 pm

stostosto, I had already made a correction on the Mexico numbers. (on the other thread) :)

19

John Emerson 10.12.06 at 4:07 pm

Ok, this is where I have a problem. It is too chaotic for people to go to hospitals (which have a discrete small number) but they can do a household survey? That is the kind of thing that makes me skeptical.

See, we’ve fallen into the trap. Because Iraq is in chaos, we have no way of knowing that things are very bad there. No data, just anecdotal information. Your guess is as good as mine, really.

20

Sebastian Holsclaw 10.12.06 at 4:14 pm

“because you have no idea how many people use a given hospital.”

Is that really an unsolveable problem? Heck by focusing on large cities you don’t have to ‘scale it up’. You can get a hard number for discrete areas. The number might not be as flashy as 600,000, but you could say things like: in hot spots like Baghdad and Fallujah X hundred thousand people were killed. Since we all accept that the killing are clumpy, why not focus on getting really accurate numbers out of the clumps instead of crappy numbers that you can ‘scale’ up.

21

Cryptic Ned 10.12.06 at 4:15 pm

I notice that all the comments here about Part 2 of the post. This may be because Part 1 is unclear. Because of Davies’s normally crystal-clear writing style, I spent about five minutes wondering what my problem was that I had no idea what Part 1 was talking about. I was trying to figure out why Iraq being a young country had anything to do with its crude death rate being low.

Eventually I realized that “Iraq is a young country” should be read as “Iraq has a young population” (implying that its people, because young, are less likely to die of natural causes in a given year), rather than “Iraq was founded relatively recently” (implying that it doesn’t have a good records-keeping infrastructure or something like that).

22

Brownie 10.12.06 at 4:20 pm

Daniel,

Then the person who issued the death certificate is meant to send a copy to the central government records office where they collate them, tabulate them and collect the overall mortality statistics. This bit of the death infrastructure is not still working in Iraq.

What sources do you have for this? I’ve no doubt it is true to some extent, but to what extent?

I’m also far from convinced about what you presuppose is the inherent mortal danger attached to asking hospitals to produce the copies and records that presumably they have kept, if not submitted to central government.

I’m not a right-wing nutter and I’ve been careful to say little or nothing about statistical models – I’m simply not qualified. But I don’t think it’s going out on a limb to suggest that the Ministry of Interior, for example, when producing their mortality figures, asked hospitals and morgues for their input. In fact, we know they did. So unless the argument is that hospitals are issuing certificates without retaining a copy and/or recording the issue, or deliberately concealing this data, the disparity in the latest Hopkins figures and those produced elsewhere remains unexplained to any satisfactory degree.

As per Hopkins, at least 80% of deaths are certified (92% of 87%). So 80% of deaths are certified, but as of 2 days ago, nobody knew anything about 9/10ths of them.

You don’t have to be an inveterate decent to be unconvinced.

23

JR 10.12.06 at 4:20 pm

“That is the kind of thing that makes me skeptical.”

I don’t understand. You don’t have any reason to believe that this study is invalid, you just think that they should have done a different study. A perfectly good response to a scientific article is: here’s a result, let’s see if we can confirm the results with a different study. But you seem to be saying, There could be more than one way to study this, therefore this way must be invalid and probably fraudulent.

24

Sebastian Holsclaw 10.12.06 at 4:24 pm

“There could be more than one way to study this, therefore this way must be invalid and probably fraudulent.”

No, I’m saying that a study which implies a civilian death rate higher than Germany during WWII deserves a skeptical eye since we aren’t, you know, firebombing cities.

25

Cryptic Ned 10.12.06 at 4:27 pm

No, I’m saying that a study which implies a civilian death rate higher than Germany during WWII deserves a skeptical eye since we aren’t, you know, firebombing cities.

But there wasn’t a civil war going on in Germany during WWII. Unless you count “Ubermenschen vs. Untermenschen”.

26

John Emerson 10.12.06 at 4:27 pm

I realize that I’m being annoying, but anyway.

What we seem to have established today is one or all of three things.

1.) Some people have a pure, non-political interest in the Iraq war primarily as an object upon which to practice statistical method.

2.) Some people think that while 600,000 extra dead might be regarded as awful, if that number were lower by a factor of five or so, that would be non-awful. And it’s awful if things are awful.

3.) Some people, for whatever reason, want us to talk about statistical methods rather than the Iraq War.

27

Charlie Whitaker 10.12.06 at 4:30 pm

Guardian piece was great, by the way.

28

Donald Johnson 10.12.06 at 4:30 pm

I suspect that one place where falsification would take place would be at point where someone might think “If I tell the truth I might be killed.” We already know that people have deliberately falsified death statistics or simply stopped reporting them.

BTW, it’s at home, but I have a book on Vietnam which mentioned how something similar happened there. The official figures for the number of cases of some disease (I think it was bubonic plague) was actually lower than the number of cases in the files of one particular hospital. I should check the details later.

I’m a numbers fetishist myself, but John Emerson does have a good point. Iraq is a total disaster and we don’t need exact death tolls to know this.

But I’ve got my own good point which I intend to beat into the ground–any rightwinger who criticizes the Lancet numbers and doesn’t call for an independent investigation fully supported (but not run in any way) by our government is someone who is more interested in suppressing bad news than in finding the truth. The US has just been accused of causing more deaths than have occurred in Darfur–apparently it’s enough just to point out why this may not be true.

The Lancet authors, to their great credit, have called for such a study twice. Too bad their critics could not care less.

29

stostosto 10.12.06 at 4:34 pm

One thing I have been wondering about in trying to picture how the survey was conducted, is the number of households surveyed per day.

1,849 houselholds were surveyed over a period from May 20 to July 10. That works out at around 36 households per day. If we allow the researchers two weekend days off per week, it is 50 households per day. They were two teams, so each team would visit 25 household in a day.

If a working day is 8 hours, that’s around 3 households an hour, or 20 minutes per household.

Hm. I wonder, what’s the norm in this sort of work?

30

spartikus 10.12.06 at 4:34 pm

It is too chaotic for people to go to hospitals

Perhaps relevant:

Iraqi Hospitals Are War’s New ‘Killing Fields’

In growing numbers, sick and wounded Sunnis have been abducted from public hospitals operated by Iraq’s Shiite-run Health Ministry and later killed, according to patients, families of victims, doctors and government officials.

As a result, more and more Iraqis are avoiding hospitals, making it even harder to preserve life in a city where death is seemingly everywhere. Gunshot victims are now being treated by nurses in makeshift emergency rooms set up in homes.

31

Michael Paleologus 10.12.06 at 4:37 pm

Let’s just perhaps take another example where there is a vast discrepancy between passive reporting systems and active surveillance: estimating the size of the AIDS epidemic. Case report systems, even with the strictest compulsory notification in place, under-estimate HIV cases by factors from 2 to 10 or even 20. The situation is even worse with reports of cause of death. That means that those who are serious about making estimates of the size of the population affected do careful sample or sentinel surveillance and come up with estimates which tend to be far larger than those captured under the passive surveillance systems, but over time have been found to be ‘more or less’ correct – the more and the less coming from the series of assumptions necessary in extrapolating the sample to the whole population.

Of course, AIDS case and AIDS death reporting is affected by stigma which is taken to cause much of the under-reporting, although a lot is also due to the inherent weaknesses of passive data collection systems. But it does not seem implausible to me that the lack of government in Iraq is at least as powerful a disrupter of completeness in reporting as is stigma in AIDS, ergo, I find nothing unremarkable in a big gap between statistically valid sample-based surveillance, and reported mortality numbers.

32

John Emerson 10.12.06 at 4:37 pm

Spartikus gives us more evidence that Iraqi statistics are no good, and that things might be perfectly all right there!

33

stostosto 10.12.06 at 4:45 pm

Emerson:

I don’t know why you feel it is unimportant whether the body count is 200,000 or 600,000. After all that’s 400,000 people we are talking about.

Besides, an actual number surely tells us something about the intensity of the Iraqi chaos. The comparison with Darfur has been made. You could equally compare with the Congo (the numbers of which I don’t have to hand).

Is the Iraqi death rate higher than that of Germany’s during WWII? Or is it only a quarter that?

I think that’s valuable information, worthy of a lot of painstaking nitpicking.

34

Daniel 10.12.06 at 4:50 pm

I’m also far from convinced about what you presuppose is the inherent mortal danger attached to asking hospitals to produce the copies and records that presumably they have kept, if not submitted to central government.

Simply walking around Iraq exposes you to mortal dange. This is sort of the point. There are citations in the study (and more in the “Human Cost” paper) for how the reporting system has been broken down. It’s not a matter of anything sinister; it’s just that if you’re working in a hospital in Iraq these days, you almost certainly have better things to do than respond to Ministry of the Interior requests for data. Making sure that people file their statistical returns on time is the most thankless job on Earth – nobody ever thinks it’s important and the clerks have no power at all. And that’s in the UK, which is not a war zone.

Regarding how I know that Iraq uses this system, I know it because everywhere uses it, because it is the only possible way to get a register of deaths & marriages to work. Deaths need to be certified quickly, so that the body can be dealt with, but to tabulate and collate them at the same speed would require a ludicrously disproportionate amount of resources.

35

Sebastian Holsclaw 10.12.06 at 4:59 pm

“Deaths need to be certified quickly, so that the body can be dealt with, but to tabulate and collate them at the same speed would require a ludicrously disproportionate amount of resources.”

Couldn’t you just make it a Sarbanes-Oxley requirement? :)

36

BruceR 10.12.06 at 5:02 pm

Brownie:

As mentioned in another thread, it’s documented that the Iraqi health ministry figures for civilian deaths in Anbar province in all of July, 2006 was exactly zero. Nil. Nada. Zip. The UN assumed this was because any figures were impossible to retrieve under the current conditions there, and footnoted the numbers they cited in their report accordingly.

I think we can assume the total deaths in that province, at least, was somewhat more than that. The hospital/morgue count is an undercount: can we concede that much?

37

John Emerson 10.12.06 at 5:04 pm

Jesus F Christ, I’m not talking about killing 400,000 people. I’m saying that for most of our purposes, “far, far too many” is as exact a number as we need, and that the study’s lower bound is “far too many”, and haf that or a quarter that would still be “far too many”.

If anyone here is involved in Iraqi demographics, Iraqi funeral planning, etc., my words do not apply to you.

38

John Emerson 10.12.06 at 5:07 pm

I do not see the point of pretending to compare mushy numbers from Iraq with mushy numbers from Darfur and mushy numbers for the Congo. This is pushing Bush’s fuzzy math to the limit/

39

Cryptic Ned 10.12.06 at 5:11 pm

And that’s in the UK, which is not a war zone.

And you say the flypaper strategy hasn’t worked!!!

40

BruceR 10.12.06 at 5:13 pm

While we’re at it, can we also all stop referring to the 600K violent deaths or 650K excess deaths in the Lancet as “civilian deaths?” The Lancet paper does not make either claim.

41

Jon 10.12.06 at 5:41 pm

brucer:

While we’re at it, can we also all stop referring to the 600K violent deaths or 650K excess deaths in the Lancet as “civilian deaths?”

Yes. This seems to be Sebastian’s misunderstanding, above:

I’m saying that a study which implies a civilian death rate higher than Germany during WWII deserves a skeptical eye since we aren’t, you know, firebombing cities.

Sebastian takes the Lancet estimated death rate for everyone in Iraq, which is maybe 2.5%. Then he compares it to the civilian death rate for Germans during WW II, which was maybe 2.6%. The correct comparison, of course, is to the total German death rate, military and civilian (and death camp), which was 10.8%. (Germany numbers taken from Wikipedia.)

42

MQ 10.12.06 at 6:21 pm

Sebastian, you have consistently been misquoting numbers on e.g. German death rates in WWII.

I followed this debate on the earlier study too, and so far the only reasonable criticisms of the study raised have been: A) recall bias might be greater for pre-war deaths, and B) deaths and casualties include insurgents, not just civilians. Everything else has just been a version of “I refuse to believe this, because I am committed to my own preconceptions over empirical evidence”.

43

Barry 10.12.06 at 6:21 pm

“No, I’m saying that a study which implies a civilian death rate higher than Germany during WWII deserves a skeptical eye since we aren’t, you know, firebombing cities.”

Posted by Sebastian Holsclaw ·

Sebastian, can’t you come up with some fresh talking points? That’s far from original.

44

David Kane 10.12.06 at 6:46 pm

Daniel writes:

When someone dies, you get a death certificate from the hospital, morgue or coroner, in your hand. This bit of the death infrastructure is still working in Iraq.

Could you provide a citation for this claim? Something on-line would be great. But if this was something told to you by, say, a reporter just returned from Iraq, that would be good to know.

The reason I ask is that this seems somewhat inconsistent with accounts that I have read in places like Fiasco. The claim is that in many areas of Iraq (e.g., Falluja, Ramadi) there is/was no local government to speak of for long periods of time. There was no coroner or morgue to hand out death certificates.

I just want to understand the facts better.

Also, can you clarify why everyone keeps death certificates? I have read that the certificates entitle one to various benefits. Is that true? If so, is there any reason to suspect that some certificates are issued fraudulently?

Again, I highly doubt that these issues affect the overall tenor of the results, but details are good to know.

45

Brownie 10.12.06 at 7:00 pm

The hospital/morgue count is an undercount: can we concede that much?

Undoubtedly. The fact remains, Hopkins finds that 80% of deaths are certified. I can accept that some of these certifications never see the light of day. But Hopkins also finds that between October 2004 – July 2006, 543,000 excess deaths have occurred (655,000-112,000 for the Mar 2003 – Sep 2004 period). This works out at a daily excess death rate of 822.

So 822 Iraqis are dying each day, of which approximately 658 are certified (80%). Yet as of 3 days ago, people were talking in terms of maybe 250 deaths per day. Meaning hospitals and morgues have been certifying 2-and-a-half times as many deaths as the least conservative estimates for the last 22 months.

It doesn’t mean Hopkins is baloney, but any objective observer should be forgiven for being sceptical.

Not that I’m objective…

46

Barry 10.12.06 at 7:24 pm

Start with posts 30 and 31, Brownie. Then read 34 and 36.

47

Brownie 10.12.06 at 7:35 pm

barry,

What next?

48

soubzriquet 10.12.06 at 7:45 pm

No, Brownie, you are clearly not objective.

But you also miss the point. There are lots of numbers floating around about the casualty rates (amongst other things) in Iraq. That doesn’t mean that all the numbers are equivalent and can be meaningfully compared.

First off, you have laughable numbers like the `30,000′ that the president is still repeating. This is a political number, though, and shouldn’t be taken at all seriously (why? because it doesn’t bear up under the slightest scrutiny).

Now we also have numbers like the IBC’s ~50,000. This is not even claimed an estimate of the total civilian deaths, let alone an estimate of the total excess deaths. What it is is a pretty solid number of verified civilian deaths. By nature this is an undercount, and their methodology doesn’t have anything to say meaningfully about about the amount of undercount.

Finally, you have numbers like the lancet study or the ~250/day number you quote.

We can forget the political numbers, of course. Of the others, you have to be careful first off to make sure they are counting the same things. Many people in the last couple of days have said stupid things about the comparison between IBC numbers and the lancet study.

Given that you have two numbers actually talking about the same thing, you can attempt a comparison. Here is where the thing about objectivity comes in. I’m not sure you actually understand this, so I’m going to spell it out. The objective thing to do when presented with two significantly different estimates is not to say `wow, how could the new estimate be so much larger, it can’t be right’. That’s simply nonsense. The thing to do is say `hmmm, one or both of these estimates is wrong. Lets look at the methods used and see if we can’t understand why’.

Yelling loudly that we can’t possibly have had ~750 d/day in Iraq and not seen it in the news isn’t evidence. That’s a bald faced assertion. Coming from the average north american keyboard commando who can just about find Iraq on a map in a pinch it also looks pretty stupid.

The fact of the matter is we don’t know. Even the people who *ought* to know best what’s going on over there have a pretty sketchy idea. So all we can do is look at the methodology of these estimates and try and see which is a better approach. This is why nobody can expect precise numbers. The best we can hope for is accurate numbers — and the nature of doing measurements in Iraq today means the intervals are going to be large. Period.

As it is right now, the overwhelming majority of the objections I’ve seen to the Lancet numbers boil down to wishful thinking. There are a few interesting questions about methodology, but nothing devestating. Other questions which rightly belong to a larger scale discussion of the methodology, not this study (regardless of the validity of the methodological comments).

That you don’t want the numbers to be this high constitutes no serious objection.

Can you offer a serious objection to the methodology? Can you offer any serious argument that another estimate has significantly better methodology? Or are you going to be like thousands of other jokers offering `i can’t believe..’, ‘clearly…’, ‘obviously the morgues in Baghdad’, ‘surely the media…’ and other mindless speculation about the day to day reality in country you can barely imagine, and a lot of effort has been spent to keep you fairly ignorant about?

so?

49

Marc 10.12.06 at 7:52 pm

Brownie, the real issue is the complete breakdown of civil society in Iraq. There are death squads in hospitals. Suicide bombs at funerals. Kidnapping is endemic and murder of kidnap victims is common. There is a shooting war, and with 3000 US dead (and an unusually low kill:wound ratio) there is almost certainly a high insurgent-to-coalition death rate.

Add all of these things up, and the possibility of a large casualty undercount by the usual methods is entirely possible. My main reservation is related to the clumpy nature of violent deaths and its correlation with neighborhood and ethnicity, which could skew statistical sampling. This can be difficult to quantify properly.

50

Charles Giacometti 10.12.06 at 8:02 pm

I have not read the study, so I can’t claim whether it is valid or not. See, that is how reality works. You actually read something before you decide if it is wrong or right.

Yet I’m willing to bet “Jane Galt” and most of the wingnut “critics” didn’t even read the study. I’m willing to bet that the few wingnuts who did read it simply don’t understand most of (or any) of the statistical concepts. Yet this doesn’t stop these people from declaring the results “false.” Since when is such willful stupidity acceptable?

Over on Jane Galt’s blog, one of her commenters suggests the peer reviewers should be shot. I bet that person didn’t read the paper either. Just a hunch.

51

John Emerson 10.12.06 at 8:17 pm

Jesus, I was just over at Galt’s. It was a Rorschach test of conservatarian posturing. “To me that looks like…. leftists epidemioligist bias!”

52

soubzriquet 10.12.06 at 8:27 pm

As against the usual rarified discourse there?

53

Eli Rabett 10.12.06 at 8:29 pm

Gee you guys really fell off the carrot truck. OK, loved one dies (maybe by electric drill to the brain, lead poisoning, or one of the other popular methods). You don’t dare take him to the hospital or morgue because then they will know you are one of those and put you into the drill press. You know, or more likely your second cousins wife’s brother knows someone who works in the hospital and has access to a a stack of death certificates, complete with seal.

You need a death certificate. You give your second cousin 200 euros. He gives his wife’s brother 150 E. The brother gives 100 to his friend and back comes the death certificate. Everyone is happy (ok satisfied.)

54

John Emerson 10.12.06 at 8:41 pm

Soubzriquet, now I remember why I haven’t been there for a year.

55

engels 10.12.06 at 9:51 pm

Over on Jane Galt’s blog, one of her commenters suggests the peer reviewers should be shot.

Well, yeehaw! That’s how you settle a disagreement that good ole’ libertarian way. Intellectual debate is for girly men.

56

Twill00 10.12.06 at 10:00 pm

Hmmm. Numbers seem suspiciously similar to the last Lancet pre-election volley. Which was debunked by the UN by a factor of 4.

One suggestion – (1) Compare the number of people killed in a single car bomb to the number maimed or injured to a lesser degree. (In typical combat it’s about ten to one.) (2) Do a random sample of people in the areas that are hardest hit, and find out what percentage have minor injuries and what percentage have none. (3) Compare the numbers. If the numbers show about a fifth (or less) of the injuries that would be projected by the number of alleged deaths, then look for the biases that are increasing your supposed death rate.

If you can’t show that your numbers are reasonable in, say, Baghdad or Basra, then they couldn’t possibly be reasonable in Iraq as a whole.

57

Steve 10.12.06 at 10:21 pm

The 2004 report was hardly “debunked” by the UN report, which measured a different statistic. To the extent the two studies can be compared on an apples-to-apples basis, the UN report confirms the Lancet study. See here.

58

charles s 10.12.06 at 10:22 pm

re comment 11:

steve,

Daniel is right and Juan Cole is wrong.

How do I know this? Juan is explaining something that doesn’t need explaining, and his explanation directly contradicts the study he is defending. 90+% of those asked could produce death certificates, so there is no need to explain why they didn’t have death certificates (which is what Juan goes on to do). Daniel instead explains why those death certificates don’t reliably make it into the central list. No one has offered any evidence to counter Daniel’s claim that the official system of data collection is broken (and multiple people have offered support for his claim – 0 deaths in Anbar province?).

That bugged me about Juan’s post when I first read it. If I didn’t hate blogger’s commenting system I would have pointed this out there.

59

Ragout 10.12.06 at 11:14 pm

I’m still waiting to hear a defense of the study’s conclusion that there was little, if any, increase in the non-violent death rate. This is very hard to believe, given the well-documented public health disaster in Iraq (crumbling hospitals, failing sanitation, etc.).

While I think the qualitative conclusion of this study is right (hundreds of thousands of excess deaths), I don’t think it’s a particularly good study, and I think y’all ought to be careful about exagerating its virtues.

The concern troll has spoken.

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James 10.12.06 at 11:19 pm

Re #29
One thing I have been wondering about in trying to picture how the survey was conducted, is the number of households surveyed per day.

1,849 houselholds were surveyed over a period from May 20 to July 10. That works out at around 36 households per day. If we allow the researchers two weekend days off per week, it is 50 households per day. They were two teams, so each team would visit 25 household in a day.

If a working day is 8 hours, that’s around 3 households an hour, or 20 minutes per household.

Hm. I wonder, what’s the norm in this sort of work?

Do you have a link to this information? I have the methodological appendicies, but it doesn’t seem to have this material.

I’ve been in market and social research for 25 years and I find the figures quoted above difficult to believe for door-to-door fieldwork, particularly given the desperate conditions reported in the report’s appendix.

61

jl 10.13.06 at 12:04 am

If the goal of the study had been to estimate the percentage of deaths in Iraq for which death certificates had been issued, their data would yield a point estimate of 91%. Applying that to the actual number of death certificates issued yields a mortality estimate in the neighborhood of 50,000 or 60,000, which matches other studies (e.g. IBC) reasonably well.

The researchers, on the other hand, observed the sample mean of 91% and concluded that the population percent is highly likely to be less than 10%.

The defense of this conclusion given above is that a very large proportion of the issued death certificates are not being recorded. But this is hypothesis, not evidence. It is also a relatively easy hypothesis to test. The Johns Hopkins team could have taken the proffered death certificate data, compared them with official records and tallied the percent that are missing. They didn’t take that step, so they provide no evidence to either support or reject the under-recording hypothesis.

Until someone takes that step we have a study whose data appear to support two conflicting conclusions. One of those conclusions comes fairly close to other estimates (albeit derived in a very similar manner) and the other differs by something like an order of magnitude.

It is neither unreasonable to conclude that the Lancet case has thus not been conclusively made, nor to conclude that leaving this significant contradiction unexamined is a serious shortcoming of the study.

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Brownie 10.13.06 at 1:17 am

Yelling loudly that we can’t possibly have had ~750 d/day in Iraq and not seen it in the news isn’t evidence. That’s a bald faced assertion. Coming from the average north american keyboard commando who can just about find Iraq on a map in a pinch it also looks pretty stupid.

soubzriquet, these exchanges only work if each party deals with the things the other has actually said. You appear to have me confused with someone else.

FWIW, there are plenty of discussions about the methodology taking place all over the internet, involving people far more qualified to comment than I am. I could cut and paste their commentary and pass it off as my own if that would make you feel better? Also FWIW, one of the main criticisms I’m hearing is not that the study definitely *is* flawed, rather that its potential to be flawed (systemic sample bias, for example) is not sufficiently acknowledged by the authors. Yes, caveats are given, but in the main, the authors convey an air of surety that the nature of the methodology in the circumstances the study was undertaken should disallow: a little too much grandstanding and not enough humility.

Additionally, if you can go to YouTube and watch a video of Horton venting his spleen at an anti-war rally, suspicions are going to be raised, justifiably or not. Horton has every right to do this and more, but if you are seriously looking to avoid the controversy that surrounds your work, it’s probably not a good idea. Grist to the mill, and all that.

I believe there is at least *something* to be said for observable facts and I think you are a little too quick to discount some of the reasonable concerns being voiced e.g. death certificates. We’re told that it’s too dangerous to go to hospital to count death certificates, but it’s not too dangerous that 80% of Iraqis are going to hospitals to get deaths certified. If Hopkins is right, 658 deaths are being certified in Iraq each day, yet previous estimates of the dead don’t get anywhere near that figure. Yes, I’ve read the explanations on this thread as to why that may be the case, but I’m still not convinced. Whether that’s because I’m not prepared to be convinced or because the explanations themselves – for which no facts are being presented so far as I can tell – are less than convincing, is something I’m sure we can argue about.

Your position appears to be that unless you try to unpick the Hopkins methodology and/or embark on your own study, you have little or no right to comment. This is palpably absurd. Unqualified, statistically illiterate dissenters criticizing sampling techniques is one thing, raising questions that the Hopkins figures either prompt or do nothing to address, is quite another.

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Steve 10.13.06 at 2:00 am

It really doesn’t matter whether it’s dangerous to go to the hospital, etc. The point is that the vast majority of families actually surveyed in this study were able to produce physical death certificates. They must have come from somewhere.

You can certainly theorize that there are a lot of fake death certificates or something – and then test that theory – but they apparently do exist, in large numbers, absent the possibility of actual fraud in the data collection process. You have to deal with this fact.

64

Daniel 10.13.06 at 2:58 am

a little too much grandstanding and not enough humility.

A little too much grandstanding and not enough humility in the study! Mote and beam, sir, mote and beam!

James: a team consisted of two male and two female interviewers. They say that they did one cluster of 40 households a day so your 20min number looks about right, but I bet they split into two teams of two so more like 30-40 mins.

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Brownie 10.13.06 at 3:57 am

Daniel,

I don’t know how many interviews with Horton you’ve heard in the last few days, but he does a very good job of presenting these figures not just as the best estimate we have, but as likely to enjoy a high degree of accuracy. You know these are not the same thing.

Further, it’s not as if Horton restricts himself to presenting the figures, rather he is simply bursting with advice about foreign policy. Everyone is entitled to an opinion, for sure, and everyone is entitled to draw conclusions about the opinions of others and the appropriateness of those opinions with regard to time and place.

Whatever the degree to which you share Horton’s view of the situation in Iraq, do you not accept that less of the mud being thrown at the Hopkins study would stick were it not for Horton’s clearly and frequently expressed political views? Indeed, do you not accept that fewer people would be so quick to dismiss the study altogether?

Horton has, in my view, unnecessarily politicized the study. Which is not to say that it wouldn’t have been politcized without the additional commentary, just that his non-academic contributions have undoubtedly complicated matters.

66

Brownie 10.13.06 at 4:11 am

Dan, can you clear up one point for me, perhaps? The link to the study I’ve been using is:

http://i.a.cnn.net/cnn/2006/images/10/11/human.cost.of.war.pdf

There is only one mention of certificates:

“We are certain that households did not report deaths which did not occur, as 92% of households had death certificates for deaths they reported.”

Firstly, my understanding is that the certificate question was asked only 87% of the time and 92% of the respondents claimed to have death certificates. What is not clear is whether the certificates were physically presented. Or if it is clear, I’ve completely missed that reference. Do you know?

67

bi 10.13.06 at 4:22 am

Brownie, you’re by your own admission not objective, and you’re not a statistician, Now by your own criteria that means we’re allowed to sling mud at you. So will you just shut up and let us sling mud at you?

68

Matthew 10.13.06 at 4:29 am

That’s not the only reference in that link.

There’s:

At the conclusion of the interview in a household where a death was reported, the interviewers were to ask for a copy of the death certificate. In 92% of instances when this was asked, a death certificate was present.

69

Lopakhin 10.13.06 at 4:39 am

Eli Rabatt: Gee you guys really fell off the carrot truck. OK, loved one dies (maybe by electric drill to the brain, lead poisoning, or one of the other popular methods). You don’t dare take him to the hospital or morgue because then they will know you are one of those and put you into the drill press. You know, or more likely your second cousins wife’s brother knows someone who works in the hospital and has access to a a stack of death certificates, complete with seal.

You need a death certificate. You give your second cousin 200 euros. He gives his wife’s brother 150 E. The brother gives 100 to his friend and back comes the death certificate. Everyone is happy (ok satisfied.)

Out of interest, why you need a death certificate? (I think this was asked earlier in the thread.) And 200 Euros is a fair whack to pay for one of them, so is there some incentive for having one? (Presumably, compensation or insurance related.)

70

Matthew 10.13.06 at 4:42 am

There’s the proper report here as well – somehow that link gets around the Lancet’s registration

http://www.thelancet.com/webfiles/images/journals/lancet/s0140673606694919.pdf

71

Brownie 10.13.06 at 4:42 am

Matthew,

Thanks, my search didn’t throw that up for some reason. I hope you don’t think I’m being obtuse if I say that “a death certifcate was present” is still open to some interpreation i.e. was it “present” in that the families in question said they had one, or was it physically presented? My bet is the latter but definitive clarification would be good.

So will you just shut up and let us sling mud at you?

bi, the day you catch me trying to unpick the Hopkins methodology, you’d be entitled to throw as much mud my way as you can muster.

72

Steve Sailer 10.13.06 at 4:51 am

The death toll seems not all that implausible considering the enormous number of bullets the US military has fired in the last few years, perhaps a billion per year more than the annual rate in 2000.

Still, the more I think about the mechanics of carrying out the survey on the street without getting killed, the more I suspect that the Iraqi interviewers didn’t actually implement the purely random survey design that the American professors from MIT and Johns Hopkins dreamed up for them. It would be nuts to to let luck determine which streets you’d choose, as the report claims they did. You’d want to only go where you knew you’d be safe. Then you’d tell the Americans you did exactly what they told you to do.

It could be that the interviewers got in contact ahead of time with neighborhood leaders to see if their presence would be welcome to reduce their chances of being killed. (That’s not good random surveying hygiene, but are you going to blame them?) Then, in a neighborhood where the local big shot wanted their presence, he might have passed the word around to aggrieved families to get ready to tell their stories to the interviewers when they showed up. This could cause a bias upward in the number of deaths reported. Or you could theorize scenarios where methodological issues would depress the death count.

The overall point, however, is that nobody else appears to be doing this kind of study because it is so hideously dangerous, which ought to tell us something.

More analysis is necessary, but, after a few hours of kicking the tires, these numbers don’t strike me as obviously implausible. I wouldn’t put tremendous confidence in them either, though, due to the savage conditions under which this heroic effort was carried out.

73

Lopakhin 10.13.06 at 4:55 am

That comment looked better in the preview. I swear.

74

soru 10.13.06 at 5:16 am

You’d want to only go where you knew you’d be safe. Then you’d tell the Americans you did exactly what they told you to do.

The thing is, if this is true, it would, counter-intuitively, almost certainly lead to an overcount in deaths.

The surveyors were doctors from Baghdad, who had published papers under the previous regime, and so by the standards of modern day Iraq probably count as Baa’thist. By that I am not saying anything about their politics, or accusing them of bias, just pointing out that people like them have been explicitly targetted for ‘revenge’ killings, so they are not disinterested neutrals.

Consequently, they would be least safe in Kurdistan or the south, the areas other sources indicate to be the safest now, and most violent pre-war.

This is backed up by the fact the survey reports no violent deaths in 2002, when press reports show a civil war was ongoing in the north, and that the northernmost and southermost provinces in the country were explicitly not sampled.

The real relevance of this is not to score points as to who is right or who is wrong, but to assess the current situation in Iraq, and what is to be done going forward.

In particular, if the grim picture painted by the survey is right, then the ugly but only alternative would be to keep troops in the country for the indefinite future to keep a lid on the violence until it burns out.

In contrast, if other reports are more accurate, then a withdrawl is possible, according to this kind of plan.

Please don’t let annoyance with some statistically illiterate Bushoid be too much of the determining factor on what you think should actually be done between now and the next US election.

Because after the election will be too late.

75

Daniel 10.13.06 at 5:35 am

Lophakin: yep, you need the death certificate to get the body buried and to claim on life insurance, get bank accounts closed, establish probate, all the grisly business. (I suspect that overworked Iraqi undertakers might be stretching a point these days, but life assurers, never).

Brownie:

Whatever the degree to which you share Horton’s view of the situation in Iraq, do you not accept that less of the mud being thrown at the Hopkins study would stick were it not for Horton’s clearly and frequently expressed political views? Indeed, do you not accept that fewer people would be so quick to dismiss the study altogether?

Frankly no. I remember when people were rubbishing IBC as “absurdly high”. There is no way to portray the deaths of half a million people in a politically neutral way. I also note that the death counts in Darfur have not exactly been presented in a politically neutral way and nobody plays this kind of game with them.

At present, I think that the only critique which can’t be immediately dismissed as hackery is the one which Johan on the Harry’s place comments made; that the numbers-on-a-map method of geographical selection is new and hasn’t been field tested to see how it compares to “GPS grid” (used in the 2004 survey) and “pen-toss” (used in a lot of Roberts’ previous work). I don’t believe that there actually is a reason to believe that numbers-on-map would introduce a big upward bias, but it’s a sensible point. I think that the attempt to smear the Iraqi doctors as Sunnis and Ba’athists who obviously made the numbers up is just disgusting.

76

Brownie 10.13.06 at 5:58 am

There is no way to portray the deaths of half a million people in a politically neutral way.

I think there is. Moreoever, if you are the editor of a medical journal that you know will shortly be publishing a study like this, appearing at anti-war rallies in the months before venting your spleen at Bush and Blair counts as unecessary politicization.

Again, Horton’s totally within his rights to do and say whatever he wants, but I don’t buy the notion that without the political baggage, the prospects of a more considered response to the study findings would be improved. It strikes me this ought to be entirely uncontroversial.

77

bi 10.13.06 at 6:08 am

Brownie: You don’t get it, do you? I am already entitled to sling mud at you. If Hopkins is fair game for mud-slinging just because Horton supports his study and adds some “political baggage” to it, then since you’re not neutral either (you said, “Not that I’m objective…”), that means you are also fair game for mud-slinging.

So, shut up and get lost. And get me someone who’s actually neutral and objective to criticize Lancet’s study.

78

Brownie 10.13.06 at 6:10 am

bi,

You do realise you sound like a three-year-old, don’t you?

79

Brendan 10.13.06 at 6:29 am

Well we have had literally hundreds of posts here on the Lancet study in the last few days. And yet, when all is said and done, the arguments against the study all boil down to three main points.

1: The argument from personal incredulity, much mocked (and deservedly so) by Richard Dawkins in the Blind Watchmaker. In this case it should be put ‘I, personally, having never been to Iraq, speaking no Arabic, not being a soldier, and never having been to a war zone (let alone a civil war), having no understanding of or training in statistics….I find these figures in credible! I don’t think I need to provide any more evidence than that.’

2: Dark hints about political bias, which mysteriously failed to bother them when similar studies in the Sudan and the Congo were published. (Have they checked the political affiliations of the authors of studies of excess mortality in the Congo and the Sudan? Do they care? Would they consider estimates of (e.g.) Sudanese fatalities to be grossly compromised if the authors of the relevant reports went on record as stating their opposition to murder and the actions of the Sudanese government?).

3: Arguments that it ‘doesn’t really matter’ because one opinion poll had a badly worded question that seemed to imply that a small majority of Iraqis thought it was ‘worth it’.

And that’s it. Note that most commentators don’t even bother trying to hide their political bias: the argument invariably goes ‘I found this paper emotionally unacceptable and so I went around trying to find evidence as to why it couldn’t be true’, not ‘I am a statistician and I happened to be looking through this article when…..’ etc.

80

Brownie 10.13.06 at 6:53 am

Arguments that it ‘doesn’t really matter’ because one opinion poll had a badly worded question that seemed to imply that a small majority of Iraqis thought it was ‘worth it’.

1 – I certainly didn’t claim the study “doesn’t matter” because of the response to the poll questions and I don’t recall having read such a comment from any other contributor. That’s just a flat-out misrepresentation.

2 – It’s more than one opinion poll that shows majority Iraqi support for the war. Try every opinion poll where that question or similar has been asked.

3 – “Badly worded” is entirely subjective. “Not worded the way I would have preferred” is not the same as “badly worded”.

4 – “Seemed to imply” is unnecessarily vague. The consistently positive response to the “worth it” question “clearly demonstrates” rather than “seems to imply”.

5 – “Small majority” is understating things when the smallest majority I have seen in one of these polls is a 61/39 split. “Comfortable majority” is nearer the mark.

That’s 4-and-a-half errors in one sentence. Is this a record?

81

bi 10.13.06 at 7:06 am

Brownie s3z,

You do realise you sound like a three-year-old, don’t you?

Well, to put it briefly, I believe in adjusting my style to suit the audience. I’m sure you don’t have a problem with that.

Brendan: And for some reason, political bias on their Own Side(tm) is totally OK, while political bias on the Other Side(tm) is absolutely unacceptable.

82

Barry 10.13.06 at 7:07 am

brownie, don’t worry, you still hold the record for errors. This is due more to volume than to skill, but that’s your strong point. As to ‘what’s next’, I had pointed to posts which rebutted your assertions.

83

soru 10.13.06 at 7:08 am

I think that the attempt to smear the Iraqi doctors as Sunnis and Ba’athists who obviously made the numbers up is just disgusting.

I’m seeing rather a low degree of correlation betwen that and what I actually said. Care to reread it?

84

Barry 10.13.06 at 7:11 am

Brendan, I’d add one more point to the deniers:

Having washed the memory of the Rwadan genocide:
“…was the massacre of an estimated 800,000 to 1,071,000 ethnic Tutsis and moderate Hutus in Rwanda, mostly carried out by two extremist Hutu militia groups, the Interahamwe and the Impuzamugambi, during a period of 100 days from April 6th through mid-July 1994.” (wikipedia,
http://en.wikipedia.org/wiki/Rwandan_genocide)

That 80,000 or more people per day, with machetes and (presumably) some small arms.

85

Brendan 10.13.06 at 7:12 am

“I do happen to think that the fact successive polls show majority Iraqi support for the war is relevant and I do genuinely wonder at how widely known this is.”

I have pointed out that the question that was asked was grotesquely biased. However, even in the example you quoted, the question was not in any sense ‘do you support the war?’ It was: ‘do you think it was a good thing to get rid of Saddam Hussein?’ (that’s not a precise wording, but as I’ve argued, that was the jist of it). The key point is as I’ve always argued, to view the ‘war’ (actually an invasion) and the subsequent occupation as two discrete entities which have nothing to do with each other is a fantasy: it’s like stating that the Russian liberation of Czechoslovakia and Hungary had nothing to do with the fact that these countries were then assimilated into the Russian Empire.

In other words, it is invalid to infer ‘support for the war’ from the questions that were asked. Given your somewhat wide use of the word ‘error’ I think that counts as an error.

In any case, this is all totally irrelevant to the Lancet study. Even if 100% of Iraqis thought the invasion and occupation of their country was simply peachy, it would have nothing to do with whether nearly 700,000 of them are now dead who would otherwise be alive. Which makes it even more mysterious as to why you keep on raising this point in a comment thread that is, let’s not forget, about the Lancet study.

86

Barry 10.13.06 at 7:14 am

Duh, 8,000 people per day. Still adds up to far more people than in Iraq, in a far shorter time.

87

Brendan 10.13.06 at 7:17 am

Incidentally, I’d like to apologise: apparently there aren’t 3 reasons as to why the Lancet studies (plural) couldn’t possibly be true: there are actually nine.

88

soru 10.13.06 at 7:25 am

It was: ‘do you think it was a good thing to get rid of Saddam Hussein?’

This is a simple flat lie, a straightforward and unambiguous contradiction of information directly available on this thread.

You know that, everyone reading this and paying attention knows that. Why do you feel your position is so weak you can’t defend it in any other way?

89

bi 10.13.06 at 7:30 am

soru: And what, pray, is this “information directly available from this thread” you refer to?

(Oh, and don’t give me that “if you’re open-minded enough you’ll find it yourself because I’m open-minded but I’m still not going to bother finding it” line.)

90

Brendan 10.13.06 at 7:38 am

Well it may well be a lie but it’s hardly a simple lie. The actual question asked was: ‘Thinking about any hardships you might have suffered since the US- Britain invasion, do you personally think that ousting Saddam Hussein was worth it or not?’

As I argued in the previous post, I argued that this is really a question about whether the Iraqis were pleased that Saddam Hussein was deposed or not. And the answer is of course ‘yes’ as any sane person could have predicted.

This is really rather different from Brownie’s interpretation that a majority of Iraqi’s ‘supported the war’.

[As I pointed out in the other post, this is like asking Hungarians or Czechs in 1949, "Thinking about the hardships you have suffered since the liberation of your country by the Russians, do you personally think that forcing the Germans out of your country was worth it or not?" Of course the asnwer would be 'yes it was worth it' and of course this would spectacularly miss the point].

In any case, this has, yet again, nothing to do with the Lancet study.

91

Ragout 10.13.06 at 7:39 am

I’m not sure why people give much credibility to the count of death certificates. The figures come from the Ministry of Health, which is controlled by Moktada Sadr, and is said to run death squads in the hospitals and morgues. In the past, Ministry officials have pretty much acknowledged that the figures are manipulated.
[both links require a subscription to the NY Times]

92

David Kane 10.13.06 at 7:41 am

Daniel writes:

you need the death certificate to get the body buried and to claim on life insurance, get bank accounts closed, establish probate, all the grisly business. (I suspect that overworked Iraqi undertakers might be stretching a point these days, but life assurers, never).

Again, do you have a citation for these claims? Something online would be great but if this is just info told to you by, say, a reporter recently returned from Iraq, that would be fine.

Although I am not an expert in Iraqi financial markets, I was not under the impression that the life insurance market in, say, Falluja, was thriving. How many Iraqis have life insurance, for example?

Again, my point is that the more that we understand about the actual mechanics of death certificates, the better we can evaluate the Lancet study. Daniel is nice to explain things to us, but not so nice to not make clear his sources.

93

Ragout 10.13.06 at 7:43 am

soru,

Good point about the survey apparently undercounting violent deaths in pre-invasion Kurdistan. There’s an obvious explanation for this: the interviewers spoke Arabic, not Kurdish.

94

john m. 10.13.06 at 7:51 am

“The surveyors were doctors from Baghdad, who had published papers under the previous regime, and so by the standards of modern day Iraq probably count as Baa’thist. By that I am not saying anything about their politics, or accusing them of bias, just pointing out that people like them have been explicitly targetted for ‘revenge’ killings, so they are not disinterested neutrals.”

“I think that the attempt to smear the Iraqi doctors as Sunnis and Ba’athists who obviously made the numbers up is just disgusting.”

“I’m seeing rather a low degree of correlation betwen that and what I actually said. Care to reread it?”

Soru, what point are you making? If the survey is unaffected by the stance of the surveyors (as you seem to be saying in your reply above despite making it clear they are not neutrals) I cannot grasp what the purpose of the original paragraph is…could you clarify your point?

95

john m. 10.13.06 at 7:56 am

Btw, I’m with Brendan et al in that not single substantial criticism appears to have be made against the study other than “F**k me that can’t be right.” Of course, with the lack of connections to international terrorism and no WMD, the humanitarian motive/justification is the only one left – and if these numbers are even vaguely correct than it’s a clean sweep for the entire strategy being clearly demonstrable as a complete and total disaster.

96

Ragout 10.13.06 at 8:02 am

John M.,

The survey could be biased by the ethnic and religious affiliations of the interviewers without the interviewers being dishonest. This has been documented a hundred times.

For example, respondents could have reported what they thought the interviewers wanted to hear. Or the surveyors could have gotten things wrong because they didn’t speak the same language as the respondents. And so on.

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Jack 10.13.06 at 8:07 am

Clearly, the Lancet study presents a grotesque underestimate.

Who really thinks that interviewers are going to the most dangerous places?

The methodology itself is systematically biased to miss out lives lost when an entire family or village is wiped out and by not including the deaths of the widely reported huge numbers of foreign combatants.

Didn’t we go though all of this last time over the Fallujah ommissions where they deliberately excluded the worst figures to keep the numbers down?

Obviously a major science journal will round things down in the interests of not rocking the boat. They are no doubt responsible for the insensitive insistence that people produce death certificates for interviewers when clearly they should be allowed to grieve in peace.

Ragout, do you have a cite for the interviewers speaking Arabic and hte interviewees not? The more we know the more we can understand the survey.

David thanks for taking a break from sorting out these folks:
http://neweconomist.blogs.com/new_economist/2006/09/reproduction.html
It’s a shame that Daniel is letting his work get in the way of answering important questions.

Soru, how was the sampling done in your survey? Did they ask many women? People in Tikrit? Turkmen? I’m sure they must be extrapolating from a much, much larger sample.

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Barbar 10.13.06 at 8:10 am

For all the war apologists in this thread… do you ever get tired of being always wrong about everything? Or is this just the case that acknowledging reality at this point will be too psychically painful, and so denying reality is the only path to follow?

Seriously, go back to the arguments you were making back in 2002, 2003, 2004, and 2005. Notice any patterns?

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Lopakhin 10.13.06 at 8:18 am

Daniel: At present, I think that the only critique which can’t be immediately dismissed as hackery is the one which Johan on the Harry’s place comments made;

With respect, I don’t agree with that. For instance, there’s the quote to which Mettaculture drew attention in a comment at HP: ‘Coalition forces have been reported as targeting all men of military age.’ (along with references to a couple of newspaper articles.) This seems to me to be an inflammatory comment and out of place in what should be a scholarly study. Then there’s the misrepresentation of US Department of Defense statistics to which I drew attention in a comment at HP. They weren’t using DoD figures, merely relying on them as a backup, but still, they should get these things right. And then there’s the matter of the pre-war death rates.

Brendan: [As I pointed out in the other post, this is like asking Hungarians or Czechs in 1949, “Thinking about the hardships you have suffered since the liberation of your country by the Russians, do you personally think that forcing the Germans out of your country was worth it or not?” Of course the asnwer would be ‘yes it was worth it’ and of course this would spectacularly miss the point].

I must say, I fail to see why that would be an unreasonable question to ask of Hungarians or Czechs. In the other thread, you suggest posing that question in the 1950s or 60s, which might make it less sensible. FWIW, probably not all Czechs or Hungarians would have answered yes in 1949; and the overall response would be worth taking into account. Forgive me if I’ve missed an argument on this matter somewhere along the way, on some other thread.

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engels 10.13.06 at 8:20 am

I agree with Jack. So-called “scientists” are nothing but cogs in the apparatus of ideological oppression, who construct culture in accordance with their bourgeois “values”. This survey is yet more establishment propaganda designed to minimise the extent of capitalism’s crimes. The estimate is just obviously far too low. And I have never seen the data. Prove me wrong, please.

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Ragout 10.13.06 at 8:25 am

Jack, the Lancet article says “All were medical doctors with previous survey and community medicine experience and were fluent in English and Arabic.” If any spoke Kurdish, the article surely would have listed it as a qualification.

It’s well-known that most Kurds in northern Iraq speak Kurdish as a first language.

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Daniel 10.13.06 at 8:25 am

David: it’s a factoid that keeps getting cited in press reports like this one, usually in the context of someone arguing that morgue counts aren’t all that unreliable (which they probably aren’t, as a measure of the deaths that arrived at that specific morgue; it’s the compilation that I think is unreliable). I haven’t checked it myself though.

Lopakhin: I think both of those are really quite subjective points of emphasis rather than anything that might affect the conclusions.

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Lopakhin 10.13.06 at 8:29 am

Obviously a major science journal will round things down in the interests of not rocking the boat. They are no doubt responsible for the insensitive insistence that people produce death certificates for interviewers when clearly they should be allowed to grieve in peace.

Mmm … didn’t want to rock the boat about MMR either, did they?

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soru 10.13.06 at 8:30 am

Didn’t we go though all of this last time over the Fallujah ommissions where they deliberately excluded the worst figures to keep the numbers down?

There is a a thing about that you may not be aware of.

According to calculations available on Tim Lambert’s blog, adding in the Fallujah data, while it increases the median prediction, also increases the variance sufficiently to make the 95% CI span zero.

Lambert dismisses that as an artefact, but I think it is somewhat interesting.

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John Emerson 10.13.06 at 8:33 am

What are you trying to gain? What is the magic number, lower than 600,000, that would make you happy, and make the Iraq war a good war? Why are you intervening here in such a kneejerk way?

You guys are like whipped boxers dead on their feet, waiting for the knockout blow, still punching feebly just because they have to, because they’re boxers. If you win this argument you win nothing. Why bother?

Our intervention has been a disaster. The statistical information here is more or less consistent with the qualitative reports we get — Iraq is descending into a goon squad civil war, and no one is safe except Americans in the Green Zone. The airport isn’t even safe. American leaders can’t announce their visits. There are large areas where no American can ever go.

The minimum estimate is 50,000, and it’s known to be an undercount. Does 50,000 seem like a small, OK nuumber to you?

[I realize that some of you are stats buffs and stats experts who have no opinion about the Iraq War. You guys carry on! We need freaks like you without political opinions if we are to get the truth!]

Obviously the people who did this study are illegal combatants. They released key information at a time calculated to interfere with a key part of the War on Terror — the Congressional Election. Only if this election is won can the terrorists be defeated.

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abb1 10.13.06 at 8:35 am

The estimate is just obviously far too low.

It wouldn’t surprise me if it indeed was far too low, simply because they must’ve known they would be accused of overcounting. Certainly they had to protect themselves by being overly conservative every step of the way.

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engels 10.13.06 at 8:36 am

Has anyone else noticed that every member of this “team” of so-called “statisticians” from the alleged John Hopkins university is American? I hardly think I need to point out what this might suggest about their unconscious biases…

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Functional 10.13.06 at 8:43 am

John Emerson — you’re right that it may not make much moral difference whether the number dead is 100,000 or 600,000. But at the same time, notice how your fellow lefties are suddenly overwhelmingly convinced that the number has to be 600,000; that the study is unimpeachable and no criticisms are correct; and that they must — must — defend the study to the death. Why are they so emotionally attached to the study, if it makes no difference? (Answer: It’s not because they’re non-partisan scholars interested solely in the truth; it’s because they’re anti-war and they’re eager to have anything that will help their side of the argument.)

Overall: Why does everyone seem to believe that a gut-check is somehow irrational? I.e., “this study is an order of magnitude greater than every other statistical source; maybe their extrapolation from a few hundred confirmed deaths isn’t actually accurate.”

What’s wrong with that? That’s the way we all reason when calculations turn out to have results that seem improbable. You’re balancing the checkbook, and you get to the end, and you have 10 times as much money in the account as you had imagined. Do you throw up your hands and say, “Whoo-hoo! That’s what the math says, and math is never wrong! I’m having a party!” Or do you recheck your work?

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Kevin Donoghue 10.13.06 at 8:43 am

According to calculations available on Tim Lambert’s blog, adding in the Fallujah data, while it increases the median prediction, also increases the variance sufficiently to make the 95% CI span zero.

Says Soru, yet again. It still isn’t true, though.

http://anonymous.coward.free.fr/misc/roberts-iraq-bootstrap.png

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john m. 10.13.06 at 8:46 am

“The survey could be biased by the ethnic and religious affiliations of the interviewers without the interviewers being dishonest. This has been documented a hundred times.”

Ragout, thanks for answering on Soru’s behalf, but are you asserting that this happened in this case? i.e. that the respondents deliberately lied because of who was asking the questions? If Soru wanted to make this point, why not just say so or is cryptic inference a more useful form of argument for some reason? Presumably on this basis all the polls discussed above telling us how delighted the Iraqis are with democracy will have suffered the same problem?

Is it really necessary to point out that asserting that something could have happened rather than offering evidence that it did happen does not actually undermine the survey? Of those hundred documented instances you refer to, what was the effect on said surveys? Were all the results wrong? Just some? What % did it effect? Were any of them similar studies, employing similar methodologies in similar circumstances? The determination of the survey’s critics to find fault – any fault – is leading to some really desperate ‘arguments’.

To that end, and in order to help, I would like to point out the entire study is discredited because I first heard about it on a Thursday.

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soru 10.13.06 at 8:49 am

What are you trying to gain? What is the magic number, lower than 600,000, that would make you happy, and make the Iraq war a good war?

A number below zero would presumably make the question unambiguous, rather than debatable as at present. That is not remotely unlikely, given the smallest mistake in the survey technique.

Brendan:
This is really rather different from Brownie’s interpretation that a majority of Iraqi’s ‘supported the war’..

Is it a fair description of your position that Iraqis, collectively and according to the survey, can be assumed:

1. to support a war that deposed Saddam and resulted in a successful and complete withdrawl within the next two years.

2. to oppose a war that would result in the continued occupation of their country in 2014 (by analogy with 1956).

I’m guessing you think it is uncontested and not worthy of debate that ‘the war’ when used by Brownie refers to the latter.

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soru 10.13.06 at 8:54 am

If Soru wanted to make this point, why not just say so or is cryptic inference a more useful form of argument for some reason?

Sorry, I thought it was obvious based on the content of the point I was responding to, which said that the surveyors, as admitted in the report, would tend to avoid the most dangerous areas.

The same thing applies to reporters – the areas that are most dangerous to a western journalist are not necessarily those with the highest mortality rates.

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Brownie 10.13.06 at 8:56 am

[The question] was: ‘do you think it was a good thing to get rid of Saddam Hussein?’ (that’s not a precise wording, but as I’ve argued, that was the jist of it).

As Soru has said, that’s what is known in polite circles as a falsehood.

Two polls were cited, and the questions were in each:

“Thinking about any hardships you might have suffered since the US- Britain invasion, do you personally think that ousting Saddam Hussein was worth it or not?”

“As you know the United States, Britain and some allies removed the government of Saddam Hussein in Iraq in 2003. Do you think that this was the right decision or a mistake?”

When you are asked “was it worth it?” about anything, you are explicitly being asked to balance a benefit obtained against cost endured. You need to lift your patronization of Iraqis to new heights if you are seriously arguing that when answering such questions, Iraqis think only about Saddam and not the action taken to remove him, and all that this has meant.

When discussions reach a point where your interlocutor has nowhere to go but to deny the meaning of words written in black and white, it really is time to call it a day, absent even the semi-literate warblings of other commentators who insist on arguing against points I’ve never made and attacking positions I do not hold.

Having played host to numerous visits from the CT authors, I expected rather better from their commentators.

Time to stop racking up the comments over here and go back over there.

It was a blast. Kind of.

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john m. 10.13.06 at 9:13 am

“The same thing applies to reporters – the areas that are most dangerous to a western journalist are not necessarily those with the highest mortality rates.”

…except for the western journalist mortality rate, obviously. It’s an interesting approach you’re taking Soru but ultimately it is an opinion based one rather than statisically generated based on actual sampling.

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Walt 10.13.06 at 9:50 am

Brownie: You are completely wrong. “Was it worth it” is a completely accurate abbreviation of those questions. Go back to wherever you came from, you dishonest hack.

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Steve LaBonne 10.13.06 at 10:07 am

Heckuva job, Brownie!

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Matthew 10.13.06 at 10:22 am

Brownie, though you’re right that saying “a death certifcate was present” is “still open to some interpreation”, that it follows “interviewers were to ask for a copy of the death certificate” I think the conclusion is that they were shown it.

You add (I think not in response to this), “the day you catch me trying to unpick the Hopkins methodology, you’d be entitled to throw as much mud my way as you can muster”.

You were critical of the original study methodology, and the statistical techniques used. Have you changed your mind on the original, or is difference in the methodology between the studies that makes the difference?

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David Kane 10.13.06 at 10:27 am

I appreciate Daniel providing a citation. However, that citation does not seem (to me) to support the claims that he is making. That article reports:

Iraqi authorities say morgue counts are more accurate than is generally thought. Iraqis prefer to bury their dead immediately, and hurry bodies of loved ones to plots near mosques or, in the case of Shiites, in sacred burial sites. Even so, they have strong incentives to register the death with a central morgue or hospital in order to obtain a death certificate, required at highway checkpoints, by cemetery workers, and for government pensions. Death certificates are counted in the statistics kept by morgues around the country.

Great. But that the issues that (reasonable) people have with the death certificate question. We all agree that death certificates are issued, that a family is better off with one than without one. Great. But I have my doubts about a) if the government is/was actually issuing certificates in the most violent parts of Iraq during large parts of the study and b) if death certificates get you benefits, are there any false ones is existence.

Recall that Daniel made a sweeping claim:

When someone dies, you get a death certificate from the hospital, morgue or coroner, in your hand. This bit of the death infrastructure is still working in Iraq.

I do not think that this claim was true in, say, Falluja, for 2004-2005. I suspect that it is not true for many other places.

This does not mean that the study is wrong or that people aren’t dead. I just don’t think that Daniel should be implying that death certificates are not an issue if the only information he has to go on is news reports which don’t address the issue.

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bi 10.13.06 at 10:32 am

Well, well, if it isn’t David “I believe it is a statement of fact” Kane, open-minded torture apologist!

How did it feel like to undergo repeated waterboarding?

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Eli Rabett 10.13.06 at 10:33 am

Let me be polite (try, try….).

Without a death certificate you can’t transfer property like houses, farm land and any number of a hundred things. Without a death certificate your loved one’s obligations don’t die with him.

You will discover this when you have to get a hundred copies of a death certificate for someone near and dear to you. It is not one of life’s pleasures, but it is dealth’s necessities. Well, maybe not in Somalia.

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roger 10.13.06 at 10:35 am

The furor about the numbers is successfully fogging the implications of the numbers. To me, one of the implications is how surprisingly little we know about the Iraq war – because it is reported (in English) almost exclusively with the American p.o.v. in mind. Nir Rosen’s book collecting his reportage of the war, In the Belly of the Green Bird, is one of the few war books I’ve read that actually mostly ignores the Americans and concentrates on the multiple factions that have been struggling in Iraq from the beginning. And it definitely presents a different war, one that even a reader of Informed comment and the daily news stories in the NYT and Washington Post does not see. At all.

Another implication is, of course, that the argument that Americans have a “moral responsibility” to the Iraqis and so must remain there is an even more brainless use of an empty phrase than we thought. Americans had a moral responsibility not to attack Iraq unless they were threatened, which they ignored – but the pretense that, after that moral lapse, now the moral Americans have a moral interest to mount an occupation is truly hilarious — rather like saying the Nazis had a moral responsibility to put France together after 1941. Putting that Welcome Wagon mask on a pillaging expedition has had the results we have been seeing for years. Moral responsibility has mainly consisted in Americans making completely cretinous Bungalow Bill decisions about Iraqi factions that they obviously have no business making, while profiting enormously from shoddy work or no work of reconstruction, which they are apparently incapable of doing, filling the country with private military forces and American soldier’s unconstrained by Iraqi law, and creating a massive jail system into which people regularly disappear for no reason. I suppose at least the latter shows that the Americans are following the you break it, you fix it rule – they broke Saddam Hussein’s system of torture prisons, and so they’ve been doing their best to restore them. And the end result has been an enormous death toll of the ‘natives’ and the continuing and incredible imperialist arrogance of the ‘occupiers’, who at the moment are engaged, incredibly enough, in trying to break up the country, fighting for the Badr brigades against Sadr’s militia, while Sciri rams through a federalism law in the joke parliament that is going to create a taliban like enclave of Islamicist rule in South Iraq.

Enough harm has been done to the Iraqis, I would think, to satisfy the American thirst to combine the pleasure of lynching with the pleasure of think that God blesses America. I certainly hope these Lancet figures count if the Dems win and they do investigate the conduct of Bush’s dirty war.

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Steve LaBonne 10.13.06 at 10:39 am

I certainly hope these Lancet figures count if the Dems win and they do investigate the conduct of Bush’s dirty war.

Don’t get your hopes up. They’re a bunch of spineless eunuchs. And all too many of them were complicit in the decision to go to war in the first place.

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John Emerson 10.13.06 at 10:51 am

A number [of extra deaths] below zero would presumably make the question unambiguous, rather than debatable as at present. That is not remotely unlikely, given the smallest mistake in the survey technique.

As I have already explained to you, this might be true of the abstract statistical manipulation of the data, but the statistical interpretation of Iraq death tolls is only a supplement to a lot of other knowledge we already have.

But at the same time, notice how your fellow lefties are suddenly overwhelmingly convinced that the number has to be 600,000

My fellow lefties mostly responding to the inevitable barrage of criticisms by statistical illiterates pulling stuff out of their butts. I personally think that the study was a good-faith effort, but that in the present political climate kneejerk criticisms were inevitable. The ignorant, ad hoc nature of many of these criticisms has been effectively demonstrated. That’s a good thing, though to me it’s a bad thing that we’ve allowed trolls to set the agenda. The topic remains the war itself and the destruction it has wrought, not the differences between avrious quantitative estimates.

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roger 10.13.06 at 11:00 am

Steve, while you are probably right that the Dems will act like they have acted, I’m not counting on their inherent morality, but on two things: the mounting toll of this insane war, and two, their self interest. Eventually, some politician is going to figure out that all the preliminaries to an anti-war politics are in place, and decide to enter that position.

Since the Dem leadership lives in D.C., I think they are insulated from the true emotional disgust with the war elsewhere because, frankly, the war is one of the best things ever to happen to D.C. The reason it has the hottest real estate market and the most booming economy east of Las Vegas is because the Bush administration has used the bogus war on terror to pour tens of billions of dollars into the local economy – via a plethora of war industry firms and all their hangers on. Dem honchos sit among all this wealth, have benefitted from it themselves, and naturally are hesitant about turning off that faucet. Thus, the triumph of Lieberman-ism. My hope is simply that the war is in the final bubble phase — the money has to run out sometime, and then D.C. will be left, overbuilt, with hundreds of disgruntled, laid off think tankers looking for another war to promote. Which will mean taking down this one.

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soubzriquet 10.13.06 at 11:00 am

Brownie: you missed the point, again. Besides the fact that your quoted paragraph is not in my opinion an unreasonable description — it wasn’t really meant to reflect only you and was badly worded. I probably should have left it out, but would you then have addressed any of the substance of the post? I somehow doubt it, but surprise me!

If you have a report from a reasonably reliable source (say, a well respected medical journal) that gives a result you don’t like, there is only one intellectually honest response to it. You simply cannot begin by trying to find flaws and expect to be taken seriously. That appoach may make you feel comfortable (being able to trumpet `ah, see, it’s broken’ at the first percieved flaw without any danger of learning something) but it is deeply flawed. The only honest approach is to first make sure you understand it (not somebody elses characterization of it) and then ask the question `can this be correct’? There is of course an opposite problem, that of grasping at numbers that support some position you hold and broading applying them without understanding either. I haven’t seen much of that going on in this current case.

Arguments from incredulity really don’t add anything of value to a discussion of this. You personally don’t give evidence (that I’ve seen) of understanding the study, other studies, or the methodologies involved. As far as I can see, you are merely (and ineptly) trying to poke holes in something you don’t like. This sort of nonesense is a waste of time to engage with, so I won’t any further.

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abb1 10.13.06 at 11:12 am

Why does everyone seem to believe that a gut-check is somehow irrational? I.e., “this study is an order of magnitude greater than every other statistical source…

It’s a fair point, but these other sources are not statistical and they only track the number of reported casualty-style deaths, like when someone gets hit by a bullet and dies within hours (at most) after the incident.

There are no news reports that would say something like: “…remember a month ago we reported an incident where 10 people were killed and 40 wounded? Well, 25 of those wounded are dead now.”

And this paricular study is concerned with increase in the death rate, which is a completely different concept.

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John Emerson 10.13.06 at 11:43 am

Gutchecks are fine, but very few Americans have enough familiarity with Iraq (now and before) for their gut feelings to be very useful. And a lot of the WWII analogies were based on a misreading of WWII — the death rates in some European countries (Poland)were far higher than the Iraqi death rate. And then there was the misunderstanding of Iraq’s low prewar death rate.

Altogether, we’re dealing with erroneous gut feelings.

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Donald Johnson 10.13.06 at 11:51 am

I thought I’d come back and make my own favorite point about all this–none of the prowar critics I’ve seen or heard have as yet called for an independent investigation to determine how many Iraqis have died. The critics are obviously very upset over this 600,000 dead allegation and wish to discredit it, but none of them are willing to call for a large scale statistical survey conducted by independent researchers with US government support (and if necessary, bodyguards) to determine the truth.

Two of these critics include George Bush and General Casey. Casey couldn’t even remember the source of the 50,000 dead figure that he cited when asked about the Lancet study in a press conference, which tells you how much he supposedly cares about the issue. Which is odd–one would think that a country intending to win over hearts and minds would be very interested in knowing how many are dying. Government bureaucrats love metrics and what metric could be more important?

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Donald Johnson 10.13.06 at 11:52 am

Remake my favorite point–I’ve made it several times in various places in the last day or so.

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engels 10.13.06 at 12:38 pm

I wouldn’t really want to give “gut feelings” a pass on this. When these people read “A Brief History of Time” did they throw it down in disgust at page one, because the figure given for the size of the universe is just too freakin’ big! Actually, I have a suspicion that Conservatives do essentially think like that, which is one reason why they are overrepresented among The Stupid.

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joe o 10.13.06 at 12:55 pm

In Vietnam, the army got fixated with body counts as a metric of success. This lead the army to count civilian deaths as viet cong deaths. By the end of the vietnam war, only 15% of the dead identified as “viet cong” had a gun on them. The fixation on body counts lead to war crimes. Incentives matter.

Which just means I am happy the us army isn’t counting the dead in Iraq. I am less happy that the army is ignoring the data collected by others.

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Lopakhin 10.13.06 at 12:58 pm

Donald Johnson: I thought I’d come back and make my own favorite point about all this—none of the prowar critics I’ve seen or heard have as yet called for an independent investigation to determine how many Iraqis have died. The critics are obviously very upset over this 600,000 dead allegation and wish to discredit it, but none of them are willing to call for a large scale statistical survey conducted by independent researchers with US government support (and if necessary, bodyguards) to determine the truth.

I’ll happily call for it. Not sure anyone’d particularly listen to me, but anyway. I think it would be in the British government’s interests to obtain a more accurate figure (and probably indirectly in my interests too, since as a British citizen, I am a possible target of reprisal attacks motivated by such high figures).

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engels 10.13.06 at 1:11 pm

(and probably indirectly in my interests too, since as a British citizen, I am a possible target of reprisal attacks motivated by such high figures)

Now that’s an argument I didn’t see before: “Careless epidemiology costs lives!”

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Kevin Donoghue 10.13.06 at 1:18 pm

David Kane,

Tim Lambert has posted a lengthy excerpt from a blog-post by Zeyad (an Iraqi dentist) where he says that death certificates are issued and officials have them. The problem is that “the Ministry of Health and the Baghdad Medico-legal Institute (Baghdad’s main mortuary) is under the control of Sadrists, who have prohibited access to medical records and morgue counts by the press, and who have an interest in manipulating numbers for their own political agendas….”

This differs from dsquared’s take on the situation but the upshot is much the same: the families get certificates but no reliable aggregate figures are available.

The entire post is worth reading, but Zeyad’s blog is a bit slow to load at present.

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Donald Johnson 10.13.06 at 1:34 pm

Joe O, it’s true that the bodycount in Vietnam turned out to be an incentive to commit mass murder (a specific example often given is that of Operation Speedy Express in the Mekong Delta, where the bodycount was 11,000 and the number of captured weapons was about 800).

But the US is supposedly trying to bring peace to Iraq, so if General Casey is serious there’s nothing more important than the knowledge of how many civilians are dying either at our hands or at the hands of fellow Iraqis or the handful of foreign jihadists. I’m assuming for the sake of argument that he is competent and has good intentions. A normal bureaucrat would studiously avoid collecting and disseminating statistics that would make him look bad.

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David Kane 10.13.06 at 1:39 pm

Kevin,

Thank you for the pointer. What about this part?

The Ministry of Health should have access to certificates issued throughout the country over the last 3 years. And both the Defense and Interior ministries have their own counts. Now why isn’t any independent body looking into that information?

This directly contradicts Daniel’s claim above (that everyone gets a death certificate but that the central government can’t access them).

Then the person who issued the death certificate is meant to send a copy to the central government records office where they collate them, tabulate them and collect the overall mortality statistics. This bit of the death infrastructure is not still working in Iraq.

Now, I don’t know if Daniel is right or Zeyad or both or neither. But I find it suspect that Daniel, on the basis of Western news reports, can claim to settle the issue of death certificates, which is why I asked him for a citation. So, I think that these questions are still open:

1) Has most (75%?, 95%?) every family with a death in Iraq received an official death certificate?

2) Does someone in the central government have access to these?

3) Does having just a certificate get you benefits that you would not get without one? If so, is there any/many fakes?

Again, for now I just want to understand better the reality in Iraq over the last 3 years with regards to death certificates. Once we understand those facts, we can connect them (or not) to the Lancet study. I think Daniel is guilty of claiming to understand these facts much more than he actually does.

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tim 10.13.06 at 2:24 pm

the Lancet report hinges on the pre invasion death rate.
everything is built on that.
The Lancet Report claims a 5.5 crude death rate.
A total of 137,500 deaths in acountry of 25 million.
However in the Appendix E it claims an infant mortality rate of 10%.
If a 10% infant mortality rate applied in Iraq (A country of 25 million with 35 births per thousand) This would give a total of 85,000 deaths.

Leaving the rest of the population with a crude death rate of 2.1%.

Less than half that of any country in the world.
Ever.

If you believe that you will believe,anything

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soru 10.13.06 at 2:27 pm

it’s true that the bodycount in Vietnam turned out to be an incentive to commit mass murder

It might be worth remembering that incentives also apply to ‘the handful of foreign jihadists’.

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Kevin Donoghue 10.13.06 at 2:44 pm

David Kane,

Daniel can fight his own corner; certainly I don’t claim to know very much about the certification process. Zeyad’s testimony suggests that people do want deaths certificates and usually manage to get them somehow. So, for your first question 90%+ seems plausible.

If Zayed is right the answer to your second question is, Yes, the officials have the data but they lie about it. Other reports say the system has crumbled:

But why are the number of Iraqi deaths so difficult to pin down? The short answer is that much of the country is too dangerous for researchers or government officials to travel in search of accurate statistics. The best tally would come from counting every death certificate issued in the country in the three years before and three years since the invasion. But there is no central reporting mechanism for this in the country.

http://www.csmonitor.com/2006/1013/p01s04-woiq.html

As to your third question, I’m not sure it matters. If people were fabricating deaths for the interviewers it looks like they took care to ensure their stories matched the fake certs. At the end of the day that just leaves you with fraud, which as Daniel says in his CIF post is the only real alternative to taking the study at face value. It just means that the researchers would be innocent dupes rather than the perpetrators.

140

Lopakhin 10.13.06 at 3:02 pm

It might be worth remembering that incentives also apply to ‘the handful of foreign jihadists’.

It’s not a handful, Soru & Donald J. There are actually ‘huge numbers’ of them – didn’t you read post #97?

141

Kevin Donoghue 10.13.06 at 3:26 pm

Just to clarify the end of my previous comment: I really don’t think a “lying Iraqis” theory holds water. There are some stories about Iraqis faking deaths (to get compensation for example) but that isn’t likely to be widespread, since officials would surely catch on. However there may be lots of lies about the cause of death.

142

bi 10.13.06 at 3:44 pm

So what’s soru’s and Lopakhin’s point? Yes, lots and lots of Iraqis died after “we” invaded Iraq, but a lot of the deaths are caused by jihadists anyway, so it’s not really “our” fault that “we” failed to make Iraq safe?

As Edroso said: “let the jaw-dropping commence!”

143

Donald Johnson 10.13.06 at 3:49 pm

Soru, commenting on my comment about Vietnam bodycount incentives-

it’s true that the bodycount in Vietnam turned out to be an incentive to commit mass murder
It might be worth remembering that incentives also apply to ‘the handful of foreign jihadists’.

Me–

Not to be snarky, but I don’t get your point. I assume everyone knows the Zarqawi types have conducting massive attacks on Shiite civilians and obviously wanted to compile a large bodycount. In fact, iirc, other Al Qaeda members were critical of this attack on Muslims (even those heretical Shiites) because it wasn’t going over too well in the Muslim world.

144

Mike H 10.13.06 at 4:20 pm

Daniel and Kevin:

I’d be interested in your thoughts on the apparent huge variance in the violent versus non-violent composition of the excess death toll from the first Lancet study to the second. The authors have made several statements that the 2006 study vindicates the 2004 survey, because the excess death figures are similar. The bottom line numbers are close, but they’re polar opposites in terms of composition.

In the interest of saving time, I’ve taken the liberty of cutting and pasting my argument from this morning at Tim Lambert’s blog. Hope that’s okay:

Tim, D Squared:

Hi, it’s been a while. Hope you’re both doing well and enjoying life. Since my main man Heiko hasn’t weighed in on this by now, I guess I’ll have to sub in.

Sortition beat me to it, but didn’t follow through. Everyone seems to be taking at face value the repeated assertions of the study authors that the 2006 survey corroborates the findings of the 2004 survey. To quote from the companion document to the 2006 study:

” That these two surveys were carried out in different locations and two years apart from each other yet yielded results that were very similar to each other, is strong validation of both surveys.”

The problem is, the two surveys didn’t yield ” very similar results.”

The authors are basing this supposed mutual corroboration entirely on the similar excess death figures derived from the studies, for the time frame covered by the 2004 survey (100,000 excess deaths in the 2004 survey and 112,000 from the 2006 survey).

However, the composition of the excess death tolls differs radically from study to study. As I argued here in 2005 when comparing Lancet 1 to the UNDP survey, deaths from various causes are not interchangeable when using one study’s bottom line to bolster the bottom line of another. In other words, one can’t simply say ” we’ll make up for a shortfall in coalition air strike deaths in one study with some heart attack deaths from the other.”

Recall that in the 2004 survey, the headline-grabbing 100,000 excess death figure owed much of its punch to the 40,000-plus excess deaths attributed to non-violent causes. The 2006 survey tells an exceedingly different tale of mortality in Iraq during the first 18 months of the war. Not only is all of the excess death toll in the 2006 survey the result of violence, it’s actually greater than the entire 112,000 excess death figure, because the death rate from non-violent causes is significantly less than the base line non-violent death rate. My rough math indicates an extrapolated violent death toll of more than 130,000 for the second survey, for the same time frame covered by Lancet 1.

As I recall from the 2004 discussions and debates, the study authors and their supporters here and elsewhere attributed the large non-violent excess death toll to the inevitable effect on infrastructure, health care, etc arising from the chaos of invasion and subsequent insurgency.

That sounded reasonable enough at the time, assuming one accepted the premise that the invasion and occupation had severely degraded and impaired Iraq’s domestic infrastructure. But now, in a complete contradiction of the defence of their earlier work, the study authors are telling us that said chaos of war had no effect on the overall post-invasion non-violent death rate until the beginning of 2006, and in fact the post-invasion non-violent mortality rate was actually lower than the pre-invasion rate for more than two years after regime change.

Obviously, there are two serious problems arising from the comparison of the data sets for the two studies. First, unless I’ve completely botched the math, the 2006 survey extrapolates approximately 75,000 more violent deaths and 63,000 fewer non-violent deaths than the first survey. This is a monstrous discrepancy, when considering the base line annual mortality figure is approximately 120,000 deaths.

Second, if there is a correlation between extreme violence in a society and an increase in the non-violent death rate, why does one study confirm the correlation, while the second rebuts it?

Posted by: Mike H | October 13, 2006 09:15 AM

145

Jack 10.13.06 at 7:16 pm

Mike, perhaps the start of a civil war might explain some of the anomolies you perceive. In addition you should be aware that the other figures you claim are inconsistent are all estimates of slightly different things and of these the most robust and compatible are also the most consistent. Have you ever considered the possibility that the estimate might in fact be fair, correct or even low? Is there a better number available?

146

Mike H 10.13.06 at 7:39 pm

Jack:

What approximate date would you give for the start of the ” civil war?”

I don’t think you understand my argument. The second Lancet study overlaps the first for the time period from March 2003 to September 2004. The studies reveal excess death figures of 112,000 and 98,000 respectively, for that time period. Because the non-violent death rate in the 2006 study is actually lower than the pre-invasion rate, the excess death toll for that study is entirely made up of violent deaths, and in fact is quite a bit higher than the 112,000 figure (somewhere in excess of 130,000).

The first study measured 57,000 deaths from violence, and more than 40,000 from non-violent causes. The second study removes all of these non-violent deaths, then subtracts more than 20,000 more non-violent deaths from the pre-invasion expected death toll over the 18 month time frame, and replaces all of them with violent deaths.

That’s some anomaly.

147

bi 10.14.06 at 12:00 am

Robert: “The numbers under the 4.5 describe the CI around it. They mean that the drop in nonviolent mortality is not significant.”

Mike H: “Robert, it is significant. The difference works out to a reduction in the non-violent death toll of more than 20,000 less deaths from Lancet 2006 to Lancet 2004.”

Robert’s saying it’s not statistically significant, dang it. Characterizing it as an “anomaly” is a clear sign of not understanding the math.

148

Anton Mates 10.14.06 at 12:40 am

Recall that in the 2004 survey, the headline-grabbing 100,000 excess death figure owed much of its punch to the 40,000-plus excess deaths attributed to non-violent causes.

I don’t see that anywhere in the first study. In fact, it says,

“Violence accounted for most of the excess deaths and air strikes from coalition forces accounted for most violent deaths.”

According to the first study’s figures, the non-violent death rate only went up about 20% from the pre-invasion to the post-invasion period, while the violent death rate went up by 5800%; violence accounted for 2% of reported deaths before and 51% of reported deaths afterwards. So only about 15% of the excess reported deaths were non-violent, which agrees with the authors’ statement above.

The only place I could find “40,000 excess deaths” mentioned after a few minutes of googling was here, but they don’t give a specific quote. Perhaps that was computed by someone after discarding the Falluja cluster?

And while the second study does show a decrease in the non-violent mortality rate, the authors don’t consider it a significant one–in fact, the error bars on that number permit a slight increase on the order of what was claimed in the first study.

I don’t see any glaring contradiction here between the two studies.

149

Anton Mates 10.14.06 at 12:54 am

Again, in an interview last year about the first study, Les Roberts said “most of the deaths were violent.” So no, the studies agree on that point.

150

Anton Mates 10.14.06 at 1:12 am

Upon further number-dabbling, I think the issue here is whether the first study’s Falluja data is included or not. Without, you do get about 40% non-violent excess deaths. But the first study only ignored that data when estimating total mortality increase, to make sure that estimate was conservative. The rest of the time they took Falluja into account, so they never make the 40% non-violent claim.

151

Ragout 10.14.06 at 1:14 am

Anton and bi,

It’s true that the latest study finds that the drop in nonviolent deaths in 2004 isn’t statistically significant, and probably doesn’t show a statistically significant difference from the increase in nonviolent deaths they found in their previous study.

*But they didn’t use the same statistical methods in their more recent study!* Did you notice that they don’t report relative risks this time around, like they did in their earlier study? If they had used the same statistical methods this time around, their estimates would have been more precise, with smaller confidence intervals. If they used consistent methods, they might well have shown that the very big difference between the new and old results for 2004 is statistically significant.

To elaborate, in their first study, simple methods showed insignificant results, which is presumably why they turned to more complicated methods. These more complicated methods make more assumptions, but produce smaller confidence intervals, allowing them to conclude that the increase in deaths was statistically significant.

In their recent study, simple methods show statistically significant results, and that’s all they report, even though they say that they calculated the more complicated estimatates too.

Let me quote the passage from the first study that discusses results using the same (simple) methods that they use this time around. Notice that the confidence intervals (CIs) of the pre-war and post-war results have a huge amount of overlap.

before the invasion…The crude mortality rate was 5·0 per 1000 people per year (95% CI 3·7–6·3)… The crude mortality rate during the period of war and occupation was 12·3 per 1000 people per year (95% CI 1·4–23·2) If the Falluja cluster is excluded, the post-attack mortality is 7·9 per 1000 people per year (95% CI 5·6–10·2; design effect=2·0).

To sum up, we don’t really know if the difference between the increase in nonviolent deaths they found last year and the decrease in in nonviolent deaths they found this year is due to chance because *they didn’t use the same statistical methods* this year.

152

Ragout 10.14.06 at 1:22 am

Anton, I don’t think that the first study reported that 40% of the excess deaths were nonviolent, but it can (almost) be inferred from the study. (Actually, I recall the nonviolent excess deaths figure as being 2/3 of deaths, not 40%). Tim Lambert obtained some further unpublished figures directly from Roberts that nailed down this conclusion.

153

Dan Simon 10.14.06 at 2:20 am

A few questions for those who consider the “excess deaths” incurred in Iraq since the US invasion to be an indictment of that invasion:

1) How many excess deaths have there been in the former Soviet Union since the collapse of Communist Party rule in 1991?

2) How many excess deaths have there been in the former Yugoslavia since its disintegration in 1991?

3) How firmly has democracy taken root in either of these two regions?

4) Western governments could have taken action to attempt to forestall both of these collapses–say, throwing their support behind the 1991 Soviet coup plotters, and condemning the secession of Slovenia and Croatia. Instead, they generally took the opposite tack, undermining the authority of both the Soviet Union and the central Yugoslav government every step of the way. In light of the answers to questions 1 through 3, then, was Western support for the collapses of the Soviet Union and Yugoslavia a mistake? If not, why not?

154

Matthew 10.14.06 at 2:47 am

Tim says “Leaving the rest of the population with a crude death rate of 2.1%.

Less than half that of any country in the world.
Ever.”

Saudi Arabia’s death rate in 2006 was 2.58 according to the CIA, its birth rate was around 30, and its infant mortality 12.

155

john m. 10.14.06 at 2:55 am

Re #153 um Dan…I’m not actually sure how to put this….let’s see…getting there…wait a sec…oh yeah…nope, that’s not right…

Sorry, I can’t come up with even a semi-rational response to your comment. You must be completely correct in your comparison of the Soviet Union, Yugoslavia & Iraq.

156

John Emerson 10.14.06 at 5:08 am

I agree with Dan Simon that, as a population-reduction measure, we should continue to liberate the world one nation at a time.

Any other random mud that anyone want to throw? It might stick!

157

tim 10.14.06 at 6:03 am

Matthew.
between 4 and 5 according to the WHO.
And it is a freak stat at that.
25% of the population are “guests” who generally dont stay around to die there.

You’re not arguing that Iraq had the lowest adult death rate in the world are you?

158

Daniel 10.14.06 at 7:20 am

Mike H: The simplest explanation, and the one I in fact believe, is that in the 2004 study, survey respondents lied about the deaths of young men who had died while fighting in the insurgency and said that they had died of natural causes, but in the 2006 study they told the truth.

This would make a certain amount of sense, as in 2004 one would still want to cover up the fact that a family member was in one of the militias, because it looked like law and order might prevail, but now it probably makes more sense to broadcast the fact that your son or nephew died fighting. So I think that the shift of young male deaths between “non-violent” and “violent” is a reasonable proxy for insurgent casualties, and the figure of 20,000 looks of the right order of magnitude given what military folk have said about the size of the insurgency.

159

tim 10.14.06 at 7:23 am

you dont believe the base figure of 5.5 do you Daniel?

160

Barry 10.14.06 at 8:51 am

Tim, post 155. Please respond, don’t just continue your original assertion, when some facts are brought to your attention.

161

tim 10.14.06 at 9:05 am

Barry ,
post 158

162

Donald Johnson 10.14.06 at 9:40 am

Daniel’s explanation might be right–I’m not sure.

But Mike isn’t giving the best argument for his case, IMO. The best argument is that the UNDP/ICLS survey found 24,000 violent deaths (19-28,000 is the CI) in the first 13 months and if I’m doing the approximate calculation correctly, the latest Lancet paper gives about 90,000. That’s based on one of the tables showing 45 violent deaths in the March 2003-April 2004 period and assuming each represents 2000 deaths. The 90,000 and 24,000 numbers aren’t for the same thing, because the 24,000 excludes criminal murders. But does someone want to argue that this explains the difference?

I doubt that it does. The first Lancet paper had criminal murders as 1/3 of the total violent death toll (excluding Fallujah). So if you tack on 12,000 deaths to the 24,000, you’d have 90,000 vs. 36,000 for the first 13 months.

Not that this disproves the paper, but it doesn’t do much to inspire confidence. Somebody’s statistical survey was affected by bias. Maybe the people in Iraq lied in the earlier survey if they had an Iraqi soldier or guerilla death in the family, as Daniel suggests. I think we’re better off just taking the IBC number and saying the true death toll is probably several times higher.

And then, of course, absolutely demanding that the US and British governments sponsor an independent investigation to determine the true death toll (with particular focus on deaths caused by the US and Britain–Iraq Body Count statistics on those are absurdly low for most months. The coalition killed 370 people in the third year of the occupation, if one goes by what the press has reported.)

163

Dan Simon 10.14.06 at 12:07 pm

You must be completely correct in your comparison of the Soviet Union, Yugoslavia & Iraq.

Well, the comparison isn’t perfect, but the similarities are striking. In each case, a brutal totalitarian dictatorship–albeit one whose worst brutalities are well behind it–falls, leaving behind a morass of political turmoil, economic ruin and interethnic strife that for quite some time makes the average citizen’s life markedly worse than before the collapse of the old regime. The main difference I see, from a geopolitical perspective, is that both the old Soviet Union and Saddam Hussein’s Iraq were serious threats to their neighbors, whereas the old Yugoslavia was not.

Now, the difference that everyone will no doubt harp on here is that the Iraqi dictatorship was toppled by an invasion, whereas the other two underwent internal collapse. There are, of course, many reasons for opposing the toppling of dictators by invasion that obviously don’t apply to the collapse of the former Soviet Union and Yugoslavia. But–and this is my whole point–the comprehensive “excess deaths” argument being presented here isn’t one of them. As the Soviet and Yugoslavian cases illustrate, regime collapses are capable of generating prodigious numbers of excess deaths absent any invasion or occupation, and by exactly the same processes–economic ruin, internecine violence–that are today in Iraq being blamed on the American invasion and occupation, rather than on the regime collapse itself.

Suppose, for example, that the US had continued to enforce its no-fly zone in Iraq following the 1991 Gulf War, with the result that the uprisings that sprang up across the country had actually succeeded in toppling Saddam Hussein. Which causes of today’s “excess deaths”–the massive looting that devastated the country’s infrastructure; the sectarian violence that kills thousands and prevents life from returning to some semblance of normalcy; the political paralysis that makes the re-establishment of social and economic order impossible–wouldn’t have been just as devastating a cause of “excess deaths” back then? Indeed, which of them wouldn’t have been even worse, without American troops helping out on the ground?

164

Donald Johnson 10.14.06 at 12:57 pm

The problem with the comparison to Russia is that a lot of people think the 1990′s excess mortality figure for that country had a lot to do with the economic policies pushed by the West. So maybe your comparison doesn’t prove what you want it to prove.

165

roger 10.14.06 at 12:59 pm

Dan, why just go back to 91? Let’s go back to, say, 1983. Suppose the U.S. hadn’t encouraged Kuwait to make loans to Saddam so that he could continue to prosecute the war he started in 1980? You get: a., Saddam’s collapse, b., no Kurds being mass murdered, and c., no need for the first Gulf war.

Isn’t that pretty? Not to speak of avoiding America basically providing naval support for Saddam in the 1985-1988 period.

Or is it your case that Saddam Hussein’s aggression against his neighbors was only bad when it didn’t suit America’s purposes?

166

Barry 10.14.06 at 2:06 pm

Tim: “Barry ,
post 158″

That’s been covered already; it isn’t out of line with neighboring countries.

167

Dan Simon 10.14.06 at 2:45 pm

Suppose the U.S. hadn’t encouraged Kuwait to make loans to Saddam so that he could continue to prosecute the war he started in 1980? You get: a., Saddam’s collapse, b., no Kurds being mass murdered, and c., no need for the first Gulf war.

Roger, I think you’ve gotten the argument backwards. Remember: along with Saddam’s collapse, you get a huge number of “excess deaths” due to the ensuing chaos and civil strife–enough that lots of people apparently consider the recent (remarkably bloodless) US action to topple him to have been a bad idea in retrospect. If anything, the same reasoning suggests that propping up Saddam in 1983 was the humanitarian course of action.

Of course, that reasoning is nonsense. Saddam started an aggressive war against a weakened neighbor in 1980, and when the tide turned against him, the US stepped in to prop him up out of cynical self-interest. So what’s your point?

168

Mike H 10.14.06 at 2:51 pm

bi:

You’re confusing the folks here, since you’re linking a comment from another blog, minus the link. My response to Robert at Deltoid is up, if you’d like to have a look.

169

Mike H 10.14.06 at 2:59 pm

Anton Mates:

The 40,000 excess death figure due to non-violent causes can be calculated from the study data itself.

If you want that confirmed, one of the study authors, Richard Garfield, gave an interview just after the study was released. As you’ll see in the chart labeled ” excess death by cause,” you’ll see he categorizes 57,600 of the excess deaths as violent, leaving 40,400 deaths that aren’t.

Epic interview

170

Mike H 10.14.06 at 3:16 pm

“Mike H: The simplest explanation, and the one I in fact believe, is that in the 2004 study, survey respondents lied about the deaths of young men who had died while fighting in the insurgency and said that they had died of natural causes, but in the 2006 study they told the truth.”

I have some problems with that, Daniel. That’s a mighty big assumption you’re making. First off, it seems implausible to me that so many would lie, enough to account for all or most of a 75,000 increase in violent deaths over the 18 months.

Second, you’re now adopting an astronomically high KIA figure for insurgents in the first 18 months, and one that would probably roughly extrapolate to several hundred thousand insurgent deaths for the entire 40 months. I just can’t see that being accurate.

By the way, here’s Tim’s explanation for the variance:

“Mike H, given the wide CI for the first Lancet study, the close agreement (98k vs 110k) with the second study is surprisingly good. I’m expecting someone to seize on this and accuse them of cooking their statistics any time now. When you break it down into violent and non-violent deaths things get more uncertain. I’m pretty sure that if you did the test you’ll find no statistically significant differences in the violent and non-violent rates between the two studies.

There’s a 50% chance that the differences will have opposite signs, and partly cancel, which is what happened

Posted by: Tim Lambert | October 13, 2006 10:59 AM

I concede I don’t know what he means by this ” test.” I asked, but didn’t get a response. Having no statistical background, his explanation probably wouldn’t help me anyway.

171

bi 10.14.06 at 3:20 pm

Mike H: No, I checked again, and I definitely didn’t get anything confused. I’m not going to bother to listen to what you say, when you can’t even be bothered to understand basic statistical concepts.

172

bi 10.14.06 at 3:23 pm

Mike H: Pick up a statistical text book and read it yourself. Come back to criticize the study when you’ve finished.

Or are we obliged to allow you to yammer on things you clearly know zilch about?

173

bi 10.14.06 at 3:27 pm

Dan Simon: So you’re lowering the standard of “success” from “make Iraq into a modern democracy where people can live and work safely” to “make Iraq into a country which is just better than if we allow Saddam’s regime to crumble by itself”.

174

roger 10.14.06 at 3:31 pm

Dan, you don’t, really. If Saddam had collapsed, there is no way the chaos that would have resulted would have equalled the number of Iraqis and Iranians murdered in that war. Not all collapses lead to mass death. In fact, in Northern Iraq in the 90s, there was a similar collapse, and it lead to something like 6-10,000 deaths.

What does multiply deaths is occupation. The U.S. occupation is the huge multiplier here. Compare the number of deaths from any other period in which an Iraqi leader was overthrown, and the deaths are way below what has happened since the U.S. decided to occupy Iraq.

Point, then, is simple. Your counterexample doesn’t hold water. The precedents for the social and political collapse of other regimes in Iraq point to this one being several magnitudes worse. The factor that made it worse was the U.S. Occupation. Getting the U.S. out of Iraq is not only what the Iraqis want, but it will be good for Iraq.

175

Anton Mates 10.14.06 at 3:33 pm

Anton, I don’t think that the first study reported that 40% of the excess deaths were nonviolent, but it can (almost) be inferred from the study. (Actually, I recall the nonviolent excess deaths figure as being 2/3 of deaths, not 40%). Tim Lambert obtained some further unpublished figures directly from Roberts that nailed down this conclusion.

I think I’ve found the comment by Tim you’re referencing. In it, he indeed says that 40% of excess deaths were non-violent not counting Falluja. (You may be recalling the 2/3 figure from the comment before Tim’s, which didn’t adjust for the different durations of the pre- and post-invasion periods under study.)

Again, there’s no contradiction here between the two studies. When you include Falluja, the first study’s proportion of excess deaths due to violence is very high; when you don’t, it drops to a little over half. The second study never excludes Falluja, so there’s no reason why it should find a large proportion of non-violent excess deaths.

176

Mike H 10.14.06 at 3:34 pm

Nice dodge, bi.

One doesn’t have to be a statistician to seee the huge variance between the two studies, in terms of violent and non-violent deaths. I realize that makes you angry, and eager to avoid dealing with it.

Tough.

177

Anton Mates 10.14.06 at 3:37 pm

If you want that confirmed, one of the study authors, Richard Garfield, gave an interview just after the study was released. As you’ll see in the chart labeled ” excess death by cause,” you’ll see he categorizes 57,600 of the excess deaths as violent, leaving 40,400 deaths that aren’t.

And again, that chart is explicitly excluding Falluja.

178

Mike H 10.14.06 at 3:39 pm

Anton Mates:

There is a huge discrepancy. You can’t include Falluja, because the 2004 authors excluded it from their results. One can’t try to reinsert it now, to try and explain away an uncomfortable variance from a new study. Even if you could, reintroducing the Falluja data makes your problem even worse in terms of study to study corroboration, because it adds about 200,000 additional violent deaths to the first study.

179

Mike H 10.14.06 at 3:47 pm

Daniel;

One other point I wanted to make in relation to your theory.

If you swap out tens of thousands of non-violent excess deaths from study 2004 to convert to tens of thousands of violent deaths for study 2006, you’re adopting a much more ramped up level of violence for the first 18 months of the war, but taking away all the effect this dramatic increase in violence should have on the non-violent mortality rate.

In other words, if the 2006 study is accurate because of the theory you provide, shouldn’t we be seeing a corresponding significant increase in real, non-lied-about non-violent deaths, as an expected consequence of the much higher violent death figure?

Instead, we have the opposite. A huge increase in violent deaths over the first study, but with a non-violent mortality rate not only far less than the first study, but less than the pre-invasion mortality rate for either study.

180

Dan Simon 10.14.06 at 4:16 pm

Dan Simon: So you’re lowering the standard of “success” from “make Iraq into a modern democracy where people can live and work safely” to “make Iraq into a country which is just better than if we allow Saddam’s regime to crumble by itself”.

I’m not “lowering the standard”–I never had such high expectations in the first place.

Again, I’ll ask: is the former Soviet Union better off–despite all the death, violence, chaos, economic decline, and resurgent authoritarianism–for being “former”? And if so, why isn’t the same true of the former Saddam-ruled Iraq?

If Saddam had collapsed, there is no way the chaos that would have resulted would have equalled the number of Iraqis and Iranians murdered in that war.

Quite possibly correct. But I’ve already noted that the US’ early support for Saddam Hussein was motivated by cynical self-interest, not humanitarian concern for saving lives.

What does multiply deaths is occupation. The U.S. occupation is the huge multiplier here.

Utter nonsense. Neither the Soviet Union nor Yugoslavia were occupied by anyone. They succeeded in generating huge numbers of excess deaths through economic collapse and civil strife all by themselves. If anything, the US occupation, by tamping down (however partially) the worst violence and assisting (however haltingly) in the reconstruction of a viable central government, has mitigated the horror.

Compare the number of deaths from any other period in which an Iraqi leader was overthrown, and the deaths are way below what has happened since the U.S. decided to occupy Iraq.

Apples and oranges. Previous regimes weren’t nearly as repressively totalitarian as Saddam’s, and therefore could be overthrown without the government disintegrating completely. The collapse of Saddam’s Ba’ath party, on the other hand, was bound to be more like the collapse of the Soviet or Titoist regimes–an internal breakdown leaving no civil society from which a successor could emerge to fill the vaccuum.

181

Anton Mates 10.14.06 at 4:35 pm

Did you notice that they don’t report relative risks this time around, like they did in their earlier study?

Sure, but they did compute them, and they seem to have used the same methodology.

First study:

“We estimated relative and attributable rates with generalised linear models in STATA (release 8.0). To estimate the relative risk, we assumed a log-linear regression in which every cluster was allowed to have a separate baseline rate of mortality that was increased by a cluster-specific relative risk after the war. We estimated the average relative rate with a conditional maximum likelihood method that conditions on the total number of events over the pre-war and post-war periods, the sufficient statistic for the baseline rate. We accounted for the variation in relative rates by allowing for over-dispersion in the regression. As a check, we also used bootstrapping to obtain a non-parametric confidence interval under the assumption that the clusters were exchangeable.”

Second study:
“Mortality rates and relative risks of mortality were estimated with log-linear regression models in STATA. To estimate the relative risk, we used a model that allowed for a baseline rate of mortality and a distinct relative rate for three 14-month intervals post-invasion—March, 2003–April, 2004, May, 2004–May, 2005, and June, 2005–June, 2006. The SE for mortality rates were calculated with robust variance estimation that took into account the correlation between rates of death within the same cluster over time. The log-linear regression model assumed that the variation in mortality rates across clusters is proportional to the average mortality rate; to assess the effect of this assumption we also obtained non-parametric CIs by use of bootstrapping.”

Is there a significant methodological difference here, other than that they broke the post-war period down into three intervals in the second study?

To elaborate, in their first study, simple methods showed insignificant results, which is presumably why they turned to more complicated methods.
***
Let me quote the passage from the first study that discusses results using the same (simple) methods that they use this time around. Notice that the confidence intervals (CIs) of the pre-war and post-war results have a huge amount of overlap.

Actually, when they excluded Fallujah, the overlap was quite small (.7, when the CIs had respective widths of 2.6 and 21.8). Generally speaking, non-overlapping CIs can guarantee a significant change, but AFAIK an overlap does not guarantee that the change is insignificant.

182

Anton Mates 10.14.06 at 4:47 pm

There is a huge discrepancy. You can’t include Falluja, because the 2004 authors excluded it from their results. One can’t try to reinsert it now, to try and explain away an uncomfortable variance from a new study.

Sure one can, because the authors didn’t exclude any clusters in their new study. If one study has an apparent outlier which it excludes, and the other one does not, there’s no “discrepancy” in their getting different results.

Even if you could, reintroducing the Falluja data makes your problem even worse in terms of study to study corroboration, because it adds about 200,000 additional violent deaths to the first study.

No, it doesn’t. It raises the excess violent death count to about 200,000, which is an increase of about 100,000 over the Falluja-excluded data. And it makes the error bars on that count so wide that the second study’s result doesn’t conflict with it at all.

183

Mike H 10.14.06 at 5:30 pm

“No, it doesn’t. It raises the excess violent death count to about 200,000, which is an increase of about 100,000 over the Falluja-excluded data. And it makes the error bars on that count so wide that the second study’s result doesn’t conflict with it at all.”

You’re wrong, Anton. From the study itself, page 4:

” In our Falluja sample, we recorded 53 deaths when only 1.4 were expected under the national pre-war rate. This indicates a point estimate of about 200,000 excess deaths in the 3% of Iraq represented by this cluster.

“Sure one can, because the authors didn’t exclude any clusters in their new study. If one study has an apparent outlier which it excludes, and the other one does not, there’s no “discrepancy” in their getting different results.”

Okay Anton, I give up. We’ll do it your way. That leaves us with these 3 violent death figures from the Lancet studies, for the first 18 months of the war:

2004 study, minus Falluja cluster – 57,000.

2004 study, with Falluja cluster – more than a quarter million.

2006 study – more than 130,000.

Becareful what you wish for, Anton.

I await the ridicule of the Lancet fans out there for pointing out such inconsistencies.

184

Brownie 10.14.06 at 6:25 pm

Mike H,

I started reading your comments last night both here and at Deltoid. I’ve watched carefully today to see how the discussion has progressed on both blgos – just in case you had got something spectacularly wrong.

Well, it seems your logic is sound, so much so that I’ve cited you on HP (http://hurryupharry.bloghouse.net).

Nice work, fella.

185

Mike H 10.14.06 at 7:24 pm

Brownie:

Many thanks for that. I’m flattered.

186

roger 10.14.06 at 7:46 pm

Dan, well, you obviously have a different idea of fruits than I do. The obvious ‘collapse’ of the Baathist regime, in your world, has nothing to do with the disbanding of the army by the Americans, as well as their general disbanding of the government, concern with creating a state economically like Pinochet’s Chile while the ‘deadenders’ flared, and in general the concrete historical occurences of 2003-2005. On the other hand, it is nice that you think the Baathists took power after the revolution deposing the King.

As for the odd position that Iraq is now better off without Saddam, but in 1983 would have been better off with Saddam – or is it that 1983 would have been chaos because the Baathist party would have disbanded – or is it that the chaos has nothing to do with the occupation and is because of apples not being oranges – in any case, it seems that any moral points one scores for getting rid of Saddam (even if the method was rather in the way Mafioso are gotten rid of — by their confederates) are going to slip away unless one decides, for no apparent reason, that chaos like this is to be expected. Yes, you supported the invasion thinking, well, 600 000 Iraq deaths is a small price to pay.
Pity the war supporters weren’t talking that talk in 2003.

187

Donald Johnson 10.14.06 at 8:01 pm

Oh, lord, did the decent left just make an appearance? I’ve got problems believing this latest Lancet study (rightly or wrongly), but surely we can all unite in demanding that the US and British governments sponsor an independent investigation to find the true number, with war crimes trials to follow if appropriate, starting with Bush and Blair for starting it all.

Is the decent left for that?

188

Brownie 10.14.06 at 8:02 pm

As for the odd position that Iraq is now better off without Saddam…

You mean the “odd” position held by a majority of Iraqis, according to the polls?

Who gets to decide whether Iraqi is “better off”, Roger? The people living there, or bloggers in Six Mile Bottom?

189

Brownie 10.14.06 at 8:06 pm

Is the decent left for that?

With respect Donald, the fact that you ask the question is proof positive that you know a whole lot less about what you call the “decent” left than you imagine. For example, every author at HP has called for the US and UK governments to do a count.

It just so happens that I made the same call about two hours ago.

Seriously, how about reading more and assuming less?

190

roger 10.14.06 at 9:23 pm

Wow, Brownie, if you analyse statistics like you parse sentences it would explain a lot.

Now, do try and read that sentence again. I’ll give you three more chances to figure out what it means. I’m not going to ask you to bring to this task any complicated rhetorical skills — don’t worry! No metaphors there to bite you, or irony. But watch out for the treacherous conjunctions! It is a skill you will need when you are older, say, and reading contracts, or signing up for cable tv. It is a harsh world out there for people who don’t understand main clause, modifying sub clause kinds of relations. Good luck! Hint: ‘but’ is one of those conjunctions like ‘and’, except often in a sentence, when you see it followed by a subjunctive modal, it is tricky, tricky tricky!

191

John Emerson 10.14.06 at 10:16 pm

The average Iraqi thinks that Iraq is better off now without Saddam, and that the US should leave immediately, and that attacks on American troops are justified. A complex mix, no?

192

Anton Mates 10.14.06 at 10:20 pm

“No, it doesn’t. It raises the excess violent death count to about 200,000, which is an increase of about 100,000 over the Falluja-excluded data. And it makes the error bars on that count so wide that the second study’s result doesn’t conflict with it at all.”

You’re wrong, Anton. From the study itself, page 4:

” In our Falluja sample, we recorded 53 deaths when only 1.4 were expected under the national pre-war rate. This indicates a point estimate of about 200,000 excess deaths in the 3% of Iraq represented by this cluster.

D’oh! You’re right about the 200,000 thing. Nonetheless, the next sentence is, “However, the uncertainty in this value is substantial and implies additional deaths above those measured in the rest of the country.” So: error bars.

“Sure one can, because the authors didn’t exclude any clusters in their new study. If one study has an apparent outlier which it excludes, and the other one does not, there’s no “discrepancy” in their getting different results.”

Okay Anton, I give up. We’ll do it your way. That leaves us with these 3 violent death figures from the Lancet studies, for the first 18 months of the war:

2004 study, minus Falluja cluster – 57,000.

2004 study, with Falluja cluster – more than a quarter million.

2006 study – more than 130,000.

So 2004 figure ignoring Falluja data

193

Anton Mates 10.14.06 at 10:24 pm

Note to self: Don’t use greater than/less than symbols on the Interweb. To continue:

So the 2006 study finds a figure which is greater than the 2004 study’s figure when the latter excluded Falluja, but less than the 2004 study’s figure when the latter included Falluja.

What’s the problem here? How else would you expect the three figures to stack up if the Falluja cluster was in fact an outlier?

194

Anton Mates 10.14.06 at 10:26 pm

And to make the first post a little more readable:

“No, it doesn’t. It raises the excess violent death count to about 200,000, which is an increase of about 100,000 over the Falluja-excluded data. And it makes the error bars on that count so wide that the second study’s result doesn’t conflict with it at all.”

You’re wrong, Anton. From the study itself, page 4:

” In our Falluja sample, we recorded 53 deaths when only 1.4 were expected under the national pre-war rate. This indicates a point estimate of about 200,000 excess deaths in the 3% of Iraq represented by this cluster.”

D’oh! You’re right about the 200,000 thing. Nonetheless, the next sentence is, “However, the uncertainty in this value is substantial and implies additional deaths above those measured in the rest of the country.”

195

Mike H 10.14.06 at 11:39 pm

“So the 2006 study finds a figure which is greater than the 2004 study’s figure when the latter excluded Falluja, but less than the 2004 study’s figure when the latter included Falluja.”

Anton, I’ve no idea where you’re trying to go with this. Forget Falluja. It isn’t helping your defense of the study, it’s hurting it.

“What’s the problem here? How else would you expect the three figures to stack up if the Falluja cluster was in fact an outlier?”

I think you know what the ” problem here” is, Anton. Earlier, you were attempting to claim that reintroducing the Falluja cluster results into the 2004 study solves the discrepancy between it and the 2006 study. Now that you know that isn’t the case, you’re singing an entirely different tune, and it sounds a whole lot like “so who said the Falluja cluster fixes everything? Not me.”

196

Ragout 10.15.06 at 12:30 am

Anton,

By my calculations, we have the following figures for the change in non-violent mortality rates:
First Study Change (After – Before) = 1.0 +/- 2.3
Second Study Change (1 Yr After – Before) = – 0.9 +/- 1.9
diff-in-diff of non-violent mortality = 1.9 +/- 3.0

So the first time round they said non-violent mortality went up by 1.0 per 1000, while the second time around they said it went down by 0.9 per 1000. The difference isn’t statistically significant, but it’s fairly close.

My point is that these calculations are based on the simplest possible statistics: comparing unadjusted means. Anything more complicated is going to reduce the confidence interval, and could well indicate a statistically significant difference. Examples of more complicated would be adjusting for region and age (which the Lancet studies never do) or basing the analysis on the log of cluster deaths (which is what they emphasized in the first study).

—– Details of Calculations —–

Mortality, excluding Falluja, old study
Before: 5.0 +/- 1.3, SE=0.65
After: 7.9 +/- 2.3, SE=1.15
change=2.9 +/- 2.6 SE= 1.3
= 71,000 +/- 63,000

Non-violent Mortality, excluding Falluja, old study
Before=45/(110,538/12) = 4.9 +/- 1.7
After = 69/(138,439/12) = 5.9 +/- 1.5
change=1.0 +/- 2.3
= 24,400 +/- 56,000
Note: SEs extrapolated from new study by multiplying by sqrt(47/33)

Non-violent mortality, new study
Before: 5.4 +/- 1.4
1 year After: 4.5 +/- 1.3
Change = – 0.9 +/- 1.9

diff-in-diff of non-violent mortality = 1.9 +/- 3.0

197

Anton Mates 10.15.06 at 12:31 am

Anton, I’ve no idea where you’re trying to go with this.

Okay, I’ll play along. To try again:

Falluja was pretty much the most violent spot in Iraq when they did the study. Therefore, when you take the 2004 data and exclude the chunk of Iraq’s population represented by Falluja, you’re probably going to underestimate the total number of violent deaths in Iraq, yes?

On the other hand, the Falluja cluster’s an outlier, and for this and various other reasons the authors listed, its insanely high mortality may be atypical. Therefore when you take the 2004 data and include Falluja, there’s a good chance of overestimating the total number of violent deaths, yes?

Therefore, the 2006 estimate being between the previous two numbers is not a problem. I’m not sure how to explain this more simply. But if you have an argument as to why it is a problem, feel free to share.

198

Anton Mates 10.15.06 at 1:58 am

Ragout,

So the first time round they said non-violent mortality went up by 1.0 per 1000, while the second time around they said it went down by 0.9 per 1000. The difference isn’t statistically significant, but it’s fairly close.

I think the second number should probably be 0.8 rather than 0.9, since the first study’s postwar period includes about a third of the second study’s next interval (where the non-violent deathrate increased a bit, though not back up to prewar levels.) While that may still be “close to significant,” as long as it’s not significant I don’t think the authors can be charged with dishonesty for not mentioning it.

My point is that these calculations are based on the simplest possible statistics: comparing unadjusted means. Anything more complicated is going to reduce the confidence interval, and could well indicate a statistically significant difference.

Right, but if the authors didn’t choose the simplest possible statistics to compute their estimated excess deaths in either study (note that they say they used the log-linear model in the second study as well), then I don’t see this implying any incomparability between the two. I realize that in principle you can throw enough parameters into a model to cook up a significant difference no matter what the data looks like, and I’m not competent to judge whether the authors did that, but I think the paper’s reviewers probably were.

199

tim 10.15.06 at 5:12 am

The pre war death rate of 5.5 is impossible if you assume an infant mortality rate of 10% as the Lancet does.

unless of course you believe that sanctions killed the under ones but once over one Iraq had the healthiest population in the world.

WHO figures show a crude death rate of 9.03

http://www3.who.int/whosis/life/life_tables/life_tables_process.cfm?path=life_tables),&language=english

200

Brownie 10.15.06 at 6:37 am

Roger,

Pitiful.

201

Brownie 10.15.06 at 6:45 am

Roger, you gave the readers this:

As for the odd position that Iraq is now better off without Saddam, but in 1983 would have been better off with Saddam – or is it that 1983 would have been chaos because the Baathist party would have disbanded – or is it that the chaos has nothing to do with the occupation and is because of apples not being oranges – in any case, it seems that any moral points one scores for getting rid of Saddam (even if the method was rather in the way Mafioso are gotten rid of—by their confederates) are going to slip away unless one decides, for no apparent reason, that chaos like this is to be expected.

and followed it with criticism of my ability to parse sentences.

You do see the irony, don’t you?

202

Lopakhin 10.15.06 at 7:45 am

Tim, your link doesn’t work. But the 9.03 figure is true – see my blog for instance. Or go to the WHO pages and select Iraq and 2001.

203

roger 10.15.06 at 9:29 am

Brownie, I’m disappointed. I told you, there was nothing complicated about the rhetoric. But – having decided, at first, that you could bite off a little bit of it and show that once again, the anti-war side (or is it the stopper side?) was soft on Saddam, now you quote the whole of a sentence listing the more and more specious and blackly comic alternative excuses to which the warmongers resort and marvel that it is such a big, big sentence! all too much to parse! so ironic! so hard to follow! Why, look at all the dashes. Such a lot of words! But I don’t expect you to understand the whole of it. Don’t worry. Only the mechanics of the first twenty three words will do.
And I know you can do it!

204

Matthew 10.15.06 at 1:23 pm

Tim,
You write:
between 4 and 5 according to the WHO.
And it is a freak stat at that.
25% of the population are “guests” who generally dont stay around to die there.
You’re not arguing that Iraq had the lowest adult death rate in the world are you?

I’ll answer once more but to be honest with you I don’t think you are particularly interested in the answer. I’m not arguing that as you well know. If you look at Wikipedia’s crude death rates you’ll see the lowest proper countries are Kuwait, Saudi and Jordan. Then Brunei, Libya and Oman. Then the Gaza Strip. Then (after the Solomon Islands) the West Bank.

These are all much lower than the estimate for Iraq, but it’s hardly an odd company to find Iraq, is it? I think if Jordan can have a death rate of 2.63, Iraq can have 5.5 or whatever it was.

205

Brownie 10.15.06 at 2:21 pm

Roger,

Let me know when you want to debate like a grown-up. I’ll be right here.

206

tim 10.15.06 at 3:41 pm

matthew,
the research claims a huge death toll for under ones in Iraq (10% infant mortality,3.4 deaths per thousand of the population)
but then it became the healthiest place in the world (2.1)

not credible.

207

Anton Mates 10.15.06 at 7:44 pm

The pre war death rate of 5.5 is impossible if you assume an infant mortality rate of 10% as the Lancet does.

I don’t think the study does assume that. You’re reading 10% off the end of the infant/child mortality graph in Appendix E, right? But that graph doesn’t continue into the pre-war period they examined; it seems to stop around 2001 or so. (It’s unclear because the time axis is badly drawn; the distance between the last two ticks is 3 years, rather than 5 as all the previous increments were.) So Appendix E doesn’t actually tell us what they thought pre-war infant mortality was.

The first Lancet study explicitly calculated a pre-war infant mortality rate as 2.9%. So far as I can see the second study didn’t make such a calculation, but they list 11 infant deaths in the pre-war period. With a sample population of 11327 at the beginning of the study and 1474 births over the whole 4.5-year period, that works out to an average yearly birthrate of about 29/1000. That implies about 380 births in the sample population during the pre-war period…which would again give you a pre-war infant mortality rate of 2.9%. (This is inexact, of course, since I don’t know yearly fluctuations in birthrate.)

In short, the first study’s infant mortality rate was given as 2.9% and the second study’s numbers imply a similar value, so there’s no reason to think the authors actually assumed it to be 10% the second time around.

Their graph was lousy, though, and if they were going to discuss the issue at all in the Appendix they really should have included their own estimate.

208

Anton Mates 10.15.06 at 9:09 pm

Also, as mentioned several times, low crude death rate doesn’t = healthy anyway. Look at the CIA Factbook list of death rates, for example.

Or, if you prefer WHO figures from 2001–the same figures that gave a crude death rate for Iraq of 9.03–they give the UK a rate of 10.83. Does that mean Iraqis were healthier than Brits that year?

209

trrll 10.15.06 at 10:04 pm

Ok, this is where I have a problem. It is too chaotic for people to go to hospitals (which have a discrete small number) but they can do a household survey? That is the kind of thing that makes me skeptical.

This might be a reasonable thing to do, but we only know that now based upon the findings of the Lancet study that death certificates were issued for the great majority of deaths. Prior to the study, there was no way of knowing whether this would have been a valid methodology. And it still would require identifying every single local authority that is issuing death certificates. If there isn’t a reliable master list somewhere, this could be more difficult and less reliable than cluster sampling.

210

trrll 10.15.06 at 10:37 pm

Additionally, if you can go to YouTube and watch a video of Horton venting his spleen at an anti-war rally, suspicions are going to be raised, justifiably or not. Horton has every right to do this and more, but if you are seriously looking to avoid the controversy that surrounds your work, it’s probably not a good idea. Grist to the mill, and all that.

The fact that the right wing is investing so much energy in ad hominem attacks on Horton indicates to me that they haven’t been able to find anything to attack the actual authors of the study. I suppose that possible political bias on the part of the editor might be a valid concern if the article were of flagrantly low quality and not up to scientific standards for the field of epidemiology. However, this is clearly not the case; the methodology is one that is standard and well-validated, and the authors do a good job of identifying and acknowledging factors that could potentially bias the conclusions.

211

Brownie 10.16.06 at 3:20 am

trill,

What exactly is “ad hominem” about my comment? I’m suggesting that Horton’s behaviour unnecessarily politicizes the study on Iraq . The point is that even if it were true that nobody could produce coherent criticisms of the report – Lancet 2 would be the first epidemiological study in the history of the world that was beyond criticism if this were correct – Horton opens the door wide to complaints that he and his organ are less than objective; complaints that may well be entirely baseless.

I would have thought that supporters of the study should be as concerned about this as anyone.

212

tim 10.16.06 at 3:25 am

Anton.
Two things here.
On infant mortality the WHO gives a figure of almost 10% for 2001.The Lancet claims that this has fallen to 2.9 percent just over a year later.
Not credible.

secondly,the WHO figure of 9.03 crude death rate if used in the research (rather than their 5.5 figure,based on analysis of a mere 82 deaths)would have changed the whole basis of the report.
They would have been left arguing that the invasion saved lives for the first two years.

213

Lopakhin 10.16.06 at 4:01 am

Anton: ‘So Appendix E doesn’t actually tell us what they thought pre-war infant mortality was.’

True, though nothing they say in that appendix would lead you to believe that they thought such an impressive transformation had occurred by 2002.

214

Anton Mates 10.16.06 at 10:37 am

Tim:

To sum up both your objections, WHO’s 2001 mortality estimates are very different from the Lancet studies’ 2002-2003 mortality estimates.

The WHO life tables are extrapolations of data from previous years–for instance, the table for 1999 relied on a variety of surveys, the latest of which was done in 1999. (See Life tables for 191 countries: Data, methods, and results for the gory details.)

So it’s possible that the WHO estimates are simply inaccurate for 2001, or at least less accurate than a post-2001 survey of that year’s mortality would have been. It’s also possible that mortality drastically improved between 2001 and early 2003.

To say the Lancet results aren’t “credible” based on conflict with WHO, you need to show that
a) WHO’s estimates are more likely to be accurate than the Lancet researchers’, even though only the latter used actual mortality data covering the time in question, and
b) mortality couldn’t drastically change in a year or two. Do you have evidence for that?

215

Anton Mates 10.16.06 at 10:53 am

Lopakhin:

True, though nothing they say in that appendix would lead you to believe that they thought such an impressive transformation had occurred by 2002.

I just emailed Dr. Burnham about that graph, and he replied,

“Thanks for your note. We included this from a USAID document, although I think the original came from UNICEF. We have no data to back that up, but presented it only as a bit of background information from what is out there. We have not done IMR or CMR from this study as of yet.”

If it’s a UNICEF figure, that last mark on the chart is probably from the Iraq Child and Maternal Mortality Surveys, published mid-1999, on which UNICEF continued to rely until 2004. That would merely require that the mortality drop occurred between 1998 and 2002.

Assuming that the UNICEF survey was accurate in the first place, of course. I know nothing of their methodology or confidence intervals.

216

Mr Brown 10.16.06 at 11:03 am

You do realise you sound like a three-year-old, don’t you? (Brownie, #78)

if you can go to YouTube and watch a video of Horton venting his spleen at an anti-war rally, suspicions are going to be raised (Brownie, #62)

Let me know when you want to debate like a grown-up. I’ll be right here. (Brownie, #206)

What exactly is “ad hominem” about my comment? (Brownie, #212)

ad hominem — an argument “against the man” or person. This is a device employed to attack not the issues but rather the one you are arguing with, especially on a personal level or basis. It is usually employed by those whose arguments are weak.

217

j. mcconell 10.16.06 at 11:37 am

First, The Lancet is no longer a reputable medical journal. This is just not my opinion, see http://www.timesonline.co.uk/article/0,,2-1658807,00.html for the opinion of 30 leading UK scientists of just how irresponsible The Lancet has become.

Second, all excess death studies like this I’ve read are simply nothing more than “made-up-numbers”. My favorite example of this syndrome is the Irish Potato Famine. According to the “excess death studies” 1 million died of hunger, according to the extensive documentary evidence 20K died of starvation, and few hundred thousand died of the diseases of poverty and malnutrition at rates not all that different from the over-crowed slums of London or Liverpool of the 1840′s.

So when it comes to the facts in 1840′s Ireland I prefer to believe the research and opinions of a Dr William Wilde, the very conscientious Medical Census Commissioner, rather than some “excess death study” written by some twit with an agenda.

And when it comes to Iraq I tend to believe the hard numbers I’ve seen that show that the violent death rate in Iraq over the last few years is very high, greater than South Africa but lower than Columbia. But 10 times higher than under Saddam? I dont think so.

Lies, damn lies, and Lancet studies..

218

Donald Johnson 10.16.06 at 3:46 pm

Brownie, just came back to applaud your call for an investigation into the death toll in Iraq. Yes, it surprises me. I haven’t seen too many war supporters wanting this. (Mike H wants it, though come to think of it I’m not sure he’s a war supporter now.)

219

Longhairedweirdo 10.16.06 at 4:18 pm

Brownie:

Additionally, if you can go to YouTube and watch a video of Horton venting his spleen at an anti-war rally, suspicions are going to be raised, justifiably or not. Horton has every right to do this and more, but if you are seriously looking to avoid the controversy that surrounds your work, it’s probably not a good idea. Grist to the mill, and all that.

You know, this kind of thing really pisses me off. It implicitly says that, even if he believes the numbers are correct, it’s poor form to go getting angry about them at an anti-war rally.

If he wasn’t ranting about these numbers, it’d make me a heck of a lot more suspicious than his being angry about them.

I believe there is at least something to be said for observable facts and I think you are a little too quick to discount some of the reasonable concerns being voiced e.g. death certificates. We’re told that it’s too dangerous to go to hospital to count death certificates, but it’s not too dangerous that 80% of Iraqis are going to hospitals to get deaths certified.

Who said that you had to go to a hospital to get a death certificate?

One cultural blindspot might be that, in America, doctors don’t make housecalls.

Do we know that’s true in Iraq? I would be mildly surprised if there weren’t house-calling doctors in Iraq. I would certainly be surprised if there wasn’t some entity capable of looking at someone who is stone-cold and say “Yeah, s/he’s dead; let me fill this out for you, so you can bury the body” without your having to go to a hospital, morgue, or doctor’s office.

220

Mike H 10.17.06 at 1:02 pm

“Brownie, just came back to applaud your call for an investigation into the death toll in Iraq. Yes, it surprises me. I haven’t seen too many war supporters wanting this. (Mike H wants it, though come to think of it I’m not sure he’s a war supporter now.)”

Hi Donald:

I abandoned this thread for fresher, greener debate pastures a couple days ago, but decided to pop back for a look at anything noteworthy.

You make an interesting observation about whether I’m a ” war supporter,” still. I confess I haven’t really asked myself that recently, at least not with the ” supporter ” moniker.

I’m disgusted with the way things have turned out. If I’d known that in advance, I wouldn’t have supported regime change, although I usually try to avoid the ” if I’d known in advance ” supposition because it’s essentially worthless when reevaluating one’s previous stance.

Most of my anger arises from the belief that this could have been done much better. I’m not prepared to say, knowing what we know now, that it could definitely have been done ” right,” but certainly better.

Bush and his inner circle deserve much of the blame, naturally. But the more *ahem* “partisan” of their critics have been unfair in apportioning blame. I see plenty of the more vocal Bush critics giving both the military and the Iraqi people complete passes on the blame game front. That’s ridiculous.

It’s ludicrous to absolve the American military of its share of responsibility, whether by inept high ranking commanders in the Pentagon and in the field, or the small percentage of psycopathic grunts on the ground who committed war crimes.

It’s equally ludicrous to allow the Iraqi people to emerge blameless. Given a chance at a fresh start, freed from a brutal dictator by the only means that was likely to accomplish that (foreign invasion), they’ve squandered it in a frenzy of sectarian, tribal hatred.

Sorry for digressing. Back to the question of my ” support, ” or lack thereof, for the war.

I support the continuing presence of coalition troops in Iraq. I think there’s a subtle difference between that, and supporting the war. It would be better if there had been no invasion, although that comes with the caveat that we don’t know what Saddam might have done to his people had he been in power still. But there was an invasion, and we are where we are. We can’t change that.

U.S. troops are preventing a much higher death toll from occurring. It’s interesting to note (and this seems to have been overlooked by many who want the U.S. out of Iraq), that it isn’t just the Shiite dominated Iraqi government that wants U.S. troops to remain. Since the Shiites started fighting back, tit for tat, on the sectarian front, we’re seeing prominent Sunnis stating that U.S. troops need to stay, to protect their communities.

You’ve seen enough of my posts here and at Deltoid to know I believe Lancet 2′s death toll is grossly inaccurate. If the Americans were to abruptly pull out, it won’t be for long.

221

trrll 10.17.06 at 5:48 pm

october 16,

“What exactly is “ad hominem” about my comment?”

An ad hominem argument is defined as “attacking an opponent’s motives or character rather than the policy or position they maintain.” So attempting to impugn the study by citing the actual or supposed political views of the Lancet editor or the authors of the report is necessarily an ad hominem argument.

In contrast, it would not be ad hominem if it you were to first show that the editing or reviewing of the manuscript was in flagrant violation of scientific standards, and then offer the editor’s political views as a possible motive.

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