Les Roberts (Johns Hopkins Bloomberg School of Public Health, Baltimore, USA) and colleagues did a survey to investigate the effect of the Iraq war on civilian deaths by comparing mortality during the 14.6 months before the March 2003 invasion with the 17.8 months after it. The investigators interviewed a total of 988 households from 33 randomly selected neighbourhoods of Iraq; in those households reporting deaths since January 2002, the date, cause, and circumstances of violent deaths were recorded.
Overall, the risk of death was 2.5 times greater after the invasion, although the risk was 1.5 times higher if mortality around Falluja (where two-thirds of violent deaths were reported) is excluded. The investigators estimate that a 1.5 times increase in deaths equates to an excess of 98,000 deaths relating to the Iraq conflict, although this estimate would be much greater if Falluja data is included.
Violence was the primary cause of death after the invasion; Violent deaths were widespread, reported in 15 of 33 clusters surveyed, and were mainly attributed to coalition forces (predominantly air strikes). Most individuals reportedly killed by coalition forces were women and children. The risk of death from violence in the period after the invasion was 58 times higher than in the period before the war. The major causes of death before the invasion were heart attack, stroke, and chronic illness.
Dr Roberts comments: "Making conservative assumptions, we think that about 100 000 excess deaths or more have happened since the 2003 invasion of Iraq. Violence
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Contact: Joe Santangelo
j.santangelo@elsevier.com
1-212-633-3810
Lancet
28-Oct-2004