Iraq: the Human Cost


The number of persons dying in Iraq has continued to escalate with each year. The proportion of deaths ascribed to coalition forces has diminished in 2006. However, the actual numbers of Iraqis whose deaths are ascribed by household members to the coalition have increased each year. Gunfire remains the most common reason for death, though deaths from car bombings have increased from 2005. Deaths from non-violent causes have increased for 2005 and 2006 suggesting a trend in deaths due to deterioration in health services and the environment health threats, as well as decreasing access to health services. From a statistical standpoint, the numbers of deaths due to non-violent causes is too small to reach definitive conclusions.

Our best estimate is the 654,965 persons have died as a consequence of the conflict. Of these, 601,027 have died from violence.While the actual value may be somewhat higher or lower than this number, the precision of these results is adequate to conclude that loss of life in this conflict has been substantial. This is far greater than reported by various media accounts and morgue tallies. This is not surprising, as reporting of events from incomplete sources cannot, in any statistically meaningful way, be converted into national death rates. Other than Bosnia, we are unable to find any major historical instances where passive surveillance methods (such as morgue and media reports) identify more than 20% of the deaths which were found through population-based survey methods. 10, 11, 12, 13

As with other recent conflicts, the civilians of Iraq bear the consequence of warfare. In the Vietnam War, 3 million civilian died; in the Congo, armed conflict has been responsible for 3.8 million deaths; in East Timor, an estimated 200,000 out of a population of 800,000 died in conflict.14, 15, 16 Recent estimates are that 200,000 have died in Darfur over the past 31 months.17 Our data, which estimate that 654,965 or 2.5% of the Iraqi population has died in this, the largest major international conflict of the 21st century, should be of grave concern to everyone.


Standard methods for estimated to burden of disease from conflicts in a reliable manner exist. In this and other conflicts it has been shown that estimation of death rates can be done in a meaningful manner.We recommend that an international mechanism be established to regularly monitor deaths due to conflict and their causes to provide information that will help protect the lives of persons caught up in the midst of conflict.


We gratefully acknowledge the assistance of Scott Zeger in the study design and analysis, Elizabeth Johnson with statistical analysis, and Court Robinson and Stan Becker, who helped with the study conceptualization and demographic analysis. John Tirman of MIT edited this report.

We express our deepest admiration for the dedicated Iraqi data collectors who have asked not to be identified.

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  13. Goma Epidemiology Group. Public Health Impact of Rwandan Refugee Crisis:What Happened in Goma, Zaire, in July, 1994. Lancet, 1995; 345:339-44.
  14. Allukian M, Atwood PL. Public health and the Vietnam War. In War and Public Health, Levy BS, Sidel VW, eds.,Washington, DC; American Public Health Association, 2000.
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  16. CNN. US approved E. Timor invasion: documents. (accessed Sept 10, 2006).
  17. Hagan J, Palloni A. Death in Darfur. Science, 2006; 313:1578-9.

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