Iraq: the Human Cost


The Human Cost of the War in Iraq: a Mortality Study 2002-06

Survey Findings

Among the 12,801 persons included in the survey, there were 1,474 births and 629 deaths reported in the period from January 2002 through June 2006.

Death rates

Deaths reported were converted to rates, that is, the number of deaths occurring for every 1,000 persons in a year. The death rate is made up of all the deaths from all causes is called the crude death rate. In the period between January 2002 and the time of the invasion (March 2003), the 2006 survey found the crude death rate was found to be 5.5 deaths per 1,000 persons each year. This number is very close the figure determined by the U.S. Census Bureau, and the number quoted by the CIA. In the 2004 survey, we found this figure to be 5.0 deaths/1,000/year, a figure that is very similar.

Crude mortality rates

For the purpose of analysis, the 40 months of survey data were divided into three equal periods—March 2003 to April 2004; May 2004 to May 2005, and June 2005 to June 2006. Following the invasion the death rate rose each year.

  • Pre-invasion: 5.5 deaths/1,000/year
  • March 2003-April 2004: 7.5 deaths/1,000/year
  • May 2004-May 2005: 10.9 deaths/1,000/year
  • June 2005-June 2006: 19.8 deaths/1,000/year
  • Overall post-invasion: 13.2 deaths/1,000/year

These and other death rates from the study data are shown in Figure 1.

figure 1

Figure 1.

Excess death rate

The rate of 5.5 deaths/1,000/year will be considered as the “baseline” crude death rate, making the assumption that without conflict this rate would have continued at this level up to the present time, or even dropped somewhat (most likely). On the graph, the number of excess deaths is shown with the red line. The post-invasion excess death rate was:

  • March 2003-April 2004: 2.6 deaths/1,000/year
  • May 2004-May 2005: 5.6 deaths/1,000/year
  • June 2005-June 2006: 14.2 deaths/1,000/year
  • Overall post-invasion: 7.8 deaths/1,000/year

Violent death rates

As there were few violent deaths in the survey population prior to the invasion, all violent deaths can be considered “violent excess deaths.” The post-invasion violent death rate was:

  • March 2003-April 2004: 3.2 deaths/1,000/year
  • May 2004-May 2005: 6.6 deaths/1,000/year
  • June 2005-June 2006: 12.0 deaths/1,000/year
  • Overall post-invasion: 7.2 deaths/1,000/year

Non-violent death rates

The deaths recorded for the pre-invasion period in both the 2004 and the 2006 surveys were almost entirely non-violent deaths. (We define non-violent deaths as not due to intentional violence—that is, our non-violent deaths include deaths in “accidents,” such a traffic fatalities.) Immediately post-invasion, the death rate due to non-violent causes dropped slightly, then stayed level for the next period, but began to rise in the period from June 2005 until June 2006. The excess death rate due to non-violent causes is estimated to be 1.2 deaths/1,000/year for this most recent period of time, and 2.0 deaths/1,000/year for the first six months of 2006. It is not possible to say that this number is a statistically significant increase over the pre-invasion baseline death rate. However, this may represent the beginning of a trend toward increasing deaths from deterioration in the health services and stagnation in efforts to improve environmental health in Iraq.

Estimating deaths among the Iraqi population

Using the figure of 5.5 deaths/1,000/year as a baseline for the following years, then any rate above this figure would be considered excess deaths. For the entire post-invasion period the excess deaths were 7.2/1,000/year.When these rates of excess deaths are applied to the population of the survey area (26.1 million), we estimate that through July 2006, there have been 654,965 excess deaths in Iraq as a consequence of the war from all causes.

Excess deaths can be further divided into those from violent and from non-violent causes. The vast majority of excess deaths were from violent causes. The excess deaths from violent causes were 7.2/1,000. Applying this to the population we estimate that 601,027 were due to violent causes.

This would leave 53,938 excess deaths due to non-violent causes. The number of deaths from non-violent causes remained more or less the same through the early 2006 when they began to rise.

The geographic distribution of deaths by governate is represented Figure 2, showing the highest death rates much where they would be expected, in the Sunni Arab provinces.

Figure 2

Figure 2. Death rates due to violent causes, by governate.

Weapons causing death

From the accounts of households, it was almost always possible to identify the weapon or type of ordnance responsible for the death of the household member. This is seen in Table 2 on the following page.

From the beginning, the major cause of deaths was due to gunshots. Air strikes were common causes of death in the beginning. Air strikes caused about 13% of deaths from known causes throughout the war. In some places air strikes caused a large proportion of deaths. Increasing deaths from car bombs developed later. In some cases, what was classified as a car bomb might have been a mortar shell impacting on an automobile.

Table 2: Source of violence 

Mar 03-Apr 04 
May 04-May 05 
Jun 05-Jun 06 
Violent, coalition  1 (50%)  16 (36%)  35 (39%)  43 (26%)  95 (31%) 
Violent, other  0 4 (9%)  17 (19%)  50 (30%)  71 (24%) 
Violent, unknown  1 (50%)  25 (56%)  38 (42%)  72 (44%)  136 (45%) 
Gunshot  0 36 (80%)  46 (51%)  87 (53%)  169 (56%) 
Car bomb  0 1 (2%)  7 (8%)  30 (18%)  38 (13%) 
Other explosion/ ordinance  1 (50%)  1 (2%)  21 (23%)  20 (12%)  43 (14%) 
Air strike  1 (50%)  6 (13%)  13 (14%)  20 (12%)  40 (13%) 
Violent, unknown  0 0 2 (2%)  4 (2%)  6 (2%) 
Accident  0 1 (2%)  1 (1%)  4 (2%)  6 (2%) 
Total deaths  2 45 90 165 302

Responsibility for deaths

Households were asked what party was responsible for the killing of their household member. In many cases it was not clear. There was great difficulty in identifying which were criminal events. Only when the household was certain that the death was as a consequence of coalition actions was this recorded as such.

In Figure 3 below we have shown the entire pattern of deaths for the survey years. The deaths from coalition forces prior to the invasion were related to air strikes in the time leading up to the invasion. For this survey, the deaths recorded were those that households attributed to specific parties.We had no independent method for identifying parties responsible for these deaths.

The percentage of the deaths that were attributed to coalition forces varied from year to year. However the absolute numbers of deaths attributed by households to coalition forces rose through 2005, then levelled off during 2005, only to start rising again in 2006. For 2006, a smaller proportion of death was attributed to the coalition, but the number of people killed in 2006 from all causes substantially increased, and this increase means a larger actual number of deaths occurring from attacks attributed to the coalition. As can be seen from Figure 3, however, the growing proportion of deaths not specifically attributed to coalition forces rose significantly in the last year. Figure

Figure 3

Figure 3.

Age distribution of deaths

Figure 4 shows the age and sex for all deaths in the survey households and those deaths that were reported from violent causes. The first graph shows all deaths. The pattern for females is what would be usual for both males and females, in almost all countries of the world. However, in this graph there is a great excess in deaths among males of all ages in comparison with females. In the next graph is shown the deaths from violent causes by age and sex. As can be seen, violent deaths account for most of the deaths, and violent deaths are almost entirely in males. Among the males, there were no practical survey methods to determine which of the deaths were among active combatants. It is interesting to note that the largest single age group of female deaths was among the under age 15 years.

Figure 4

Figure 4.


Any collection of information is open to potential bias, and has limitations. All efforts were made to randomly select the households to be included in this survey, but it may have been that households with more deaths or households with fewer deaths were over represented in this survey. The finding that the 2006 results are very close to the 2004 household results suggests this did not occur. As in all surveys, a larger sample would have likely have produced a result with greater precision, although this would have exposed the survey teams to higher risk. In the future, when safety has improved, a large survey will be needed to determine in detail the total implications of the conflict for the people of Iraq.

The households were selected for this survey according to population size we obtained from the Ministry of Planning, but this may not have fully reflected migration within or outside the country. However, it is unlikely that this would have occurred at a scale necessary to affect findings.

Perhaps the greatest potential limitation to this type of survey is the problem people have recalling the date of specific events, especially over several years. Again, the close similarities between the 2004 and the 2006 data suggest this was not a major problem. Households could have concealed deaths from the interviewers, though by promising anonymity to households we tried to minimize this risk. We are certain that households did not report deaths which did not occur, as 92% of households had death certificates for deaths they reported.

In the news media coverage of the 2004 survey report, much was made of the wide confidence intervals, which is a statistical technique that was frequently misunderstood.With the much larger sample of the 2006 survey, the confidence intervals are narrowed significantly. For the single most important categorynges from 426,369 to 793,663. That means that we are 95% certain that the correct number is between those two, and 601,027, is the statistically most probable number. The likelihood that another number is the correct number decreases very rapidly as one moves up or down from the figure of 601,027.

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