[Vision2020] Body Count in Iraq

[Joan Opyr]

Thanks for the information, Dave.  I'm a regular reader of The Economist, though, as you can imagine, we part company on many issues.  The Iraq War was one of those issues -- The Economist has spent the past four years making a variety of excuses for Mr. Bush's poor planning and conduct of the war, at least in part, I believe, as some kind of defense for endorsing him in 2000.  (Oh, what a boo-boo.)

It wouldn't surprise me in the least to learn that all causes of death had gone up in Iraq, and that those were taken into account as well as deaths directly attributable to violence.  Imagine: the country is in complete and utter turmoil.  Phone service is sporadic; there is no functioning police force; the hospitals are understaffed, overcrowded, and short on supplies.  Fallujah has been flattened.  The water's dirty, the lights won't stay on, and you can't drive safely from one end of Baghdad to the other.  So, you're pregnant and need to get to the delivery room.  The cord's knotted around the baby's neck.  Bad outcome.  Grandpa falls and breaks his hip.  Ordinarily, this wouldn't kill him, but under the circumstances, he doesn't get the treatment he needs, he develops a secondary infection, and he dies.  These, too, are casualties of war; they're casualties of the chaos of war.

Joan Opyr/Auntie Establishment
www.auntie-establishment.com

PS: The Economist has been wrong on virtually all of its Iraq predictions/analyses thus far.  Dead wrong.  Call me foolish, call me stubborn, call me a three-legged mule, but I'll stick with The Lancet.  If this war follows the pattern of all previous conflicts, we won't have any accurate figures on the civilian casualties until years after the conflict has ended

----- Original Message -----
From: David M. Budge
Sent: Sunday, February 13, 2005 7:00 PM
To: Joan Opyr
Cc: Vision2020 Moscow
Subject: Re: [Vision2020] Body Count in Iraq

Joan,

Just FYI re: The Lancet study - not that this will assuage the horror,  
but again, one must be cautious when using statistics.  The confedence  
interval is 95% from 8,000 to 196,000 deaths.  The sample was small, and  
the study includes all deaths, violent or natural.  

Dave Budge

>From The Economist 11/4/04

Money Quote:

    The study can be both lauded and criticised for the fact that it
    takes into account a general rise in deaths, and not just that
    directly caused by violence. Of the increase in deaths (omitting
    Fallujah) reported by the study, roughly 60% is due directly to
    violence, while the rest is due to a slight increase in accidents,
    disease and infant mortality. However, these numbers should be taken
    with a grain of salt because the more detailed the data--on causes
    of death, for instance, rather than death as a whole--the less
    statistical significance can be ascribed to them.

The Entire Article:


The Iraqi war

Counting the casualties
Nov 4th 2004
>From The Economist print edition


AP



A statistically based study claims that many more Iraqis have died in  
the conflict than previous estimates indicated

THE American armed forces have long stated that they do not keep track  
of how many people have been killed in the current conflict in Iraq and,  
furthermore, that determining such a number is impossible. Not everybody  
agrees. Adding up the number of civilians reported killed in confirmed  
press accounts yields a figure of around 15,000. But even that is likely  
to be an underestimate, for not every death gets reported. The question  
is, how much of an underestimate?

A study published on October 29th in the Lancet, a British medical  
journal, suggests the death toll is quite a lot higher than the  
newspaper reports suggest. The centre of its estimated range of death  
tolls--the most probable number according to the data collected and the  
statistics used--is almost 100,000. And even though the limits of that  
range are very wide, from 8,000 to 194,000, the study concludes with 90%  
certainty that more than 40,000 Iraqis have died.


Numbers, numbers, numbers

This is an extraordinary claim, and so requires extraordinary evidence.  
Is the methodology used by Les Roberts of the Johns Hopkins University  
School of Public Health, in Baltimore, and his colleagues, sound enough  
for reliable conclusions to be drawn from it?

The bedrock on which the study is founded is the same as that on which  
opinion polls are built: random sampling. Selecting even a small number  
of individuals randomly from a large population allows you to say things  
about the whole population. Think of a jar containing a million marbles,  
half of them red and half blue. Choose even 100 of these marbles at  
random and it is very, very unlikely that all of them would be red. In  
fact, the results would be very close to 50 of each colour.

The best sort of random sampling is one that picks individuals out  
directly. This is not possible in Iraq because no reliable census data  
exist. For this reason, Dr Roberts used a technique called clustering,  
which has been employed extensively in other situations where census  
data are lacking, such as studying infectious disease in poor countries.

Clustering works by picking out a number of neighbourhoods at random--33  
in this case--and then surveying all the individuals in that  
neighbourhood. The neighbourhoods were picked by choosing towns in Iraq  
at random (the chance that a town would be picked was proportional to  
its population) and then, in a given town, using GPS--the global  
positioning system--to select a neighbourhood at random within the town.  
Starting from the GPS-selected grid reference, the researchers then  
visited the nearest 30 households.

In each household, the interviewers (all Iraqis fluent in English as  
well as Arabic) asked about births and deaths that had occurred since  
January 1st 2002 among people who had lived in the house for more than  
two months. They also recorded the sexes and ages of people now living  
in the house. If a death was reported, they recorded the date, cause and  
circumstances. Their deductions about the number of deaths caused by the  
war were then made by comparing the aggregate death rates before and  
after March 18th 2003.

They interviewed a total of 7,868 people in 988 households. But the  
relevant sample size for many purposes--for instance, measuring the  
uncertainty of the analysis--is 33, the number of clusters. That is  
because the data from individuals within a given cluster are highly  
correlated. Statistically, 33 is a relatively small sample (though it is  
the best that could be obtained by a small number of investigators in a  
country at war). That is the reason for the large range around the  
central value of 98,000, and is one reason why that figure might be  
wrong. (Though if this is the case, the true value is as likely to be  
larger than 98,000 as it is to be smaller.) It does not, however, mean,  
as some commentators have argued in response to this study, that figures  
of 8,000 or 194,000 are as likely as one of 98,000. Quite the contrary.  
The farther one goes from 98,000, the less likely the figure is.

The second reason the figure might be wrong is if there are mistakes in  
the analysis, and the whole exercise is thus unreliable. Nan Laird, a  
professor of biostatistics at the Harvard School of Public Health, who  
was not involved with the study, says that she believes both the  
analysis and the data-gathering techniques used by Dr Roberts to be  
sound. She points out the possibility of "recall bias"--people may have  
reported more deaths more recently because they did not recall earlier  
ones. However, because most people do not forget about the death of a  
family member, she thinks that this effect, if present, would be small.  
Arthur Dempster, also a professor of statistics at Harvard, though in a  
different department from Dr Laird, agrees that the methodology in both  
design and analysis is at the standard professional level. However, he  
raises the concern that because violence can be very localised, a sample  
of 33 clusters really might be too small to be representative.

This concern is highlighted by the case of one cluster which, as the  
luck of the draw had it, ended up being in the war-torn city of  
Fallujah. This cluster had many more deaths, and many more violent  
deaths, than any of the others. For this reason, the researchers omitted  
it from their analysis--the estimate of 98,000 was made without  
including the Fallujah data. If it had been included, that estimate  
would have been significantly higher.

The Fallujah data-point highlights how the variable distribution of  
deaths in a war can make it difficult to make estimates. But Scott  
Zeger, the head of the department of biostatistics at Johns Hopkins, who  
performed the statistical analysis in the study, points out that  
clustered sampling is the rule rather than the exception in  
public-health studies, and that the patterns of deaths caused by  
epidemics are also very variable by location.

The study can be both lauded and criticised for the fact that it takes  
into account a general rise in deaths, and not just that directly caused  
by violence. Of the increase in deaths (omitting Fallujah) reported by  
the study, roughly 60% is due directly to violence, while the rest is  
due to a slight increase in accidents, disease and infant mortality.  
However, these numbers should be taken with a grain of salt because the  
more detailed the data--on causes of death, for instance, rather than  
death as a whole--the less statistical significance can be ascribed to them.

So the discrepancy between the Lancet estimate and the aggregated press  
reports is not as large as it seems at first. The Lancet figure implies  
that 60,000 people have been killed by violence, including insurgents,  
while the aggregated press reports give a figure of 15,000, counting  
only civilians. Nonetheless, Dr Roberts points out that press reports  
are a "passive-surveillance system". Reporters do not actively go out to  
many random areas and see if anyone has been killed in a violent attack,  
but wait for reports to come in. And, Dr Roberts says,  
passive-surveillance systems tend to undercount mortality. For instance,  
when he was head of health policy for the International Rescue Committee  
in the Congo, in 2001, he found that only 7% of meningitis deaths in an  
outbreak were recorded by the IRC's passive system.

The study is not perfect. But then it does not claim to be. The way  
forward is to duplicate the Lancet study independently, and at a larger  
scale. Josef Stalin once claimed that a single death is a tragedy, but a  
million deaths a mere statistic. Such cynicism should not be allowed to  
prevail, especially in a conflict in which many more lives are at stake.  
Iraq seems to be a case where more statistics are sorely needed.Get more from the Web.  FREE MSN Explorer download : http://explorer.msn.com
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