How Many Iraqis Have Really Died?

It's one of the most controversial questions today: How many Iraqis have died since the 2003 U.S.-led invasion?

That there is no definitive answer should not come as a surprise, given the chaotic situation in Iraq. Still, it's an important question to ask for obvious humanitarian, moral and political reasons.

Theoretically, the public health surveys and polls that have been conducted in Iraq -- at great risk to the people involved -- should help inform and further the debate. But the data is complicated by different research approaches and their attendant caveats. The matter has been further confused by anemic reporting, with news articles usually framed as a "he said/she said" story, instead of an exploration and interpretation of research findings.

These are the conditions under which spin thrives: complex issues, political interests and weak reporting. So it's not too surprising that last month saw a spate of what international health researcher Dr. Richard Garfield calls "Swift Boat editorials."

Attack: Iraq research

Garfield co-authored a 2004 study, published in the British medical journal The Lancet, that estimated that 98,000 more Iraqis died in the 18 months following the U.S. invasion than would have died otherwise. The recent editorials skewered a 2006 follow-up study that estimated more than 650,000 Iraqi "excess deaths" in the 40 months following the invasion. (Garfield was not involved with the 2006 study; in fact, he co-wrote a critique of it to which the study authors have responded.)

"The truth was irrelevant," fumed the Wall Street Journal's Jan. 9 editorial, adding that the 2006 Lancet study "could hardly be more unreliable," yet its 650,000 figure "was trumpeted by the political left because it fit a narrative that they wanted to believe. And it wasn't challenged by much of the press because it told them what they wanted to hear."

In a more measured column published the previous day, the Washington Times also rejected the Lancet study's 650,000 figure, in favor of the up to 87,000 "documented civilian war deaths" reported by the Iraq Body Count project. The two figures represent "the difference between epochal human tragedy and genocidal madness," opined the newspaper. A similar editorial by conservative columnist Jeff Jacoby ran in the Boston Globe and International Herald Tribune the following week. Other editorials and news articles questioning the Lancet study appeared throughout January.

What fueled renewed criticism of 15-month-old research? Two things: a National Journal article that described what it called "potential problems" with the Lancet study, and a new survey from the Iraqi health ministry and World Health Organization (WHO) that estimated 151,000 "violent deaths … from March 2003 through June 2006," the same period covered by the Lancet paper.

The recent newspaper editorials were prompted by, and quoted extensively from, the National Journal's Jan. 5 cover story, "Data Bomb." That article (and the editorials it inspired) bemoaned a lack of skepticism towards the 2006 Lancet study, especially among reporters. "Within a week, the study had been featured in 25 news shows and 188 articles in U.S. newspapers and magazines," wrote co-authors Neil Munro and Carl M. Cannon.

However, this characterization neglects the fact that much of the initial coverage of the Lancet study was skeptical bordering on critical. A review of October 2006 U.S. newspaper and wire stories containing the words "Lancet," "Iraq," and "dead" or "death" found that most news reports presented the study as "controversial" (Associated Press, Los Angeles Times, San Francisco Chronicle and Christian Science Monitor, among others), "discredited" (Boston Herald), "politically motivated" (Baltimore Sun), or even an "October surprise" (Washington Post) designed to hurt Republicans in the November 2006 midterm elections. (In contrast, letters to the editor that cited the Lancet study that month unanimously accepted its conclusions, as did the vast majority of editorial columns.)