New research on the human cost of the war in Iraq estimates that roughly half a million men, women and children died between 2003 and 2011 as a direct result of violence or the associated collapse of civil infrastructure.
In a study published Tuesday in the journal PLOS Medicine, researchers concluded that at least 461,000 "excess" Iraqi deaths occurred in the troubled nation after the U.S.-led invasion that resulted in the overthrow of President Saddam Hussein. Those were defined as fatalities that would not have occurred in the absence of an invasion and occupation.
The study's release follows several controversial and widely varying estimates of Iraq war deaths. It is the first analysis published since 2006, the bloodiest period of the war.
Lead author Amy Hagopian, an associate professor of global health at the University of Washington, said the analysis was limited by a lack of accurate health and census reporting in Iraq. However, she said, it was a duty of public health officials to assess the effects of war.
"It's a politically loaded topic," Hagopian said. "Everyone's against polio and wants to eradicate it, but it's different with war."
According to Hagopian and her colleagues, at least 60% of the excess deaths were the result of violence. The rest were linked to so-called secondary causes.
"War causes a huge amount of chaos, disruption and havoc," Hagopian said. "Some deaths are direct, but there are also deaths that result from destroyed infrastructure, increased stress, inability to get medical care, poor water, poor access to food.... These are all reasons why people die."
Of those deaths determined to be the result of direct violence, the study attributed 35% to coalition forces, 32% to sectarian militias and 11% to criminals. Contrary to public perception of mayhem in Iraq, bombings accounted for just 12% of violent deaths. The overall majority of violent deaths, 63%, were the result of gunfire.For discussion on this deeply disturbing subject, see Speaking of Medicine, the journal's blog.