University of Washington School of Public Health

UW SPH News: New Approach Estimates Human Cost of Iran-Iraq War and First Gulf War

New Approach Estimates Human Cost of Iran-Iraq War and First Gulf War

11/08/2016
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Using a new approach to measure historical war-related deaths, researchers at the University of Washington School of Public Health confirm that nearly 240,000 people died from causes attributable to wars in Iraq from 1980 through 1993.

The study, published online Oct. 21 in the open-access journal PLOS One, used data from a survey of Iraqi households to estimate casualties of the Iran-Iraq War and the First Gulf War. Researchers then verified the mortality estimates by tracking the frequency of war-related news in the region during the time period, as covered by the New York Times.

“War is one of the most urgent public health problems today,” said Amy Hagopian, associate professor of health services and global health at the School. “Unfortunately, however, conflict epidemiology—the study of the health effects of war and armed conflict—is ignored by both government science agencies and foundations alike.”

Researchers used data from a nationwide survey conducted in 2011 of 4,287 adults from 2,000 households throughout Iraq. The survey was conducted by the University Collaborative Iraq Mortality Study, which was led by Hagopian and included researchers from four other universities.

“We asked all adults in each household about the vital status of their siblings. In this way, we learned about the status of 25,000 adults dating back to the 1980s and early 1990s,” Hagopian said. The adults were interviewed about the circumstances surrounding their siblings’ death, including how, when and where they died.

Death rates were multiplied by population estimates. Findings showed that more than 498,760 adults, aged 15-60 years, died during the study period. Nearly half of these deaths were attributed to direct war-related injuries, like those caused by gunshots and airstrikes. Almost all of the survey participants were able to report a cause of death for their deceased family member, the researchers noted.

“We needed a way to assess whether these reports were reliable, despite the length of the recall period,” Hagopian said. “We decided that since the two wars were pretty well covered in the New York Times, we could use categories and counts of news stories as a proxy for the intensity of the war.”

Researchers used the ProQuest New York Times database to search for articles about events associated with Iraq and Iran for the years of this study. After eliminating reports of duplicate events, researchers counted 4,769 unique war events that could have influenced Iraqi mortality.

“Our methods question was whether the pattern of mortality, as reported by siblings, would mirror the newspaper account pattern,” Hagopian said. “It turned out it was.”

The findings showed that an increase in war-related news reports corresponded with an increase in sibling reports of deaths for the same period of time.

Hagopian was a senior author. Shang-Ju Li, the lead author, was studying for his MPH in the School’s Department of Global Health at the time of the study. Abraham Flaxman, assistant professor of global health at the School, and Riyadh Lafta, affiliate professor of global health at the School and a professor of medicine at Mustansiriya University in Baghdad, also contributed.