In an update of a two-year-old survey that sparked wide disagreement, Johns Hopkins researchers now estimate that more than a half-million Iraqis have died as a result of the U.S.-led invasion and its bloody aftermath.
Reporting this week in the online edition of The Lancet, a leading British medical journal, the researchers estimated that 654,000 more Iraqis died of various causes after the invasion than would have died in a comparable period before.
The scientists attributed 600,000 of those deaths to acts of violence.
Gunshots emerged as the leading cause of death, accounting for 56 percent of the total. Airstrikes, car bombs and other explosions each accounted for 13 percent to 14 percent. Almost 60 percent of the deaths were among males 15 to 44.
"In this conflict, like all other recent conflicts, it's the population that bears the consequences," said Dr. Gilbert Burnham, lead author and co-director of the Center for Refugee and Disaster Response at the Johns Hopkins Bloomberg School of Public Health.
"To put these numbers in context, deaths are occurring in Iraq now at a rate more than three times that from before the invasion of March 2003," he said.
With deaths increasing at that pace, Burnham said, the crisis in Iraq qualifies as a "humanitarian emergency," a public health term applied to situations in which populations die at twice or more the usual rate.
The Pentagon declined to comment on the study, saying that officials had not yet read it. Army Lt. Col. Christopher Garver, a spokesman for the Multi-National Force in Iraq, said the force was "interested" in the study but doesn't normally comment on Iraqi deaths.
"We're obviously trying to reduce the amount of violence of all kinds in Iraq, but it's really a government of Iraq issue," he said.
In August, the Defense Department reported to Congress that the number of civilian casualties had increased sharply, without estimating total deaths.
In 2005, however, the Bush administration estimated that 30,000 civilians had died. A report by the Los Angeles Times in June, based on statistics from the Iraqi Health Ministry and the Baghdad morgue, put civilian deaths at 50,000.
To estimate deaths for this week's report, the Hopkins group recruited Iraqi doctors to conduct household surveys in 47 neighborhood clusters across Iraq that contained 1,849 households and 12,801 people. The doctors asked family members to report births, deaths and the movement of people into and out of their households.
