Last fall, a major public-health study appeared in The Lancet, a prestigious British medical journal, only to be missed or dismissed by the American press. To the extent it was covered at all, the reports were short and usually buried far from the front pages of major newspapers. The results of the study could have played an important role in future policy decisions, but the press’s near total silence allowed the issue to pass without debate.
The study, though scientifically robust, had several elements working against it. One was its subject matter: Researchers had done a door-to-door survey of nearly 8,000 people in thirty-three locations in Iraq to estimate how many people had died as a consequence of the U.S.-led invasion and occupation. Americans, and their media, were reluctant to accept the study’s conclusions — that the number was likely around 100,000; that violence had become the primary cause of death since the invasion; that more than half of those killed were women and children.
Adding to the scent of propaganda was the fact that The Lancet had rushed the study into print at the lead author’s request. Some reporters may have guessed that the rushed publication — with the U.S. presidential election looming — meant that the study itself was essentially political. But medical journals often fast-track papers that have immediate importance to doctors or to public-health policy. When I was working on a follow-up article about the study for The Chronicle of Higher Education in January, I made three phone calls to other major medical journals and quickly discovered that the manuscript’s turnaround time, about four weeks, was not outside the norm for fast-tracked papers and did not necessarily mean that editing and peer review had been compromised.
But there’s more to the matter than ideology. The way the researchers presented their results made it difficult for statistics-shy journalists to grasp their significance. The scientists, from Johns Hopkins University, Columbia University, and Al-Mustansiriya University in Baghdad, reported a so-called 95 percent confidence interval. They said that they were 95 percent sure the number of deaths lay between 8,000 and 194,000.
Eight thousand and 194,000? What’s a reporter to make of such a broad range? The lower end of that range overlaps well with previous, nonscientific estimates, but the middle and upper range seem outrageous. True, had the researchers surveyed more houses in more neighborhoods, the interval would have been narrower. But each day spent traveling within Iraq for the study presented grave dangers to the American and Iraqi researchers.
Reporters’ unease about the wide range may have been a primary reason many didn’t cover the study. One columnist, Fred Kaplan of Slate, called the estimate “meaningless” and labeled the range “a dart board.”
But he was wrong. I called about ten biostatisticians and mortality experts. Not one of them took issue with the study’s methods or its conclusions. If anything, the scientists told me, the authors had been cautious in their estimates. With a quick call to a statistician, reporters would have found that the probability forms a bell curve — the likelihood is very small that the number of deaths fell at either extreme of the range. It was very likely to fall near the middle.
The Washington Post’s Rob Stein quoted a military analyst at Human Rights Watch as saying, “These numbers seem to be inflated.” If even Human Rights Watch doesn’t believe the estimate, why should you? (The analyst told me that he hadn’t read The Lancet paper at the time, and that he told Stein so, although the Post didn’t mention that. The analyst now has no reservations about the study’s conclusions.) A reporter asserted in The New York Times that “the finding is certain to generate intense controversy,” even though she quoted no one critical of the study.
British newspapers, by and large, did better — most journalists there seemed unfazed by the wide range of the possible death toll and some newspapers put the story on page 1. Perhaps it is no coincidence, then, that the British government felt forced to acknowledge it. Parliament held hearings and the foreign secretary, Jack Straw, wrote a lengthy response to the paper. But the Bush administration has kept mum on the topic, sticking to General Tommy Franks’s oft-quoted, “We don’t do body counts.”
Had the U.S. and UN responded as they did to the lead author’s similar studies in the Congo a few years ago, tens of millions of dollars in humanitarian aid might have gone to Iraq, and military decisions could have been altered. But without a nudge from journalists, the government has managed to ignore the paper. Even though it tries not to harm civilians, the military makes no attempt to quantify its “collateral damage.”
In the meantime, five months have passed since the paper came out. If the death rate has stayed the same, roughly 25,000 more Iraqis have died
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