Roberts: Death Rates don't Actually Decline During Wars

Leslie F. Roberts writes in a guest op-ed for Informed Comment

An astonishing version of the Human Security Report was released this past week. It was astonishing for its primary headline: “NEW REPORT REVEALS THAT DEATH RATES DECLINE DURING TODAY’S WARS.”

The researchers at Simon Fraser University used the war-monitoring PIRO dataset in Sweden, along with UN and World Bank data, and expert guesses, to examine a variety of recent conflicts. They focused on UN statistics of under-5 mortality to assess the health effects of these conflicts. In most of the wars they examined, under-5 death rates were lower at the end of the conflict than at the start. They attribute this previously unseen pattern to the changing nature of war, health development in general, and humanitarian assistance in those countries affected by conflict. This would be great news, if only it were true.

In learning these lessons, the authors defined wars as causing at least 1000 deaths in a country irrespective of size and to be continuing when at least 25 deaths per year were occurring. This means that many of the wars they examined (in places like Chad, Guinea Bissau, Mauritania, and Senegal) involved tiny fractions of the total population for short periods of time. The nation-wide surveys on which the UN bases its under-5 mortality estimates are typically conducted with host governments and repeated every few years. Imagine someone saying that the inflation adjusted median income in the US rose between 1997 and 2002 therefore terrorist attacks are good for people’s finances. That is a similar leap of logic as the finding that mortality rates go down in times of war.

The report’s analysis also does not weigh the wars so that the largest wars are weighted more… in fact the conclusions basically exclude the wars in Iraq and Afghanistan. This also has the effect of exaggerating the importance of minor conflicts such as those in Senegal and Cote d’Ivoire and diminishing the lessons from major conflicts in Sudan, Cambodia, and DR Congo. The report concludes that small focused surveys done in real-time to report war deaths are so potentially fraught with limitations, that they should not be conducted.

Why is this important for the average American? This is very much about the ability of governments to control the message when it comes to civilians dying, and the inability to hold the UN accountable for humanitarian situations which are ignored. This report, and the UN, advocate measuring mortality in partnership with combating governments via large nationwide surveys every few years. This approach has little value for documenting the sorts of crises unfolding at this moment in the Central African Republic or Haiti. For that, smaller, careful surveys, limited to the areas of crisis, with just a few questions, are more useful. These real-time surveys tend to be conducted by private NGO’s, relief agencies, or academics. They consistently record more deaths than government statistics or media reports. This is not usually an issue of honesty, it is that the household surveys with their focus and short periods of recall are typically more accurate. For example, over the past 8 years, the US Bureau of Labor Statistics survey of random households has estimated the number of jobs created as almost 50% higher than its employer payroll monitoring of 150,000 major employers. The household surveys just capture more little events, be they people dying or people starting to work for themselves.

The Bush Administration benefited enormously from the confusion it was able to trigger and support in the debate over how many people died because of the 2003 invasion of Iraq. The highest profile estimates made were published in the British medical journal The Lancet. (And, for example, reporters who called the US Centers for Disease Control and Prevention (CDC) when the first 2004 Iraq report in The Lancet was released were referred to a “Harvard statistician” familiar with the study…a statistician actually at the American Enterprise Institute and who had been a signatory on the Project for a New American Century call for Iraqi invasion.) Perhaps the most aggressive critic of those studies was a previously little known economist at the Royal Holloway University named Michael Spagat, who, it was revealed in the Huffington Post on Saturday, was a “technical advisor” on this new Human Security Report.

In war-induced crisis after crisis, be it Biafra in the 1960’s or Somalia today, NGO’s or scientists with small, statistically weak samples undertaken in the most difficult of settings, have brought the world’s attention to the places it most needed to be. This report is a brazen attack on the ability of non-state and non-UN actors to tell the world about humanitarian crises. It would be a tragedy indeed if an indirect effect of the US invasion of Iraq was to create a more cynical, disempowered, and ineffective humanitarian community.


Leslie F. Roberts
Associate Clinical Professor of Population and Family Health
Mailman School of Public Health
Columbia University

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