…Excess mortality studies have been used to measure everything from the life expectancy of smokers to “temperature-related stress” in the Netherlands. The problem is that such studies are inherently reliant on conjecture. There can be other problems as well, namely politics, as I learned a decade ago while poking holes in an excess mortality study in Iraq published by the Lancet.
An article in the British medical journal estimated some 650,000 “excess” Iraqi deaths in the 40 months following the U.S. invasion. This figure was seven times higher than the toll based on body counts. It was based on field surveys supposedly done by a former health official in Saddam Hussein’s government and was authored by outspoken critics of the Iraq war — and of George W. Bush. It was also timed to come out just before the 2006 midterm elections.
To some neutral observers, the controversy underscored the importance of actually documenting wartime casualties. I don’t know how much Donald Trump knows about this topic. But he apparently is aware that “excess mortality” is not how U.S. authorities have previously tallied storm deaths. The National Hurricane Center, for example, estimated that 1,833 people died in Hurricane Katrina, most from drowning.
In Puerto Rico, there were myriad problems getting accurate data, the biggest being that electricity was knocked out for so long. This inhibited the reporting ability of island health officials. It also led to deprivations that killed health-impaired residents months after the hurricane season ended. In that environment, excess mortality studies made sense. Inevitably, they would be imprecise, and perhaps just wrong. The first such study, by researchers at Penn State University, estimated the number of deaths at 1,085 – when the government in San Juan was still listing the official toll as 64. Days later, the New York Times, using island death certificates, produced an estimate of 1,052.
Harvard went next. Its study, trumpeted uncritically around the world, had problems. For one thing, its range of 793 to 8,498 excess deaths was unhelpful. So the media settled on the median figure, 4,645, which was little more than a guess. The bigger problem is that the methodology was a mish-mash. Harvard’s researchers compared actual deaths in 2016 to estimates based on interviews – polling surveys – in 2017. “The big thing is the methodology is so completely different, you don’t now what you’re dealing with,” said University of Texas biostatistics professor Donald Berry. “What you end up with is garbage.”
That’s the background when the governor of Puerto Rico tapped George Washington University’s school of public health to do another excess mortality survey. Like all such studies, it’s based on assumptions and guesswork – in this case assumptions complicated by the outward migration of tens of thousands of Puerto Ricans to the mainland after the hurricane. That said, I know of no evidence that would undermine its estimate of 2,975 excess deaths…
(REAL CLEAR POLITICS)