Accounting for uncertainty in conflict mortality estimation: an application to the Gaza War in 2023-2024.

IF 2.5 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Ana C Gómez-Ugarte, Irena Chen, Enrique Acosta, Ugofilippo Basellini, Diego Alburez-Gutierrez
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引用次数: 0

Abstract

The ongoing Gaza War has resulted in significant loss of life and intensified an existing humanitarian crisis. Despite increasing demand for accurate data, mortality estimates remain challenging due to the inherent 'statistical fog of war'. Accurate quantification is hindered by incomplete reporting and uncertain age-sex distributions of casualties. Official death tolls are likely influenced by damaged infrastructure, security disruptions, and political motivations, complicating detailed demographic verification. Our study introduces a novel methodological approach-a Bayesian model incorporating novel priors-to explicitly account for measurement errors in mortality estimation by addressing reporting completeness and uncertainty in demographic distributions. We use these methods to estimate sex- and age-specific mortality patterns and associated life expectancy (LE) and LE losses due to direct conflict deaths from the Gaza War. We find that LE in Gaza was 42.3 (39.4-45.0) in 2023 and 40.4 (37.5-43.0) in 2024, corresponding to LE losses of 34.4 (31.7-37.3) and 36.4 (33.8-39.3) years, respectively, compared to a counterfactual scenario with no conflict-related deaths. This corresponds to 78,318 (70,614-87,504) conflict deaths by the end of 2024, reflecting a 14-fold increase in all-cause mortality during the conflict's first year. The age-sex pattern of Gaza's conflict deaths aligns with UN-IGME profiles from past genocides. To contextualize these estimates, we compare them with LE losses observed in the Gaza Strip, the West Bank, and all of Palestine between 2012 and 2019. Our estimates align with previously published work, after adjusting the reporting priors to ignore underreporting. Our versatile and robust framework for mortality estimation under conditions of data scarcity can inform future conflict research.

考虑冲突死亡率估计中的不确定性:2023-2024年加沙战争的应用。
正在进行的加沙战争造成大量生命损失,加剧了现有的人道主义危机。尽管对准确数据的需求不断增加,但由于固有的“战争统计迷雾”,死亡率估计仍然具有挑战性。不完整的报告和不确定的伤亡年龄性别分布妨碍了准确的量化。官方的死亡人数可能受到基础设施受损、安全中断和政治动机的影响,使详细的人口统计核查变得复杂。我们的研究引入了一种新的方法——一种包含新先验的贝叶斯模型——通过解决人口分布中的报告完整性和不确定性来明确解释死亡率估计中的测量误差。我们使用这些方法来估计特定性别和年龄的死亡率模式以及相关的预期寿命(LE)和加沙战争直接冲突死亡造成的寿命损失。我们发现,加沙的寿命在2023年为42.3(39.4-45.0),2024年为40.4(37.5-43.0),对应于寿命损失分别为34.4(31.7-37.3)和36.4(33.8-39.3)年,与没有冲突相关死亡的反事实情景相比。到2024年底,这相当于78,318(70,614-87,504)人死于冲突,反映出冲突第一年全因死亡率增加了14倍。加沙冲突中死亡的年龄-性别模式与联合国政府间调查小组过去种族灭绝事件的概况相一致。为了了解这些估计的背景,我们将其与2012年至2019年在加沙地带、西岸和整个巴勒斯坦观察到的LE损失进行了比较。我们的估计与以前发表的工作一致,在调整报告之前忽略了漏报。我们在数据稀缺条件下的死亡率估计的通用和健壮的框架可以为未来的冲突研究提供信息。
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来源期刊
Population Health Metrics
Population Health Metrics PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
6.50
自引率
0.00%
发文量
21
审稿时长
29 weeks
期刊介绍: Population Health Metrics aims to advance the science of population health assessment, and welcomes papers relating to concepts, methods, ethics, applications, and summary measures of population health. The journal provides a unique platform for population health researchers to share their findings with the global community. We seek research that addresses the communication of population health measures and policy implications to stakeholders; this includes papers related to burden estimation and risk assessment, and research addressing population health across the full range of development. Population Health Metrics covers a broad range of topics encompassing health state measurement and valuation, summary measures of population health, descriptive epidemiology at the population level, burden of disease and injury analysis, disease and risk factor modeling for populations, and comparative assessment of risks to health at the population level. The journal is also interested in how to use and communicate indicators of population health to reduce disease burden, and the approaches for translating from indicators of population health to health-advancing actions. As a cross-cutting topic of importance, we are particularly interested in inequalities in population health and their measurement.
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