Comparing Wars with Adjusted Body Counts

Phillip Carter and Owen West have an interesting article in Slate entitled, “Iraq 2004 Looks Like Vietnam 1966 – Adjusting body counts for medical and military changes.”

After factoring in medical, doctrinal, and technological improvements, infantry duty in Iraq circa 2004 comes out just as intense as infantry duty in Vietnam circa 1966—and in some cases more lethal. Even discrete engagements, such as the battle of Hue City in 1968 and the battles for Fallujah in 2004, tell a similar tale: Today’s grunts are patrolling a battlefield every bit as deadly as the crucible their fathers faced in Southeast Asia.

Economists like to quote statistics in “constant dollars,” where they factor in historical inflation rates to produce statistics that allow for side-by-side comparison. Warfare is more complex than macroeconomics, but it is possible to produce a similar “apples to apples” comparison for casualties across conflicts. In a recent article for the New England Journal of Medicine, Atul Gawande (a former Slate contributor) concluded that improvements to military medicine since Vietnam have dramatically reduced the rate at which U.S. troops die of wounds sustained in combat. The argument follows a 2002 study that tied improvements in U.S. civilian trauma medicine to the nation’s declining murder rate. While firearm assaults in the United States were rising, the murder rate was falling, largely because penetration wounds that proved fatal 30 years ago were now survivable. Thus, today’s murder rate was artificially depressed in comparison to the 1960s.

Gawande applied the same methodology to U.S. casualty statistics in previous wars, arriving at a “lethality of wounds” rate for each conflict. In World War II, 30 percent of wounds proved deadly. In Korea, Vietnam, and the first Gulf War, this rate hovered between 24 percent and 25 percent. But due to better medical technology, doctrinal changes that push surgical teams closer to the front lines, and individual armor protection for soldiers, this rate has dropped to 10 percent for Operation Iraqi Freedom for all wounds. For serious wounds that keep a soldier away from duty for more than 72 hours, the mortality rate is now 16 percent. Simply, a soldier was nearly 1.5 times more likely to die from his wounds in Vietnam than in Iraq today.

This analysis is interesting. The fact that our doctrine is putting the troops in comparatively less harm and that improvements in armament and medical care reduce the lethality of being hit are wonderful things. Certainly, one shouldn’t discount the courage and skill of our fighting forces because they are dying at a lesser rate than their predecessors. Indeed, it would be difficult to argue that the World War II generation was more heroic and there is simply no question that the 2004 force is incredibly more skilled than their 1944 or 1964 forebears.

Clearly, though, improved tactics, equipment, medical care, and all the rest make this war comparatively less dangerous than Vietnam or World War II. If one adjusts for the parachute, jumping from an aircraft with a parachute is identical to jumping without one. I’ll take a parachute, anyway.

Critics of the war may use this analysis as one more piece of ammunition to attack the effort; some supporters may continue to refer to casualties as “light,” noting that typically tens of thousands of Americans must die in war before domestic support crumbles. Both miss the point. The casualty statistics make clear that our nation is involved in a war whose intensity on the ground matches that of previous American wars. Indeed, the proportional burden on the infantryman is at its highest level since World War I. With next year’s budget soon to be drafted, it is time for Washington to finally address their needs accordingly.

They’ll get no argument from me on that.

FILED UNDER: Iraq War, Military Affairs
James Joyner
About James Joyner
James Joyner is Professor and Department Head of Security Studies at Marine Corps University's Command and Staff College and a nonresident senior fellow at the Scowcroft Center for Strategy and Security at the Atlantic Council. He's a former Army officer and Desert Storm vet. Views expressed here are his own. Follow James on Twitter @DrJJoyner.


  1. Some Guy says:

    Thank God that a laughable comparison to Vietnam is the best those idiots can come up with.

    They’re out of touch, out of depth, and out of hope. We’re winning, and there’s nothing they can do to stop it.

  2. James Joyner says:

    Both Carter and West are veterans with excellent credentials on such matters. Carter is a former MP officer and West was a Marine officer who led a Force Recon unit in this war.