Study: Gaza war's first 15 months deadlier than earlier tallies

By Rami Ayyub

JERUSALEM, Feb 19 (Reuters) - More than 75,000 Palestinians were killed in the first 15 months of Israel's military assault in Gaza, a figure far higher than the 49,000 deaths local health officials announced at the time, says a new study by The Lancet Global Health medical journal. 

Violent death estimates and demographics

Study Findings and Methodology

The peer-reviewed study, published on Wednesday, found that women, children and the elderly comprised some 56.2% of violent deaths in Gaza during that period, a composition that it said roughly aligned with reporting by Gaza's health ministry. 

The field work was conducted by the Palestinian Center for Policy and Survey Research, run by Palestinian pollster Khalil Shikaki, who has carried out public opinion polling in the West Bank and Gaza for decades. The lead author is Michael Spagat, a professor at Royal Holloway, University of London.

Survey scope and approach

The study is the first independent population survey of mortality in the Gaza Strip, said its authors, whose research involved surveying 2,000 Palestinian households over seven days starting on December 30, 2024.

"The combined evidence suggests that, as of Jan 5, 2025, 3–4% of the population of the Gaza Strip had been killed violently and there have been a substantial number of non-violent deaths caused indirectly by the conflict," the authors wrote. 

U.N. assessment of Gaza health data

Debate over official tolls

U.N. HAS LONG DEEMED MINISTRY FIGURES TO BE RELIABLE

The Gaza death toll has been bitterly disputed since Israel’s assault began after the Hamas-led October 7, 2023, attack on southern Israel. Gaza health authorities, whose figures the U.N. has long deemed reliable, report more than 72,000 killed and estimate thousands more remain uncounted beneath destroyed buildings 28 months later.

Israeli responses and clarifications

Israel has questioned those tallies, citing Hamas control of the ministry, though a senior military officer told Israeli media last month its figures were broadly accurate — a view the army later said did not reflect official data.

Lancet researchers said their analysis contradicts claims of inflation and suggests the ministry numbers are, if anything, conservative under extreme conditions.

MORTALITY CALCULATION BASED ON FACE-TO-FACE INTERVIEWS

Researchers who published a statistical analysis last year for The Lancet, its flagship journal, found the health ministry likely undercounted deaths by about 40% during the first nine months of the war. The new research published on Wednesday appears to suggest an undercount by a similar margin. 

Sampling, interviews, and weighting

Field staff, mostly female and experienced in surveying, conducted face-to-face interviews with Palestinians from households across Gaza's different districts, the authors wrote. The questionnaire, reviewed by Reuters, asks respondents to list individuals in their immediate household who were killed. 

"We calculated mortality estimates as weighted sums. Each individual in the sample received a weight representing the number of people in the Gaza Strip they represent," the authors wrote. 

Confidence intervals and limitations

The authors wrote that the survey was the first on Gaza mortality that did not rely on administrative records from the health ministry. They said their results on violent deaths had a 95% confidence interval, a value that indicates how accurately a pollster has captured a data point. 

Estimated non-violent excess deaths

There were an estimated 16,300 non-violent deaths during the first 15 months of the war, caused by disease, pre-existing conditions, accidents or other causes not directly related to combat, the authors wrote. These are separate from the 75,200 violent deaths estimated during that period.

Context of Oct. 7 attacks and hostages

Hamas-led militants killed more than 1,200 people and took over 250 hostages during their 2023 attack on southern Israel, according to Israeli tallies. The hostages and the remains of those killed in captivity were released during ceasefires. 

Hamas disclosures on fighters’ deaths

Hamas has confirmed the deaths of military leaders in fighting with Israel but has rarely disclosed fatalities among its fighters. 

(Reporting by Rami Ayyub; Editing by Howard Goller)