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August 5, 1988

Man-made Death: A Neglected Mortality

JAMA. 1988;260(5):686-687. doi:10.1001/jama.1988.03410050106040

HERMAN Biggs, an American pioneer in public health, identified "the reduction in the death rate" as "the principal statistical expression and index of human and social progress."2 In Twentieth Century Book of the Dead,1 a seminal but neglected 1972 study, Scottish writer Gil Elliot distinguishes between biologic death—death from natural causes directly—and man-made death—death from war, political violence, and their attendant privations. Historians and statisticians seldom have examined man-made death beyond counting the number of combatants killed, Elliot notes, although "the scale of man-made death is the central moral as well as material fact of our time."1(p6) Elliot's "nation of the dead," 100 million corpses, challenges that evasion with a powerful metaphor.

Statistics on homicide and other unofficial violence locate and enumerate "private" man-made deaths for sociological examination and for comparison among political entities— cities, regions, and nations—by quality of life. By contrast, "public" man-made death is