Impacts of an environmental disaster on psychosocial health and well-being in Karakalpakstan.

The people of Karakalpakstan, along with those of the entire Aral Sea region, are facing a multitude of health problems corresponding to the drying of the Aral Sea and accompanying ecological consequences. In case studies of other environmental disasters, research has shown that environmental exposures may impact not only the physiological but also the psychosocial health of individuals. This research aims to determine the contribution of the environmental disaster to the psychosocial health of people living in Karakalpakstan, a semi-autonomous Republic in Uzbekistan. An interview survey was carried out by Médecins Sans Frontières, with the assistance of the McMaster Institute of Environment and Health, local Universities and local health care workers, on a random sample of 1118 individuals aged 18 years and older in three communities in Karakalpakstan in May/June 1999. The communities were chosen according to distance from the former seashore, urban/rural characteristics and ethnic composition. The survey included questions about perceived general health, the General Health Questionnaire, the somatic symptom checklist of the Symptom Check List-90, questions about perceptions of the environmental disaster, social support as well as socio-demographic and socio-economic characteristics. Findings show that 41% of all respondents reported environmental concern while 48% reported levels of somatic symptoms (SCL-90) associated with emotional distress, above the normalized cut-point. Significant differences in levels of emotional distress were reported between men and women as well as between ethnic groups. Environmental problems are commonly perceived to be the cause of somatic symptoms and are significantly related to self-rated health status.