Environment and health in Central Asia: quantifying the determinants of child survival

Abstract

The impact of environmental degradation on well-being is largely ignored in terms of economic costs of development. Due in large part to measurement difficulties, the environment in the daily welfare of the world's poorest remains inadequately accounted for in development policies. The aim of this work is, therefore, to advance our understanding of the relationship between the environment and human health. Anthropogenic activities in Central Asia have severely disrupted the natural environment. The poorest, most vulnerable members of society are at an increased risk of mortality and a life-time of illness associated with worsening ecological conditions in the region. The work is by nature inter-disciplinary and pulls from many social sciences in an attempt to provide new insight into the role of long term environmental degradation and the impact on social welfare.

There are three main original contributions of this work. Firstly, the research demonstrates the traditional emphasis in the literature on socioeconomic factors in explaining high rates of child mortality in Central Asia is inadequate. Secondly, for the first time in an international cross-section examining the determinants of child survival, the macro-level environment is put forth as a key determinant of excess child mortality in Central Asia. An improved measure of income is used for the first time in such a study to control for important distributional effects within and between countries. The results confirm the hypothesis that traditional determinants do not account for endemically high rates of mortality in the region. Secondly, using administrative (oblast) data from Uzbekistan, Chapter 6 presents the first study of its kind to incorporate important geographic as well as socioeconomic information in explaining variation in infant mortality due likely to ecological degradation. Ultimately, the findings demonstrate the environment must be adequately considered in all policy making aimed at improving health outcomes in the region.