Environment/Climate Change
Validation of the Urdu language Hogg Eco-Anxiety Scale and Associated Factors of Eco-Anxiety in Gilgit-Baltistan, Pakistan Rohini R. Datta* Rohini R. Datta Falak Madhani Daniel S. Farrar Muhammad Yasin Shahirose S. Premji Nazia Jabeen Shariq Paracha Imran Ahmed Faisal Ali Sher Hafiz Khan Masood Ali Khan Muhammad Karim Lisa G. Pell Adria Rose Dr. Saleemuddin Sajid B. Soofi Monica Taljaard Rachel F. Spitzer Sifat Wali Zulfiqar A. Bhutta Shaun K. Morris
Eco-anxiety is a distinct mental health event that refers to climate change-related distress. Gilgit-Baltistan (GB), a territory in northern Pakistan, is highly vulnerable to the impacts of climate change. We aimed to validate the Urdu version of the Hogg Eco-Anxiety Scale (HEAS-13) and identify factors associated with eco-anxiety in GB. We conducted a cross-sectional household survey in GB from July–September 2024 during the endline phase of a cluster randomized trial. One adult aged 15–49 years was randomly selected per household. Eco-anxiety was evaluated using an Urdu-translated HEAS-13, and depression and anxiety were assessed using translated versions of the Patient Health Questionnaire (PHQ-9) and the short-form Generalized Anxiety Disorder Scale (GAD-2) respectively. Internal consistency was assessed using Cronbach’s alpha, and convergent validity of HEAS-13 with PHQ-9 and GAD-2 was assessed using Spearman’s rank correlation coefficients. Multivariable linear regression was conducted to identify factors associated with increased eco-anxiety. In preliminary analysis (n=1140 participants), 48% experienced floods in the past five years, 45% reported increased hot weather, and 41% reported decreased water quality. The median HEAS-13 score was 3 (out of 39, IQR 0–6). In the past two weeks, ≥1 eco-anxiety symptom was experienced by 56.8% for several days and by 18.4% nearly everyday. The translated scale showed good internal consistency (α=0.81) and moderate convergent validity with PHQ-9 (ρ=0.62) and GAD-2 (ρ=0.43). Older age, greater household wealth, higher PHQ-9 and GAD-2 scores, more perceived environmental changes, and experience with climate disasters were significantly associated with increased eco-anxiety (Figure). Preliminary findings suggest the presence of mild eco-anxiety in GB and that the Urdu-translated HEAS-13 can be used to assess eco-anxiety. Future analysis will explore subscale structure and test-retest reliability of the Urdu HEAS-13 in GB.
