Abstract
The incidence of endemic goiter in southeast Kazakhstan, a highly goitrogenic province of the Soviet Union, is related to the geochemical setting of the region's natural areal complexes. The occurrence of endemic goiter is usually attributed simply to iodine deficiency. However other chemical elements also tend to reduce or enhance the goitrogenic properties of a particular environment. A detailed analysis of the various environments in southeast Kazakhstan shows that not all parts of the region are equally goitrogenic and that high, medium and low risk areas may be distinguished. The various natural areal complexes of different levels of goitrogenicity are mapped together with actually observed incidence of the disease. It is recommended that public health activities, such as the provision of iodized salt, be directed in particular at the high and medium risk areas.