The wide range of factors involved in environmental health and the complexity of interactions between all environmental determinants require the validation of multidimensional approaches. While the development of composite indices is receiving growing attention by scientists and public authorities, the concept continues to lack transposability and robustness partly due to varying conceptualizations and/or methodologies.

This review aims to promote harmonizing practices governing the first step of development of composite index, namely identification and characterization of the dimensions and variables that are included in environmental health indices. A review of available literature (more than 1500 studies) was conducted to identify the composite indices developed to assess territorial determinants from an environmental health perspective. This process made it possible to identify 23 spatialized composite indices and to assess a total of 329 variables. This diversity highlights that the absence of a common framework can lead to a strong subjectivity and limit comparisons between different environmental health indices. The specificity and the availability of certain variables would limit the transposability of indices.

In light of current knowledge, this review proposes a consolidated methodological framework based on a categorization of variables into dimensions and sub-dimensions related to heath, environment, social, economics, services and policy. To characterize the sub-dimensions, several variables are possible and can be chosen according to the availability and/or accessibility of the data. The adaptation of a composite index to a specific territory or to a specific issue would then be effective through the included variables. This also aims to be transposable to any spatial unit (country, region, census tract).

This work is a first step towards a proposal of guidelines designed to provide a consensual framework that could facilitate the exploitation of environmental health indices. This transparency could also increase the understanding and adoption of these tools by public authorities and general public.

涉及环境健康的各种因素以及所有环境决定因素之间相互作用的复杂性都需要对多维方法进行验证。尽管综合指数的发展越来越受到科学家和公共当局的关注，但由于部分概念和/或方法的不同，该概念仍然缺乏易位性和鲁棒性。

这项审查旨在促进协调综合指数制定第一步的实践，即识别和表征环境健康指数中包含的维度和变量。对现有文献进行了回顾（超过1500项研究），以确定从环境健康的角度评估领土决定因素的综合指数。这个过程使得有可能确定23个空间综合指数并评估总共329个变量。这种多样性突出表明，缺乏通用框架会导致强烈的主观性，并限制了不同环境健康指数之间的比较。某些变量的特异性和可用性将限制索引的易位性。

根据当前的知识，本次审查提出了一个综合的方法框架，该框架基于将变量归类为与健康，环境，社会，经济，服务和政策有关的维度和子维度。为了表征子维度，可能有几个变量，可以根据数据的可用性和/或可访问性选择这些变量。这样，通过包含的变量，可以使综合索引适应特定地区或特定问题才有效。这也旨在可转置到任何空间单位（国家，地区，人口普查区域）。

这项工作是朝着指导方针提议迈出的第一步，指导方针旨在提供一个可以促进环境健康指数开发的共识框架。这种透明性还可以提高公共当局和公众对这些工具的理解和采用。