Spatialized composite indices to evaluate environmental health inequalities: Meeting the challenge of selecting relevant variables

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Brousmiche, Delphine | Occelli, Florent | Genin, Michaël | Cuny, Damien | Deram, Annabelle | Lanier, Caroline

Edité par HAL CCSD ; Elsevier

ACL. 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.

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