Influencing Variables of Health: Dimensions and Their Determinants – A Systematic Review

Background: The aim of this systematic review is to identify all determinants and influencing factors to
quantify health as holistically as possible using a multilevel model. The model is derived from determinants,
influencing factors, and variables of found health measurement constructs. Thus, the quantifiability of
health in the model can be ensured.
Methods: The present systematic review is based on the items of the PRISMA guidelines and thus
corresponds to the valid guidelines of a systematic review. Literature searches were conducted in English
(PubMed, Scopus, Web of Sciences) and German databases (BISp-Surf). All instruments that measured health
within one of the five identified dimensions of health (mental, physical, social, existential, environmental)
were included. The scores were rated with a quality appraisal tool. All scores were incorporated into a newly
created multilevel health model to show health as holistically as possible with all important determinants,
influencing factors, and variables.
Results: In total, 47 instruments distributed over five dimensions of health were found through the
systematic literature search. ... mehrOf these, 19 instruments were rated as "weak", 19 as "medium", and six as
"strong". The review offers good comparability because most instruments were questionnaires.
Conclusion: A multilevel health model based on health measurement instruments was created. This model
offers a simple and clear holistic representation of relevant determinants and influencing factors of health.
In the future, the model can be used as a basis for the creation of a multidimensional health score that can
evaluate people’s individual health.