Deprivation is often used to distinguish between social groups, particularly when examining social health inequalities.1 The concept refers to a disadvantage relative to the local community or the society to which an individual belongs.2
Deprivation can exist in people’s living conditions, in their immediate living environment as well as in their larger environment at the neighbourhood, municipal, regional and national level. Living conditions and living environments are in constant interaction.
Components of deprivation
Three main dimensions of deprivation can be distinguished : the material, the social and the environmental.2 They consist of domains representing separate aspects of everyday life (Figure 1).3
The domains related to the material dimension are education, employment and income.
The domains related to the social dimension are personal characteristics, physical and mental health and social connexions.
The environmental dimension is encompassed by two sub-dimensions: the immediate living environment and the larger living environment. The domain related to immediate living environment sub-dimension is housing. The larger living environment consists of the economic, institutional, communal, social, cultural, and political domains as well as of the physical natural and built domains.4
Deprivation can occur in only one domain and not in others. Multiple deprivation is present when several domains are disadvantaged.2 In that case, the number of affected domains is counted. When several domains are simultaneously deprived and our interest is in the combined effect of specific disadvantaged domains, we look at multidimensional deprivation (Figure 2).
Deprivation of individuals and deprivation of living environments
Specific biological and personal characteristics such as age, sex, physical traits, physical and mental health, religion and immigrant status are susceptible to contribute to the marginalization of these population groups with the risk of depriving them even if they possess the necessary resources to live in adequate conditions. The marginalization takes root in the lack of control over resources by social groups and affects individuals’ living conditions and activities negatively. For example, some highly skilled immigrants drive taxis because they are not allowed to work as doctors. Women still earn lower salaries than men for the same work in some occupations. There is a strong association between biological and personal characteristics, vulnerability and living conditions.2
Additionally, living environments can also be deprived and thus exposing its residents to increased risks. The deprivation of immediate and larger living environments includes housing quality and the nature of the economic, social and cultural environment, access to institutional and community services as well as to political participation, and ecological characteristics of the larger neighbourhood which affect individuals. Furthermore, there are dynamic interactions between living conditions and environments which can reinforce deprivation.5
Deprivation is often measured with quantitative indicators. It is generally estimated through an index which integrates and synthesizes them. The INSPQ offers the Material and Social Deprivation Index created with data from the 1991 to 2016 Canadian census. Its validity and usefulness have been shown repeatedly at the local, provincial and national level. However, social changes and current knowledge about the concept of deprivation generated the need for new measures capable of detecting deprivation in additional domains. The INSPQ is currently working on novel modular indices of deprivation, consisting of dimensions and domains, to create multidimensional measures capable of identifying the accumulation of deprivation and interaction between domains. Distinguishing dimensions and domains of deprivation has the advantage of facilitating identification of specific manifestations of deprivation, particularly for research and intervention. Multidimensional indices allow the targeting of specific living conditions or environments presenting elements of deprivation in order to improve the lives of most deprived populations.
- Pampalon R, Hamel D, Alix C, Landry M. A Strategy and Indicators for Monitoring Social Inequalities in Health in Québec. 2015. Québec : INSPQ
- Townsend, P. Deprivation. Journal of Social Policy. 1987; 16(2):125-146.
- Noble S, McLennan D, Noble M, Plunkett E, Gutacker N, Silk M, Wright G. The English Indices of Deprivation (IMD) 2019 – Research Report. 2019. London: Ministry of Housing, Communities and Local Government.
- Centre Léa-Roback. Le point sur … l’effet de quartier. Mieux comprendre le lien entre le quartier et la santé, 2007(1).
- Macintyre S, Ellaway A, Cummins S. Place effects on health: how can we conceptualise, operationalise and measure them? Soc Sci Med. 2002; 55(1):125-39.
- Deprivation index
- Surveillance des inégalités sociales de santé (in French)
- Suivre les inégalités sociales de santé au Québec – Santéscope (in French)
Other interesting websites
- Closing the gap in a generation. Health equity through action on the social determinants of health. Final report of the Commission on Social Determinants of Health, World Health Organisation 2008.
- Townsend Archives
Last updated : November 2019