Indices of multiple and multidimensional deprivation


The Material and Social Deprivation Index (MSDI) was created at the end of the nineties with the aim of measuring the deprivation of Quebecers at the small area level.1,2 The internal composition and the method to calculate the deprivation quintiles has not changed since its first creation. The development of a new deprivation index is needed for various reasons:

  • Structural and organizational transformations as well as changes in the global economic, social and political context require a review of the current tool for the measurement of deprivation.
  • Currently the context is favourable for the development of new indices. The Politique gouvernementale de prévention en santé and the Programme national de santé publique 2015-2025 put a strong emphasis on the surveillance and the reduction of social inequalities of health as well as on the collaboration with stakeholders in various domains (ex. physical, sociocultural, economic and political) who can have a direct impact on population health through their responsibilities and their actions. Furthermore, the MSDI is used in the Quebec Health Inequalities Surveillance System. An updated and more accurate representation of deprivation equips researchers and professionals with a measure that is more specifically adapted to their needs.
  • The increased use of the MSDI by regional stakeholders and in domains other than health has revealed criticism about the index’ sensitivity and reliability. Three main reasons explain the weaker performance of the MSDI in sparsely populated, rural and remote regions :
    • specific deprivation characteristics are more difficult to capture with a quantitative tool in rural areas where realities can be vastly different from urban areas ;
    • the apparent socioeconomic heterogeneity of the dissemination areas (DA) in rural regions associated with their considerably larger territory compared to urban regions increases the variance in population characteristics;
    • and the higher socioeconomic similarity of rural DAs makes it challenging to distinguish between disadvantaged and advantaged DAs whereas in urban areas the often substantial differences between DAs help distinguish them.
  • Users of the MSDI show high interest for the development of an index documenting deprivation in living conditions and environments which are likely to show varying levels of deprivation.

Aims of the development of new indices of multiple and multidimensional deprivation in Québec (IDMMQ)

The new IMMDQs are based on research by the Social Disadvantage Research Group, at Oxford University in Great Britain. Nowadays two independent groups with members from the original group, the research collective and the Oxford Consultants for Social Inclusion elaborate the multiple deprivation indices in use by the British government for the follow-up on trends in social inequality over the past 20 years.

Unlike the MSDI which is mainly used as a substitute for lacking information about socioeconomic position of individuals, the IMMDQs will measure the deprivation of areas, through population characteristics and those of the physical natural and built context as well as the socioeconomic, institutional, political and cultural context. The IMMDQs will highlight deprivation in living conditions and environments, grouped in three major dimensions (material, social and environmental), as well as more detailed domains (educational, professional, income domains, biological and personal characteristics of the population, social connexions, physical and mental health, housing, natural and built physical environment, commercial and public services and political context), all of which will measure relative deprivation separately and which can be combined.

The main purposes of the IMMDQs are:

  1. Build a multiple and multidimensional deprivation index based on a conceptual model;
  2. Offer an alternative and complementary measure of deprivation to highlight potential social inequalities, particularly social inequalities in health;
  3. Calculate specific deprivation, with a separate deprivation value by domain and by dimension;
  4. Calculate multiple deprivation, that is the number of deprived domains and dimensions;
  5. Assemble and summarize measures of deprivation from distinct domains into a global and synthetic measure of deprivation.

The new IMMDQs facilitate:

  1. The assessment of deprivation defined as the relative inequality of population groups compared to other groups in a specific domain;
  2. The compensation for the lack of socioeconomic information in administrative databases;
  3. The comparison of multiple and multidimensional deprivation in sex and age groups (children, working adults, retirees);
  4. The comparison of multiple and multidimensional deprivation at different area levels and across sociosanitary regions (dissemination areas, municipalities, RTS, RLS, RSS, geographical zones);
  5. The support of planning exercises and resource allocation in various public sectors;
  6. The needs assessment for social and environmental equity;
  7. The follow-up of social inequality over time (with subsequent versions of the IMMDQs);
  8. The research and epidemiological studies on the effect of social inequality on diverse aspects of quality of life, among which health;
  9. The support of the policy impact and intervention evaluation in the domain of social inequality of health;
  10. The promotion of action on social and environmental determinants of health through the pinning down of the relevant and main domain of deprivation.


  1. Pampalon R, Raymond G. A deprivation index for health and welfare planning in Quebec. Chronic Dis Can. 2000;21(3):104-113.
  2. Pampalon R, Hamel D, Gamache P, Philibert MD, Raymond G, Simpson A. An area-based material and social deprivation index for public health in Québec and Canada. Can J Public Health. 2012;103(8):17‑22..


More texts will be added here when they become available.

First thoughts on the development of indices of multiple and multidimensional deprivation in Québec:

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