A tool for measuring marginalization across Canada

The Canadian Marginalization Index (CAN-Marg) is an index that seeks to:

• Show differences in marginalization between areas
• Understand inequalities in various measures of health and social well-being, either between population groups or between geographical areas.

The tool has been used by health system planners, governments (municipal, provincial, territorial), researchers and universities among other organizations across Canada.

Visit the Ontario Community Health Profiles Partnerships website to download the tool and user guide.

CAN-Marg can be used for:

• Planning and needs assessment: For example, CAN-Marg can be used to identify where rates of hospitalizations for a particular disease, such as diabetes, are high and additional services might be needed.
• Resource allocation: For example, marginalization indices can be used in funding formulae for primary health care services.
• Monitoring of inequities: For example, marginalization indices can provide a way to monitor changes in area marginalization over time to look for improvement or to identify areas that may be in decline.
• Research: For example, in the health sector there is a long history of using small area indices to describe the relationship between marginalization and health outcomes; greater marginalization is associated with higher mortality rates and higher rates of many diseases.

About the tool

CAN-Marg combines a wide range of area-level census indicators into four distinct dimensions of marginalization in urban and rural Canada. This 2016 edition of CAN-Marg uses the same dimensions as the 2006 version, with updated names. After consultation, we changed the names of the dimensions to avoid the deficit-based language used in the previous versions; the names now closely align with the census measures that comprise each dimension.

• Households and dwellings (previously called ‘Residential instability’): Includes indicators that measure types and density of residential accommodations, and certain family structure characteristics, such as % living alone and % dwellings not owned.
• Material resources (previously called ‘Material deprivation’): Includes indicators that measure access to and attainment of basic material needs, such as % unemployment and % without a high school degree.
• Age and labour force (previously called ‘Dependency’): Includes indicators to describe % seniors (65+), the dependency ratio (the ratio of seniors and children to the population 15-64) and % not participating in the labour force.
• Immigration and visible minority (previously called ‘Ethnic concentration’): Includes indicators to describe % recent immigrants and % who self-identify as a ‘visible minority’ (defined by Statistics Canada).

The Index was developed using a theoretical framework based on previous work on deprivation and marginalization. It was then empirically derived using principal component factor analysis. Learn more about our methods.

CAN-Marg has been demonstrated to be stable across time periods and across different geographic areas (e.g., cities and rural areas). CAN-Marg is associated with health outcomes, including hypertension, chronic disease, depression, anxiety, self-rated health/stress, body mass index, smoking, binge drinking, physical inactivity, disability, activity limitation, flu shot immunization, community sense of belonging and low infant birthweight as published in a series of peer-reviewed journal articles.

CAN-Marg 2016 is the first update since the 2006 version due to the lack of long-form census data in 2011.

Publications

The index is widely used in Canadian health research.

Ontario Marginalization Index (ON-Marg)

MAP has also developed a small-area based measure of marginalization widely used by policy planners and researchers in Ontario. Learn more