Highlights
- Higher material deprivation was associated with overall higher cancer incidence in Ontario.
- Some cancers showed more pronounced incidence rate trends linked to material deprivation than others.
- Material deprivation is an important consideration for the development of cancer prevention strategies.
From 2010 to 2016, the incidence rate for all cancers combined in Ontario was higher in regions with higher material deprivation than in the least materially deprived regions. Material deprivation means individuals and communities are unable to access and attain basic material needs. The most deprived regions had an overall 12% higher cancer incidence rate compared with the least deprived (data not shown).
This overall trend was driven by some cancers more than others. Incidence rates for lung and colorectal cancers rose as material deprivation increased. Lung cancer incidence rates were 80% higher and colorectal cancer rates were 18% higher in the most materially deprived regions than in the least deprived regions. However, breast and prostate cancer incidence rates decreased as material deprivation increased. The figure highlights these four common cancers and shows the differences in cancer incidence rates in regions with the least (Q1) to the most (Q5) material deprivation.
Material deprivation is one of the 4 dimensions of the Ontario Marginalization Index (ON-Marg). This area-based index measures multiple dimensions of marginalization in Ontario at the neighbourhood level. The material deprivation dimension incorporates income, education, quality of housing and family structure. Indicators for this dimension measure the proportion of the population who are without a high school diploma, single-parent families, receiving government transfers, unemployed, low-income and living in poor housing conditions.[1] Regions of Ontario are categorized into quintiles from the least deprived (Q1) to the most deprived (Q5). The other 3 dimensions of ON-Marg are residential instability, dependency and ethnic concentration.
Because the social determinants of health are often related, multi-dimensional indices, such as ON-Marg, have been developed to examine the impact of their intersection on health outcomes in Ontario.[2] The 2016 version of ON-Marg, created by Public Health Ontario and the Centre for Urban Health Solutions at St. Michael’s Hospital, groups data from the 2016 census across four dimensions of marginalization. Each dimension is provided in quintiles and at multiple levels of geography, including dissemination area. There are some limitations to using ON-Marg; for example, area-level marginalization may not reflect individual-level marginalization and the use of a composite index means the impact of each individual indicator cannot be determined.
Associating ON-Marg data with regional cancer incidence data provides a novel opportunity to identify associations between different dimensions of marginalization and cancer outcomes. Understanding these associations can be critical for policy and program specialists planning cancer prevention strategies to improve the health of the population.
For more information about ON-Marg, visit Ontario Marginalization Index
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