Children born and raised in complex vulnerable situations use much more medical care during their first six years of life, while health expenditure for these children is also higher. These figures were revealed in a study by the National Institute for Public Health and the Environment (RIVM). Taking all medical care costs into account, care costs for children in this group are on average €7,000 (almost 55 per cent) more over the first six years of life, with €2,500 spent during their birth year. These children also use more social care and support services, such as special education and youth care.
The term ‘vulnerable situation’ is often used to indicate that parents (including prospective parents) and children are more likely to experience health problems and have less access to care. A situation of complex vulnerability means that several vulnerability risk factors are present at the same time, which could include poverty or an unhealthy lifestyle, while there are not enough factors that can compensate for these risks, such as a supportive social network.
Types of care also differ between groups
Care cost differences are apparent in medical care as a whole, as well as being evident in individual types of care. This includes services provided by GPs, hospitals, pharmacies, allied health professionals and dentists.
Differences increase as children become older
Notably, the difference between the use of and expenditure on services provided by allied health professionals (such as physiotherapists or speech therapists) increases as children become older. One possible explanation for this is that these children are more likely to have developmental delays in speech, language or motor skills. It is also notable that children in vulnerable situations use dental care services less, while dental care costs are higher; a difference that increases as they become older. This is in line with earlier figures.
Decline in numbers of children in families living in complex vulnerable situations
The percentage of children born into families with complex vulnerabilities fell from 8.2% in 2017 to 6.6% in 2023. This is associated with various trends. The proportion of households in debt and receiving benefits fell during this period. Families are increasingly living in neighbourhoods with a higher quality of life, while more parents are in paid employment and have higher educational attainment. In some Municipal Public Health Service regions, such as IJsselland, Gelderland-Zuid and Drenthe, the decline in the percentage of children in vulnerable situations is particularly notable. Complex vulnerabilities occur more frequently in Zuid-Limburg, Flevoland, Rotterdam-Rijnmond, Haaglanden and Amsterdam than in other regions.
Continued investment in prevention
According to the researchers, the results indicate the importance of continued investment in young families, both before, during and after pregnancy. This is already happening via the Kansrijke Start (Solid Start) programme and through improved collaboration between medical and social services. This ensures that problems are identified and addressed at an earlier stage, reducing the use for more intensive care later in life.