The number of chronically ill people in the Netherlands has been increasing. RIVM National Institute for Public Health and the Environment has investigated the impact of this increase on social participation in terms of work, education, voluntary work and informal care.

The study shows that the extent to which people can (or continue) to participate depends on their subjective health, perceived limitations and psychological well-being, rather than their chronic condition. Social participation tends to improve health. However, when the burden becomes too high, for example because of poor working conditions or demanding informal care, social participation has an adverse effect on health.

For children and adolescents, health problems impede on participation in education, although only slightly. More importantly, young people with health problems less often have a job than their healthy peers. For older people, good health is important to continue labour participation. Yet, health has very little impact on their return to work after dismissal or prolonged absence due to health problems. Few elderly return to work, even if they are healthy.

RIVM National Institute for Public Health and the Environment also examined how social participation of the chronically ill can be improved and what interventions have been implemented. Examples include adjustments to reduce the workload and therapies to cope with the effects of chronic diseases. However, little is known about the effectiveness of most measures.

The information about health and social participation presented in this report, serves as input for the Public Health Status and Forecast Report (PHSF: in Dutch VTV). Since 1993, every four years RIVM has published the Dutch PHSF Report, which gives an overview of population health in the Netherlands. The Ministry of Health, Welfare and Sports uses this information to draw up the National Health Policy note. The report is in Dutch only.