This study examined social and physical environmental exposures, health, and healthcare utilization among children aged 0–12 in urban areas. A population-based cross-sectional design was used, incorporating general practitioners’ data (2018–2019, n = 14,547), and societal and environmental data. Latent class analysis identified three distinct classes based on child and family demographics: ‘Dutch-origin two-parent household’ (n = 7267), ‘households with diverse countries of origin’ (n = 4313), and ‘single-parent household’ (n = 2967). Binary and multinomial logistic regression examined associations with environmental factors and child health outcomes. Children from the Dutch-origin class most often had favorable family demographics, neighborhood conditions, and health outcomes. Children from the diverse countries of origin class most often faced adverse neighborhood conditions, had higher rates of physical or somatic health conditions, and higher healthcare costs. Children from the single-parent class more often had less favorable family demographics, a higher likelihood of mental health problems, more frequent general practitioner visits, and were often in contact with youth care. This study highlights how child and family demographics and social and neighborhood conditions impact child health and healthcare utilization. Future approaches should focus on strategies to build and strengthen family and community resilience and adopt family-centered, context-sensitive interventions.

Background: The increase of adolescent multimorbidity in welfare states is a major concern for current and future population health. However, current health interventions remain insufficient. Syndemic research among adolescents in high-income countries could improve understanding of mechanisms contributing to social and health inequalities. This study explores the existence of clustered health conditions among adolescents aged 10–19 registered at general practices in two average Dutch cities: The Hague and Leiden. We examine which social and contextual factors are associated with these clustered health conditions and to what extent these clusters relate to healthcare use and costs. Methods: This cross-sectional study used general practitioner registration data on diagnoses from the Extramural Leiden University Medical Centrum Academic Network database to explore multimorbidity based on the 2-year prevalence of 20 health conditions among adolescents (n=10 841). Latent class analysis was applied to distinguish multimorbidity classes. Statistics Netherlands provided information on factors at the individual (eg, country of origin), family (eg, divorced parents) and household (eg, income) levels. Multinomial logistic regression analysis was applied to identify multimorbidity class differences in these social contextual factors, healthcare use and costs. Results: In 2018 and 2019, 25.7% (n=2781) of adolescents had at least two health conditions. We identified four classes characterised by a high probability of health conditions: ‘asthma-skin conditions’ (n=442), ‘skin conditions-pain’ (n=794), ‘externalising behavioural disorders and skin conditions’ (n=565) and ‘gastrointestinal conditions, internalising disorders and pain’ (n=980). Adolescents in classes characterised by externalising or internalising conditions combined with physical and somatic health conditions were most often linked to several more prominent adverse social contextual factors, such as early school dropout. Increased healthcare use and costs across all classes indicated a higher disease burden for adolescents with clustered health conditions compared with those with one or no health conditions. Conclusions: Disease clusters are prevalent in adolescents living in Dutch cities, driven by social contextual factors at the individual, household and parental levels, and show increased healthcare use and costs. Our results support the need for integrated preventative strategies focusing on multi-level aspects.

The global expansion of the COVID-19 virus led many countries, including the Netherlands, to implement socially restrictive measures to protect vulnerable groups from the virus, without considering negative consequences. Older individuals show large differences in vulnerability, but were defined as vulnerable, overlooking their strengths and resilience. We aim to investigate the impact of the COVID-19 pandemic and its restrictive measures on provided help by community dwelling older individuals in the Netherlands; and (2) to examine the cross-sectional effect of social capital and mental wellbeing on the provided help. This cross-sectional study utilized data from the Impact Corona study from October/November 2020. Community-dwelling older individuals in the Netherlands, aged 65 years and older, completed an online questionnaire. Providing help was measured by ‘already providing help’ to at least one of the defined subgroups for the question ‘To what extent are you willing to offer help to (group) during the covid-19 pandemic?’. Followed by the question of what type of assistance this was, such as grocery shopping. Social capital was measured by the amount of social contact, trust in people in general, knowing sufficient people who could provide help and provided help in the neighborhood. Mental wellbeing was measured by questions about feeling more anxious, stressed and staying home during the pandemic. Data was analyzed using descriptive statistics and logistic regression analyses. 7,616 Older individuals participated in this study. About one third (32.9%) of the older individuals provided help during the COVID-19 pandemic (56.2% female, 73.4% multi-person household, 60.4% in good health). The majority provided the same (60.9%) or more (29.7%) help than before the pandemic and had a higher social capital, and a better mental wellbeing, compared to older individuals who did not provide help. Overall, a third of the older individuals still provided help and remained socially involved during the pandemic. They had high social capital and mental well-being, supporting their helping behavior. When developing future restrictive measures, a distinction based on health and vulnerability should be prioritized over one based primarily on age, to prevent the emergence of a different form of vulnerability.