Impact of Living and Working Conditions on Healthcare


The determinants of health are referred to the range of factors which impact the health status of the individuals. According to WHO, the determinants of health include social and economic environment, persons individual characteristics and physical environment (WHO, 20202). In Dahlgren and Whitehead’s model, wider determinants of health are mentioned which includes individual lifestyle factors, social conditions, community influences, living and working condition and others (Rice and Sara, 2019). In this assignment, the living and working condition as the determinant of health is to be considered to determine the way it impacts healthcare for Sam. For this purpose, the policies and evidence of social determinants impact on the individual in the case study are also to be discussed.


Impact of determinant of health

The case study of Sam informs that she is unemployed Asian female and has been diagnosed with schizophrenia who is living in a temporary bedsit waiting to be rehoused by the council. As asserted by Howes et al. (2017), living in stressful environment leads people with schizophrenia experience higher symptoms and abnormalities regarding the disease. This is because the stressors create increased subtle alteration in the brain functioning leading to worsen mental health condition. This fact can be supported from the Marmot Review where it is mentioned that living in deprived areas leads people suffering from mental health condition experience hindered health and lower life expectancy (, 2020). Thus, in case of Sam, her temporary living environment may has created stressful living condition which has contributed towards worsening her symptoms regarding schizophrenia such as making her hear voices of her late partner and others. It may also eventually lead her to experience lower life expectancy and die early.

The temporary living condition for managing special needs children creates stress and anxiety on the parents as they are unable to ensure a safe and stable living environment for the child (Harris et al. 2017). According to Marmot review, nearly 37% of children are in poverty and it has led them to access worst education and chances of success in career (, 2020). In case of Sam, it is seen that she have a special needs child regarding whom she is worried. The current lack of stable living environment and poverty for Sam's daughter would lead her to face incapability to develop self-management in leading her own life. These thoughts may have contributed Sam to face increased anxiety and stress which has contributed towards worsening her health condition regarding schizophrenia.

The unemployed condition leads people with schizophrenia have inadequate finances to support their healthcare and therapeutic interventions. It makes the people suffering from the mental health condition remain deprived of effective care leading to their deteriorated condition out of financial stability (Martini et al. 2018). This is evident from the Marmot Review which informs that unemployment is considered to be one of the key reasons for rising suicide rates and deteriorated mental health condition (, 2020). In the case of Sam, it is seen that she is unemployed and have no source of income at the present to support her healthcare services and intervention regarding schizophrenia. Thus, it may has led her to remain deprived of essential healthcare services required to cope with schizophrenia, in turn, worsening her symptoms. This is evident from the case study which reports that Sam has never been able to avail effective and full healthcare required in managing and treating her schizophrenic condition.

The lack of effective living and working condition leads the individuals suffering from mental and physical health issues have poor health condition (Lee et al. 2019). This is because the individual out of poverty is unable to avail required nutrition along with healthcare services to support their health issues. This is evident from the Marmot Review which informs that financial incapability is one the reason for inability to avail nutritious food by individuals (, 2020). In the case of Sam, it is seen that she is unemployed and do not have adequate finances to be spent on managing nutrition and enhanced well-being. It has contributed to deteriorated schizophrenic condition in Sam along with hindered weight management. This is because out of unemployed state she is unable to make money to be used in availing assistance from dieticians or physical instructors to manage her weight. Moreover, it has made her unable to avail additional psychiatric therapies which are often essential in managing schizophrenia.

In 2014, the Public Health England informed that 53% patients with schizophrenia are provided additional healthcare support to control abnormal blood glucose level (PHE, 2015). Thus, it indicates that Sam being a schizophrenic patient and currently being detected with diabetes is able to access healthcare for the condition from PHE. This is going to ensure her enhanced health condition irrespective of her financial and working ability. As commented by Krupchanka et al. (2016), presence of effective living and working condition is necessary for personal development. This is because it allows effective connection of the mind and the body to be built to make them work together to develop potential and talent in executing activities. In case of Sam, it is seen that she has a temporary living environment with no employment that may have made her face hindered personal development required to improve her efficiency to control symptoms regarding schizophrenia. This is because in this condition she is unable to manage her mind and body at the same time to lead a healthy life.

In the current context within the UK, it is reported that only 13% of the people suffering from schizophrenia are only able to find any nature of work to support their social condition. This is because the employers feel that people with schizophrenia are violent and do not have mental efficiency to effectively function in meeting work requirements (, 2020). Thus, current working condition for the schizophrenic patients in the UK may have led Sam unable to find work and remain unemployed. The PHE mentions that according to NICE guidelines people with schizophrenia who are unable to attend mainstream work are to be trained and developed to execute alternative occupational activity (PHE, 2015, NICE, 2014). Thus, by following the NICE guidelines Sam is required to be involved in alternative activities so that she is gradually able to find mainstream employment which would promote her mental health condition. This is because positive work environment and employment are related to ensure financial security and enhancing the mental health condition of the people.

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According to NICE guidelines, the people suffering from schizophrenia are required to be assessed by a psychiatrist regarding the quality of their occupational and living environment. This is because the physical living environment is seen to have influence on the mental health efficiency of the service users with psychiatric issues (NICE, 2014). In case of Sam, it is seen that her living environment was not effectively assessed by the psychiatrist as per the NICE guidelines which led her to remain living in temporary environment which acted as stressor in worsening her condition regarding schizophrenia. The NICE guidelines mention that effective family support is required to promote living condition of the schizophrenic patients which is hindering their health. This is because family involvement in caring for schizophrenia patients leads to lower stress and anxiety among the patients and the personalised care by the family helps the mentally ill patients to cope with hearing voices and additional symptoms of schizophrenia (NICE, 2014). However, in case of Sam, it is seen that there is lack of family support towards her living condition after the death of her husband. This may have contributed to the stress and anxiety in her to face worsens symptoms of schizophrenia out of unsupported living environment.

According to WHO, the people suffering from schizophrenia are required to be provided opportunity of assisted living, supported housing and supported employment. This is because it leads the people with schizophrenia develops recovery from their health condition. It is evident as in assisted living or supported housing adequate facilities are present to support everyday living needs of the patients such as medical management, personal care, hygiene management and others (WHO, 2019). It indicates that for Sam to recover from her present health condition, she is to be provided assisted living or supported housing instead of temporary living condition which is further deteriorating her mental heal condition. This is because assisted living would help Sam to get assistance with her personal care and additional everyday living needs, in turn, helping her be able to take her own care as well as her daughter's who is having special needs. In addition, supported employment would make Sam develop self-sufficiency and stable financial condition to develop a better future for her daughter, in turn, lowering her current anxiety with managing her daughter that is contributing to worsen her schizophrenic health condition.


The above discussion informs that living and working condition is potential health determinant that influences the health condition of the people suffering illness. It is evident as hindered working condition has led Sam who is suffering schizophrenia to remain unemployed leading her to face financial instability. This, in turn, has contributed her to develop stress and anxiety out of unstable future which may have contributed to increase the expression of symptoms of schizophrenia. The lack of family support and housing is also considered to have contributed to her worsened mental health condition. The lack of effective living and working condition is seen to have contributed in making Sam unable to have enough finances in supporting additional psychological therapies required to fully manage schizophrenia. According to NICE and WHO, effective family support along with supported living and supported employment are to be provided to schizophrenia patens to ensure their effective recovery. Thus, the guidance are to be followed to enhance living and working condition of Sam to ensure improvement of her schizophrenic condition.


Harris, J., Madden, H., Oyston, J., Billington, H., Venturas, C. and Porcellato, L., 2017. A health needs assessment for children and adults with neurodevelopmental conditions in Liverpool. Public Health Institute, Liverpool John Moores University, pp.2-8.

Howes, O.D., McCutcheon, R., Owen, M.J. and Murray, R.M., 2017. The role of genes, stress, and dopamine in the development of schizophrenia. Biological psychiatry, 81(1), pp.9-20.

Krupchanka, D., Kruk, N., Murray, J., Davey, S., Bezborodovs, N., Winkler, P., Bukelskis, L. and Sartorius, N., 2016. Experience of stigma in private life of relatives of people diagnosed with schizophrenia in the Republic of Belarus. Social psychiatry and psychiatric epidemiology, 51(5), pp.757-765.

Laidi, C., Prigent, A., Plas, A., Leboyer, M., Fond, G., Chevreul, K., Aouizerate, B., Andre, M., Berna, F., Capdevielle, D. and Chereau-Boudet, I., 2018. Factors associated with direct health care costs in schizophrenia: Results from the FACE-SZ French dataset. European Neuropsychopharmacology, 28(1), pp.24-36.

Lee, E.E., Martin, A.S., Kaufmann, C.N., Liu, J., Kangas, J., Daly, R.E., Tu, X.M., Depp, C.A. and Jeste, D.V., 2019. Comparison of schizophrenia outpatients in residential care facilities with those living with someone: Study of mental and physical health, cognitive functioning, and biomarkers of aging. Psychiatry research, 275, pp.162-168.

WHO 2020, Determinants of Health, Available at: [Accessed on: 18th June 2020]

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