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those with disabilities and may have an age limit. Healthcare vans with lower rates and fees maybe available, but may limit area travel, or may not travel outside of city limits. In a rural area access to healthcare is often limited to dependable transportation. In urban areas, public transportation is available on every corner through, buses, subways, taxi, or uber. In urban area ravel between cities or town is somewhat less challenging, with airports, train station access, and
Health Assessment 14bus stations. Access to healthcare is more challenging living in a rural community verses urban area. The young man lives in a rural community and has completed high school education. Currently is unemployed and has enlisted into the army national guard. The young man drives an older car, but reports is reliable. Concern would be, how long the car would remain reliable totravel 30 miles to primary care office. In this office, there is limited specialty appointments such as cardiology, orthopedics, ear nose and throat specialist, as they are only in this office a couple of times a week. Living in this rural community over time, may limit his access to care and continued preventative care. Which would decrease the quality of care he might receive and health outcomes over time. Neighborhood Healthy Food Options According to Healthy People 2020 diet is directly relatedto health status (2018). The neighborhood itself presents physical and social determinants to access, availability, knowledge, and attitude of healthier foods. Maintaining a healthy diet reduces the risk for health related concerns such as high blood pressure, obesity, heart disease, and diabetes (Healthy People 2020, 2018). Neighborhoods and the built environments present more challenges in lower income and rural areas, as they tend to have fewer healthy food options, and more fast food and convenient store options. In turn this is promoting unhealthy eating habits. The cost of healthy food also plays a role in unhealthy diet. It costs more to buy fresh produce, meats, and higher quality of food. While poorer quality of food is more affordable, especially in areas of lower income. The quality of food affects nutritional and caloricvalue, lower quality results in higher calories and less nutritional value (Healthy People 2020, 2018). Access to healthy food options is clearly dependent on the neighborhood in which one lives.
Health Assessment 15In regards to the client, he lives in a rural, lower income area. In the geographical area, there are 3 fast food restaurants, 3 convenient stores, 1 grocery store, and access to farmers market that is seasonal in nature. The local grocery store is high priced, especially for fresh produce and non-processed items. In this respect the neighborhood has presented the attitude that fast and convenient foods are an acceptable diet. As a teenage boy, he is often looking for quick and convenient foods. Reports that he chooses these foods most nights, despite his parentspreparing a healthier option at home. Eating the higher calorie, non-nutritive diet has led to his weight gain over the past year.