Active Case
Food Insecurity & Transportation Barrier
Training note: before arranging services, confirm whether anyone is sick right now or out of needed medicine. A food or transport plan never delays care for someone who is unwell.
Step 1 of 7: Review the case
Read what the case states, what it does not state, and what this practice case is asking you to learn.
Fictional resident
Ms. Dania Reyes
29 years old · Parent of two children, ages 4 and 7
ZIP code
78220
Preferred language
English; prefers text messages
Coverage
Children covered by Medicaid/CHIP; parent uninsured
What is happening
Ms. Reyes contacts a community program in July. School meals ended for the summer. She has food in the house for tonight but nothing planned after tomorrow. She has no car, and the nearest bus stop is a 25-minute walk with two young children. The clinic asked her to bring her 4-year-old back for a follow-up visit about three months ago; she has not been able to make the trip. She has the children's shot records at home and does not know what, if anything, is due.
What you are practicing here
- Establish the timeline the household is actually on before choosing a service.
- Tell apart what this case states from what a reader might assume about a parent.
- Build a plan whose steps she could actually carry out from her own address.
The detailed learning objectives for this case name the intended answers, so they are shown in the debrief after you submit. The safety note on the case page is different: it states the intended emergency response deliberately, because safety information is never withheld to make an exercise harder.
What the resident says matters most
- Food for the children within the next day
- Not missing work hours to travel across the city
- Getting the children caught up on check-ups
Strengths already present
- Reached out early, before the food ran out
- Already using WIC for her younger child
- Keeps a working phone and answers texts reliably
- Neighbor sometimes shares rides
Stated in the case
- Food in the home for tonight, nothing planned after tomorrow
- No vehicle; nearest bus stop is a 25-minute walk
- School meal program is on summer break
- A clinician-recommended follow-up visit for the 4-year-old was missed about three months ago
- Immunization status unknown; shot records are at home and need review
- Receives WIC for the younger child; not receiving SNAP
Not known — would need asking
- Whether anyone in the household is sick right now or out of medicine
- Which days and hours she could actually reach a distribution site
- Whether a transit or ride service covers her specific address
- Whether she wants help with a benefits eligibility screening
- What the children's records show is actually due, which only a records review can establish
Social determinants in this case
Some domains are stated in the case; others are only possible mechanisms to consider and are not established here. The full five-domain framework is mapped on the Methods page.
- Economic Stability stated in this caseFood runs out within about two days and she has roughly $18 until Friday.
- Neighborhood and Built Environment stated in this caseNo vehicle, a 25-minute walk to the nearest stop, and two transfers to the clinic.
- Health Care Access and Quality stated in this caseA clinician-recommended follow-up was missed because the trip could not be made.
- Education Access and Quality stated in this caseSchool meals ended for the summer, which changed the household food supply.
- Social and Community Context possible mechanism, not establishedA neighbor sometimes shares rides; how dependable that is has not been established.
Why this is structural: Food assistance and pediatric care are both real and both out of reach when transit routes, service hours, and work schedules do not line up. The gap is in how services are placed and scheduled, not in how hard the parent is trying.