| Course | HD420 Social Determinants of Health and Health Behavior |
|---|---|
| Unit | Unit 5 |
| Paper type | Access barrier study |
| Length | About 690 words, 5 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | BS in Health and Wellness |
| Updated | October 2026 |
Free sample paper for HD420 Unit 5
Sixty-Four Miles to a Therapist: A Unit 5 Access Barrier Study Pricing One Visit and a Full Course of Treatment
[Student Name]
Purdue University Global
HD420: Social Determinants of Health and Health Behavior
Unit 5 Access Barrier Study
[Instructor Name]
[Date]
The county, the clinic and every cost are composite; the access concept paper, the access framework and the study of mental health care geography cited are real.
The Change
The county clinic, short of staff, closed its new-patient list for adult Medicaid members last spring. Existing patients kept their therapists. New adults with Medicaid were referred to an in-network clinic in the next county's largest town, 64 miles away. Studies of mental health care geography have found that low-income and rural communities already have fewer specialty mental health providers nearby (Cummings et al., 2017); this change made one county's gap much wider.
The Person in the Calculation
The study uses a composite client: a thirty-four-year-old woman with moderate depression and anxiety, referred by her primary care clinic, who works hourly as a home care aide with no paid leave, earns about [$15] an hour, has two children aged six and nine and drives a twelve-year-old car.
One Visit, Priced
Distance: 128 miles round trip. At the federal mileage rate commonly used to price driving costs, about [$0.67] a mile, that is about [$86]. Her actual out-of-pocket fuel cost is closer to [$20], but wear on an old car is real. Time: about two and a half hours of driving plus a one-hour session and waiting, roughly four hours in all. Lost wages: the clinic's last appointment is at 4 p.m., so she must leave a shift early; four hours at [$15] is [$60]. Child care: after-school care for two children for the afternoon, about [$25]. Copay: none under Medicaid. Total cost of one visit to her: about [$105] in cash and lost pay, using her fuel cost, or about [$171] using the mileage rate.
A Full Course, Priced
A typical course for moderate depression might involve weekly sessions for twelve weeks. Twelve visits at about [$105] each is about [$1,260], roughly two to three weeks of her take-home pay. If her car breaks down partway, the course stops.
The visit is free to her under Medicaid, yet each one costs about a week's grocery budget in fuel, lost wages and child care, so the coverage card in her wallet does not translate into care she can afford.
The Barrier in the Access Framework
The classic definition of access describes the fit between people and services across availability, accessibility, accommodation, affordability and acceptability (Penchansky & Thomas, 1981). Here the problem is not affordability in the insurance sense, since visits are covered, but accessibility, the distance, and accommodation, the clinic's hours. A newer framework would add her ability to reach and pay for care, which her job and family limit (Levesque et al., 2013).
What Would Change the Price
Telehealth: video sessions from home would remove almost all travel costs, though she has only a phone, limited data and no private room while children are home. Evening hours at the distant clinic would remove lost wages but add child care. A visiting therapist at the county clinic one day a week for Medicaid patients would cut distance to a few miles. Reopening the county clinic's list would require funding for staff, which is the root cause.
Who Else Is Affected
The same arithmetic applies to anyone in the county with Medicaid who needs a new therapist, and it is worse for those without a car, who face a bus trip with two transfers and a day lost. The county's emergency department reports more visits for mental health crises since the list closed, which suggests some people are not getting care until a crisis.
Conclusion
Coverage without nearby services leaves people paying in time and lost wages instead of copays. Pricing the barrier shows why many referred patients never go, and points to remedies, telehealth support and a visiting therapist, that reduce the price without waiting for the clinic to rebuild its staff.
References
Cummings, J. R., Allen, L., Clennon, J., Ji, X., & Druss, B. G. (2017). Geographic access to specialty mental health care across high- and low-income US communities. JAMA Psychiatry, 74(5), 476-484. https://doi.org/10.1001/jamapsychiatry.2017.0303
Levesque, J.-F., Harris, M. F., & Russell, G. (2013). Patient-centred access to health care: Conceptualising access at the interface of health systems and populations. International Journal for Equity in Health, 12, 18. https://doi.org/10.1186/1475-9276-12-18
Penchansky, R., & Thomas, J. W. (1981). The concept of access: Definition and relationship to consumer satisfaction. Medical Care, 19(2), 127-140. https://doi.org/10.1097/00005650-198102000-00001
The Purdue Global HD420 Unit 5 instructions
The fifth unit usually asks you to examine one access barrier, often distance, cost or hours, and to show its effect on a real or composite person in concrete terms. A few pages usually suffices. Strong studies include a clearly described barrier, a person whose circumstances make the costs specific, each cost calculated with a stated basis, a total for one visit and for a course of care, and the barrier placed within an access framework. Many sections reward pricing possible remedies with the same method. State your assumptions, such as wage and mileage rate, so the reader can check them. Cite access frameworks and evidence on the service gap itself.
How this HD420 Unit 5 example is built
The study describes the clinic's change and cites research on mental health care geography. A section introduces the composite client: job, wage, children and car. One visit is priced line by line: distance with two ways of valuing it, time, lost wages, child care and copay, with a total. A full course is priced next; the highlighted sentence separates coverage from access. A section places the barrier in the classic access dimensions and a newer patient-centered framework. Remedies are priced or weighed: telehealth, evening hours, a visiting therapist and reopening the clinic. A section notes who else is affected, and a conclusion recommends the remedies that lower the price fastest.
HD420 Unit 5 rubric: what earns full points
Access barrier studies are typically graded on the clarity of the barrier, the realism of the costs, use of an access framework and the quality of the remedies. Realism of costs often carries the most weight, because the unit is about showing what a barrier means in a person's budget and time. Clarity rewards a specific change or condition. Framework credit goes to naming which access dimension the barrier affects. Remedies earn points when they are assessed with the same costing method. Stated assumptions and correct arithmetic are expected. A study that separates insurance coverage from actual access shows the distinction the course wants students to carry forward into later units.
HD420 Unit 5 help: mistakes that cost points
A frequent problem is describing a barrier in general terms, such as long distances, without any costs. Another is counting only money and leaving out time, lost wages and child care, which are often larger. Some students choose a client whose circumstances are vague, so the figures could apply to anyone. Others propose remedies without checking whether they actually lower the cost, such as telehealth for someone without private space or data. Leaving assumptions unstated makes the numbers impossible to check. If your barrier is different, perhaps clinic hours or a language mismatch, describe the person and the service, and the costs can be worked out line by line.
Get an HD420 Unit 5 example written to your instructions
Tell us the barrier and the population your HD420 Unit 5 study covers, and include the prompt and rubric as your section posted them. Within 24-48h you get a free first custom sample that measures that barrier with named sources, splits the burden by group, and connects it to whatever outcome data exists for your area. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
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HD420 Unit 5 questions, answered
How do I put a dollar figure on travel?
The federal mileage reimbursement rate is the usual basis, since it covers fuel and vehicle wear, and a mapping service gives the distance. For transit riders, use the fare and the total trip time instead. State the rate and its year, show the arithmetic once, and apply the same method to every visit so the total can be checked.
Should lost wages count if someone has paid leave?
Not as a cash cost, and the study should say so. For workers with paid leave the cost is leave used, which still matters but differs from pay lost. Many hourly jobs in retail, food service and agriculture offer none, so splitting the population by leave access is often where the most useful finding sits.
Can the study cover a barrier other than distance?
Yes. Cost, hours, language, documentation requirements and appointment wait times all work, and some sections ask for two or three barriers together. Whatever the barrier, the same standard applies: measure it with a stated method and source, show who meets it most, and connect it to an outcome in population data where one exists.
Where can I find a free HD420 Unit 5 sample paper?
You can read the full Unit 5 study here, pricing a 64-mile trip to a therapist for a composite home care aide with Medicaid.
Why is a covered visit still a barrier?
Because travel, lost wages and child care can cost far more than a copay, so coverage alone does not make care reachable.