This is a post-apocalyptic game. This means that despite the fact that there's some infrastructure that keeps working despite no one knowing how, like the power grid, the waste treatment plant and sewers, the water treatment plant, and the city's limited access phone and internet service (City needs an ISP, by the way. Get on that, Geeks.) that there are many, many things that are harder to get. Services that cannot be accessed the way they used to be. The three biggest areas of challenge are medical and community services, food and goods, There are basically no police or fire services left, and there's no department of sanitation that will be coming to haul trash nicely to a landfill.
There *is* a Security Force in the Safe Zone that is meant to provide the NPC security for the Safe Zone (while there's not a police department, the community has been trying to organize itself for its areas of need). They would very likely try to intervene if they see violent crime or open, outright theft, and they'll attack things that get in from outside the Safe Zone.
Garbage is going to either accumulate or be burned. Some enterprising individuals are no doubt working on large carts that can haul waste to the landfill, and there's certainly room for someone to develop a similar system for compostable debris that can be applied to fields. (No more chemical pesticides or fertilizers, there has to be a return to more organic methods. This means smaller crops, but the food harvested will be better for people anyhow.)
Most American cities have at best 3-4 days fresh food on hand, and maybe a week's canned goods. If the logistics pipelines are cut, as they were in EOTW, once the supermarkets are stripped bare, it's all gone. Foraging for canned goods outside the Safe Zone is a viable occupation. Who knows, if you get lucky you might even find someone's home canning setup - a /major/ score in this world.
Barring access to supernatural healing resources, there are almost no chronic, long-term sufferers of serious medical issues. They've died in droves for lack of treatment. Diabetics who needed insulin, Cancer patients, Renal patients, the frail and fragile and elderly, they just aren't making it. Pneumonia has returned as a big killer, along with influenza, and the scourge of childhood disease is a problem again, with Whooping Cough, Diphtheria, Chicken Pox, Mumps, Scarlet Fever. RSV infections in infants that can lead to pneumonia, Reye's Syndrome is back too.
Medical care is very patchy and sporadically available. Easy access to prescription drugs is unlikely, and vaccines for the killer diseases are almost impossible to get, as all those supplies were shipped in from outside. There's no more yearly flu vaccination. There's very little acute care, almost no emergency care whatsoever, and many doctors and nurses have re-routed their focus to trauma care, Preventative medicine, and Midwifery.
If you wear eyeglasses, be super careful, because replacing broken eyeglasses is going to be quite a trial. Contact lens wearers will likely end up switching to glasses. People in need of dental services may have to search hard for a practicing dentist. Or have that bad tooth pulled by an amateur.
Pregnancy and childbirth are dangerous again. The supply of available birth control methods is dwindling too, although some people like have 2-year implants or IUDs. Condoms are a bit of a commodity. A stockpile of birth control pills is almost as valuable as coffee to the foresighted.
Children are a mixed blessing. On the one hand, they're perpetuation of the human race. On the other, they can actually shorten the lives of careless parents when they are young and helpless. Very young children are illness prone, and they're made out of delicious tender meat. Taking a child that young out of the Safe Zone is a bit like stripping naked, rolling in butter, and then donning a garment made entirely of beef jerky. Children are very vulnerable, and until a child is old enough to understand what danger is, and to shoot a gun or use some kind of blade, it is on the parents to keep them alive. There are mindless or nonsentient creatures just looking for food. There are Privateers. There are slavers, though children are generally more trouble then they are worth unless the mother can be caught too. There could be almost anything, in the world.
It really is a bad old world out there. No one is safe. There's nothing sacrosanct.