| Course | HEP 386 Assessing Strengths and Needs for Health Education and Promotion |
|---|---|
| Module | Module 4 |
| Paper type | Literature review draft |
| Length | About 647 words, 5 pages |
| Format | APA 7 student paper |
| School | Arizona State University |
| Program | BS in Health Education and Health Promotion |
| Updated | October 2026 |
Free sample paper for HEP 386 Module 4
Food Insecurity and Adult Health: A Literature Review for a Yuma County Assessment, First Draft
Student Name
BS in Health Education and Health Promotion, Arizona State University
HEP 386: Assessing Strengths and Needs for Health Education and Promotion
Instructor Name
Month Day, Year
Food Insecurity and Adult Health: A Literature Review for a Yuma County Assessment, First Draft
Introduction
Food insecurity, the lack of reliable access to enough food for an active and healthy life, affected 13.5% of U.S. households in 2023 (Rabbitt et al., 2024). Modeled estimates suggest it is far more common among adults in Yuma County, Arizona, at about one in four (Centers for Disease Control and Prevention [CDC], 2025). This review summarizes what is known about its health effects, who is most affected and what helps, to guide a community assessment in Yuma.
Health Consequences of Food Insecurity
Research across age groups shows a steady pattern: households that cannot count on food report worse health. A review of recent U.S. studies concluded that food insecurity is consistently associated with poorer physical and mental health in children, working-age adults and seniors (Gundersen & Ziliak, 2015). For adults, the strongest evidence concerns diet-sensitive chronic disease. Among poor adults surveyed nationally, those who were food insecure had about 20% higher risk of hypertension and 30% higher risk of hyperlipidemia than food-secure adults with similar incomes and backgrounds, and the association with diabetes strengthened when stricter definitions of food insecurity were used (Seligman et al., 2010).
Food insecurity may also shape when health crises occur. In California, hospital admissions for low blood sugar among low-income residents climbed by about a quarter in the last week of each month, when food budgets tend to run out, while admissions among higher-income residents showed no such pattern (Seligman et al., 2014). The costs reach the health system as well: adults reporting food insecurity went on to spend roughly $1,900 more per year on health care than comparable adults (Berkowitz et al., 2018).
Most of these studies are cross-sectional or observational, so they cannot prove that food insecurity causes disease. Poor health can also strain budgets and lead to food insecurity, and the two likely reinforce each other.
Adults at Greatest Risk
National surveys show that food insecurity follows income, but it also concentrates in particular groups and places (Rabbitt et al., 2024). Agricultural workers are an important example for Yuma. Among migrant farmworkers surveyed in Georgia, nearly two thirds reported not having enough food, and those without the protections of the H-2A guestworker program faced about three times the risk; lacking cooking facilities and transportation added to that risk (Hill et al., 2011). Although the Georgia findings may not transfer directly, they point to practical barriers, kitchens, rides and stable housing, that an assessment in Yuma should examine.
Responses That Reduce Food Insecurity
Two kinds of responses have the strongest evidence among the sources reviewed. The biggest by far is the Supplemental Nutrition Assistance Program. In a national evaluation of about 6,500 households, participation for six months cut the share of households that were food insecure and the share with very low food security (Mabli & Ohls, 2015). Clinic-based produce prescriptions are newer. Across nine programs, adults and children who received vouchers for fruits and vegetables ate more of them, became less likely to be food insecure, and adults with poorly controlled blood pressure or blood sugar saw meaningful improvements (Hager et al., 2023). Neither study randomized participants, so some benefits may reflect who chose to take part.
Implications for Yuma County
The literature suggests that food insecurity in Yuma County likely contributes to its high diabetes and obesity estimates, that agricultural and low-wage workers deserve particular attention and that increasing SNAP use among eligible households and partnering with clinics on produce prescriptions are promising responses. Yuma's position as a major vegetable-growing region could make produce-based programs especially practical.
Gaps
No published study examines Yuma County's food insecurity directly, and research on Arizona farmworkers or border communities is scarce. The assessment's windshield survey and interviews with a person affected by food insecurity and a person working on it will help fill those gaps.
References
Berkowitz, S. A., Basu, S., Meigs, J. B., & Seligman, H. K. (2018). Food insecurity and health care expenditures in the United States, 2011-2013. Health Services Research, 53(3), 1600-1620. https://doi.org/10.1111/1475-6773.12730
Centers for Disease Control and Prevention. (2025). PLACES: Local data for better health, county data, 2025 release [Data set]. https://data.cdc.gov/500-Cities-Places/PLACES-Local-Data-for-Better-Health-County-Data-20/swc5-untb
Gundersen, C., & Ziliak, J. P. (2015). Food insecurity and health outcomes. Health Affairs, 34(11), 1830-1839. https://doi.org/10.1377/hlthaff.2015.0645
Hager, K., Du, M., Li, Z., Mozaffarian, D., Chui, K., Shi, P., Ling, B., Cash, S. B., Folta, S. C., & Zhang, F. F. (2023). Impact of produce prescriptions on diet, food security, and cardiometabolic health outcomes: A multisite evaluation of 9 produce prescription programs in the United States. Circulation: Cardiovascular Quality and Outcomes, 16(9), e009520. https://doi.org/10.1161/CIRCOUTCOMES.122.009520
Hill, B. G., Moloney, A. G., Mize, T., Himelick, T., & Guest, J. L. (2011). Prevalence and predictors of food insecurity in migrant farmworkers in Georgia. American Journal of Public Health, 101(5), 831-833. https://doi.org/10.2105/AJPH.2010.199703
Mabli, J., & Ohls, J. (2015). Supplemental Nutrition Assistance Program participation is associated with an increase in household food security in a national evaluation. The Journal of Nutrition, 145(2), 344-351. https://doi.org/10.3945/jn.114.198697
Rabbitt, M. P., Reed-Jones, M., Hales, L. J., & Burke, M. P. (2024). Household food security in the United States in 2023 (Economic Research Report No. 337). U.S. Department of Agriculture, Economic Research Service. https://doi.org/10.32747/2024.8583175.ers
Seligman, H. K., Bolger, A. F., Guzman, D., López, A., & Bibbins-Domingo, K. (2014). Exhaustion of food budgets at month's end and hospital admissions for hypoglycemia. Health Affairs, 33(1), 116-123. https://doi.org/10.1377/hlthaff.2013.0096
Seligman, H. K., Laraia, B. A., & Kushel, M. B. (2010). Food insecurity is associated with chronic disease among low-income NHANES participants. The Journal of Nutrition, 140(2), 304-310. https://doi.org/10.3945/jn.109.112573
Reading the HEP 386 Module 4 assignment instructions
The Literature Review First Draft in HEP 386 Module 4 is worth 40 points. Using the sources you collected in Module 3, write a connected review that synthesizes what the research says about your priority health concern, organized by theme or by your review questions rather than source by source. The same module includes the secondary and primary stakeholder interviews, the first volunteer experience and a reflection, so plan your time. Expect instructor feedback on this draft, and keep track of it for the final presentation of your assessment. Aim for the length and citation style your instructor sets, usually APA. Leave a day for revision before you submit.
How this HEP 386 Module 4 example is built
The sample opens by defining the concern and stating the review's purpose. Three thematic sections follow: health consequences, groups at greatest risk and responses that work. Within each, studies are compared and linked in prose rather than summarized one at a time, and each section closes by rating how solid its evidence is. The draft closes with implications for the community and the gaps that the windshield survey and interviews must fill. Numbers are paraphrased in plain words, such as "about a quarter" or "roughly $1,900," with the exact figures kept in the sources. The draft also acknowledges reverse causation, that poor health can lead to food insecurity, which shows critical reading. The tone stays measured throughout.
Where the marks sit in the HEP 386 Module 4 rubric
The first draft is worth 40 points. Readers look for synthesis across sources, accurate reporting of findings, attention to study design and limitations, a logical organization and correct APA citations. Marks drop when the review reads as a list of abstracts, when findings are overstated as proof of causation, when local relevance is missing and when citations are incomplete or inconsistent with the reference list. A draft that connects the research to the community, names where evidence is thin and prepares the reader for the fieldwork findings to come demonstrates the purpose of a literature review inside a needs assessment, which the rubric rewards.
HEP 386 Module 4 help from the desk
Start each paragraph with a claim, then use two or more sources to support it. Use phrases that compare studies, such as "similarly" or "in contrast." Name the design when it limits a conclusion. Paraphrase, and cite every finding. Close by saying how the findings apply locally. Read the draft aloud to catch paragraphs that only list sources. If your draft still sounds like a matrix, the desk can help you turn it into synthesis. Return to your matrix and color-code each finding by theme before you write; each color becomes a section. Keep a list of questions your interviews could answer, since gaps in the literature are good interview topics. Proofread the reference list last.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Arizona State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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HEP 386 Module 4 questions, answered
Where can I find a free HEP 386 Module 4 sample paper?
The complete first draft of the review, organized in three themes, appears here.
How should a literature review be organized?
By themes or review questions, comparing studies within each, not by summarizing sources one at a time.
What is synthesis in a literature review?
Combining findings from several sources to make a point none of them makes alone.
Is food insecurity linked to diabetes?
Studies link food insecurity to diet-sensitive chronic disease, with stronger diabetes associations under stricter definitions.
What else is due in HEP 386 Module 4?
Two stakeholder interviews, the first volunteer experience, a volunteer reflection and an interview self-evaluation.