How Higher Ed Can Support College Student Health Concerns

The American College Health Association (ACHA) conducts the National College Health Assessment survey annually to help universities collect data on college students and overall student health. The following topics represent survey results regarding common health concerns, behaviors, and perceptions reported by college students over the past year.

Stress, Anxiety, and Depression

According to a survey conducted by TimelyCare, 82% of college students say they continue to experience increased emotional distress and anxiety as a result of COVID-19. The top five stressors cited in the survey by students were:

1. Impact on the quality of their education
2. Not knowing what life may look like in a new normal
3. Isolation from friends and family
4. Missing a vibrant campus life
5. Struggles with remote learning

As reported by the New York Times, it’s been a challenging time for college students, who had their campuses shut down, their education drastically changed, and they were last in line for vaccines. Winter makes the mental health crisis worse, with health professionals seeing more severe symptoms of mental health disorders. Additionally, things such as anxiety disorders, depression, eating disorders, and addictions have increased in young people since the pandemic. This is why mental health services and strategies for self-care are critical for college students.

Cold, Flu, and Sore Throat

Most college students living on their own for the first time get exposed to new public health risks like cold, flu, and upper respiratory issues like a sore throat. Such risks come from living in close quarters with other students, the stress of being away from home, the pressure of academic life, and the use of drugs and alcohol.

On average, college students who get the flu experience illness of eight days or more—not being able to attend a class for that long impacts academic performance. Over six months, a study of 4,919 college students at the University of Minnesota found 83% contracted an upper respiratory infection or cold, and 36.7% contracted influenza-like illnesses. These illnesses caused 6,023 bed-days, 4,263 missed school days, 3,175 missed workdays, and 45,219 days of disease. Of the cohort, 27.8% did poorly on a test, and 46.3% did poorly on a class assignment.

Meningitis

A bacterial or viral infection most often causes meningitis. A fungal infection may also cause meningitis, a reaction to certain medications or medical treatments, an inflammatory disease such as lupus, some types of cancer, or a traumatic injury to the head or spine. Symptoms often resemble the flu and may include high fever, severe headache, stiff neck, rash, nausea, vomiting, fatigue, and confusion.

College freshmen, especially those who live in dormitories, are at a slightly increased risk for bacterial meningitis. The Centers for Disease Control and Prevention (CDC) recommends all students transitioning from high school to college and living in residence halls receive the meningococcal vaccine.

Eating Disorders

Eating disorders are prevalent during the college years. Most eating disorders begin among young adults between the ages of 18 and 21. With many college students living on their own for the first time, it can be challenging to recognize the risk factors and warning signs.

The National Eating Disorders Association website offers resources like a support hotline for eating disorders, including anorexia, bulimia, and binge eating disorder.

ADHD

By some estimates, between 2% and 8% of college students have attention-deficit/hyperactivity disorder (ADHD). Researchers find that students with ADHD have a more challenging time graduating and have a lower grade-point average — about half a grade lower — than their peers who do not suffer from the disorder. To be successful, it’s essential that students managing ADHD understand how to advocate for themselves, take advantage of accommodations available on campus, and have a plan for making it to graduation.

Common Illnesses

College campuses are known for spreading illnesses and contagious diseases. There are various causes at play in everyday college life — students often deal with high stress, lack of sleep, poor diets, and may not be accustomed to taking care of their physical health. Common illnesses include allergies, stomach flu, influenza, mono, athlete’s foot, human papillomavirus (HPV), pink eye, etc.

Alcohol and Substance Abuse

College students have always represented a large portion of the population abusing drugs and alcohol. The Addiction Center reports that 80% of U.S. college students have used alcohol. An estimated 110,000 students between 18 and 24 are arrested every year for alcohol-related violations, such as public drunkenness or driving under the influence.

Additionally, a national survey found that 33% of full-time college students ages 18 to 22 engaged in binge drinking in the past month. Binge drinking is defined in the survey as consuming five drinks or more on one occasion for males and four drinks or more for females. This type of alcohol use can pose serious health and safety risks, including car accidents, drunk-driving arrests, sexual assaults, and other injuries. Frequent binge drinking can cause long-term harm to physical health, like damage to the liver and other organs.

Thirty-seven percent of college students use illicit drugs regularly (e.g., opioids, stimulants, benzodiazepines, cannabinoids, barbiturates). The exposure to a variety of people in college, stressors of adjusting to new environments, participating in fraternity and sororities, and many other aspects of student life increase the risk of college drug use. This substance abuse can lead students to take high-risk actions like driving under the influence of an illicit substance or getting involved in criminal activity.

Lack of Sleep

Students experience new challenges when starting at university like leaving home, increased independence, changes in peer groups, new social situations, maintenance of academic responsibilities, increased access to alcohol or drugs, and living with a roommate. Research shows that 41% of students with roommates wake up at night due to their cohabitants’ noises. These challenges are all associated with sleep disturbances and lack of sleep. 60% of college students suffer from poor sleep quality, and 27% are at risk of one sleep disorder.

Balancing Work and Academics

One disadvantage for college students working through school is the limitation on time — precisely the time for study, sleep, physical activity, and healthy eating habits. Working 35 hours or more per week in college has adverse effects on students, including a higher risk of dropping out, delayed graduation rates, declining student mental health, and poor academic performance. Full-time workers have less time for academic studies and school activities and often miss or skip class.

Roommate Difficulties

In a nationwide survey published by George Mason University, over 50% of women and 44% of men reported frequent or occasional conflict with roommates or housemates. The survey also found that almost 6% of undergraduates said that roommate difficulty hindered their academic performance (i.e. received a lower grade on an exam, received an incomplete, or dropped a course). For students who may not be used to living in such proximity, the transition to living on campus with a roommate can be difficult.

Sexual Assault and Relationship Violence

A 2019 Association of American Universities survey on sexual assault and misconduct revealed a 13% non-consensual sexual conduct rate. The Rape, Abuse, and Incest National Network found that female college students between 18 and 24 are three times more likely than the general population to experience sexual violence. In contrast, male college students are five times more likely to be a victim than non-students.

Women who have been sexually assaulted will likely face significant mental health problems, including depression, anxiety, and post-traumatic stress disorder. Men face similar mental health problems, including anxiety, depression, post-traumatic stress disorder, flashbacks, and eating disorders. The ACHA has put together a list of resources on campus and sexual violence.

Sexual Health

While sexually transmitted diseases (STDs) affect individuals of all ages, STDs take a hefty toll on young people. The CDC estimates that youth ages 15 to 24 make up just over one-quarter of the sexually active population but account for half of the 20 million new sexually transmitted infections that occur in the United States each year. To raise awareness, colleges and universities should make resources and referrals available to support and inform students about sexual health.

Mumps

Once a ubiquitous childhood disease, Mumps was nearly eliminated in the United States after launching a vaccine in 1967. But the condition is making a comeback in young adults. Hundreds of outbreaks have occurred across college campuses since the early 2000s. The CDC advises a third dose of the measles, mumps, rubella (MMR) vaccine for people at high risk, such as college students.