Student Health Guide: College Students

If you are a college student, you are likely drinking too much, staying up too late and snacking on far too much junk food. Sure, it's fun. But it's also unhealthy. Check out these important health tips and concerns.

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In fall 2016, the National Center for Education Statistics reported that approximately 20.5 million students were expected to attend a U.S. college or university. That was an increase of about 5.2 million since the fall of 2000. And if you are currently one of the millions of these college students in this growing statistic, you likely fall under a few other statistics as well.

A 2012 National College Health Assessment Report conducted by the USC American College Health Association (ACHA) found the major factors that most frequently occurred and most negatively impacted academic functioning for undergraduate students. These factors included stress, anxiety, sleep difficulties and illness. Participation in extracurricular activities and internet use and computer games also ranked high.

Did You Know

55.5% of students experienced more than average stress due to academics, relationships and finances.

The students reported that academics, intimate relationships and finances caused them extreme difficulty in the past year, with 55.5 percent of them experiencing “more than average” or “tremendous stress.”

A report issued by the University of Minnesota Boynton Health Service, tasked with conducting a comprehensive survey on the health of college students, found that “alcohol use continues to be a concern for universities and colleges.” And mental health results showed that depression and anxiety were the two most frequently reported diagnoses of students, with 15.7 percent of students being diagnosed with a mental health illness of any kind in the past 12 months.

Dr. Ed Ehlinger, the director and chief health officer of the Boynton Health Service, said, “Education is one of the strongest influences on economic and health status… College students face multiple risks to their health and their behavior affects all parts of their existence. We need to look at a student as a complex and complete person.”

Nutrition icons

Nutrition

Every college student has likely heard of “The Freshman 15.” But in 2008, the National Institutes of Health (NIH) published an article challenging that notion, and the results were that the evidence for the phenomenon is limited.

In fact, the authors of the study observed instead an average weight gain among unmarried freshman students living on-campus of about 2.7 pounds, with about 50 percent of the students gaining weight and another 15 percent actually losing weight. Men were observed to have gained more weight than women.

Freshman weight Gain

A more recent study published by NIH in 2015 showed that freshman weight gain is still an issue, with about two-thirds of students gaining weight during their first year of college.

The study did conclude, however, that freshman weight gain was 5.5 times greater than that of the general population.

A more recent study published by NIH in 2015 showed that freshman weight gain is still an issue, with about two-thirds of students gaining weight during their first year of college. However, this study recorded the amount gained in the first year at closer to seven pounds, with the majority of the weight being gained in the first term.

The authors of the study concluded, “Given adolescent weight gain is highly linked to overweight and obesity in adults, a better understanding of university student weight gain is crucial if we are to combat the rising adult obesity prevalence.”

Why Is It a Problem?

The Washington Post published an article in 2016 that attributed the weight gain in freshman students to “generous meal plans, large portions, binge drinking, heavy snacking, more stress and less physical activity.” The author of the article concluded, “Any adult following that unhealthy lifestyle would gain weight, too.”

The authors of the 2015 study published by the National Institutes of Health (NIH) stated, “In those late adolescent years and early adulthood, transition from secondary school to university is a critical and vulnerable period for body weight changes and unhealthy lifestyle adoption… Given adolescence weight gain is highly linked to overweight and obesity in adults, the significant weight gain at university needs to be further understood if we are to combat the rising adult obesity prevalence.”

Forming Bad Habits

The study found that weight gain and unhealthy lifestyle habits occurring in the college years were likely to persist into adulthood.

The authors noted that according to the World Health Organization (WHO), obesity has reached “epidemic proportions.” WHO reported an approximate 1.4 billion people worldwide are overweight and another 300 million individuals are considered clinically obese.

People who are overweight and/or obese are at an increased risk of developing the following conditions:
  • Type 2 diabetes
  • High blood pressure
  • High cholesterol
  • Heart disease
  • Stroke
  • Cancer
  • Sleep apnea
  • Osteoarthritis
  • Fatty liver disease
  • Kidney disease
  • Pregnancy problems (for the mother and the child)

The 2007 University of Minnesota Boynton Health Services study found that nearly two-fifths or 38.5 percent of the students surveyed fell within the categories of being overweight or obese.

Nutrition Diagram
Two-fifths or 38.5% of the students fall within the categories of being overweight or obese while attending college

What Can Be Done?

Some weight gain is normal for the growing adolescent body, but it can become a problem if it is significant and it happens over a short period of time. Furthermore, not eating the right portions of healthy foods can starve the body of necessary nutrients and result in a lack of energy, concentration and memory.

TeensHealth from Nemours reported that one study found that freshman who gained four pounds in just 12 weeks were only eating an average of an extra 174 calories per day. Cutting out one sugary drink or midnight snack each day could fix the problem.

Nemours provided some tips to avoid weight gain including the following:
  • Avoid eating when stressed, while studying or while watching TV or simply lounging
  • Eat your meals slowly
  • Eat at regular times and don’t skip meals
  • Keep all snacking to a minimum
  • Keep nutritious foods and snacks, such as fruits, nuts, yogurt, vegetables and granola, readily available
  • Switch whole fat choices to low-fat
  • Watch your portions and avoid additional servings
  • Avoid vending machines and fast food establishments
  • Avoid or limit soft drinks and other sugary beverages (including flavored coffee drinks), and limit alcohol consumption

The stress and anxiety associated with college, and just making a transition in general, can often result in overeating and other bad health choices. The Washington Post suggested exercise as a more positive alternative to dealing with negative emotions. Regular exercise and proper sleep habits are also major contributors to maintaining a healthy weight.

Also, while alcohol contains calories, and over-drinking can result in alterations to your sleep schedule and lead to overeating, it is possible to consume alcohol in moderation and still avoid weight gain. One drink a day for women and two drinks a day for men, choosing light beers or wine spritzers and alternating alcohol with water, are all ways to avoid extra, unneeded calories.

Nutrition icons

Sleep

Dr. James R. Oelschlager of the Florida Institute of Technology Counseling and Psychological Services said that “getting six to eight hours less sleep than usual over a week can impair mental efficiency and reaction time, and cause depression, anxiety and irritability.”

Sleep is vital for everyone, not just for college students. But as a college student, you may be more prone to sleep deprivation due to late-night studying and an inability to fall asleep or stay asleep.

Medical director of the now-shuttered Sleep HealthCenters in Brighton, Mass., Dr. Lawrence Epstein said that how much sleep a student is getting is directly associated with how well they perform in school. He reported to the American Academy of Sleep Medicine that “recent studies have shown that adequate sleep is essential to feeling awake and alert, maintaining good health and working at peak performance.”

Did You Know

Sleep allows your brain to organize, sort and store everything that has been learned and experienced throughout one’s day.

Epstein also pointed out that two weeks of six hours or less of sleep a night is comparable to going without sleep for 48 hours straight. And new research shows that getting enough sleep is imperative to an individual’s cognitive functioning, including, of course, learning and memory.

The University of Georgia University Health Center said that sleep is the time during which your brain “organizes, sorts and stores” everything that has been learned and experienced throughout one’s day, making it easier to recall the information at a later date. It can also get rid of any irrelevant information and make connections with memory that may not have even been made while the person was awake.

Beyond academic performance, sleep is important for a student’s overall health and well-being. Getting enough sleep at the right times can help to protect an individual’s mental health, physical health, overall quality of life and safety. In teens especially, sleep is still assisting in the body’s and mind’s growth and development.

According to the National Institutes of Health, sleep can help a person’s mental health by enhancing learning and problem-solving, helping individuals control emotions and behavior, and assisting in an individual’s ability to cope with change.

Some ways in which sleep can assist in a person’s physical health include:
  • Healing and repair of the heart and blood vessels
  • Maintaining a healthy balance of hormones that signal our brains of when we’re hungry or full
  • Controlling the effect of insulin (the hormone that controls blood glucose – sugar – levels) on our bodies
  • Triggering the hormone that promotes natural growth, boosts muscle mass, and repairs cells and tissues
  • Playing a role in puberty and fertility
  • Supporting your immune system to keep you healthy

What’s the Problem?

A study published in the Journal of Adolescent Health found that only 30 percent of students get the recommended number of hours of sleep each night.

In the 2012 National College Health Assessment Report, 24.3 percent of students surveyed said that daytime sleepiness or lack of sleep was “more than a little problem,” while 12.6 percent of the students said it was “a big problem.”

Lack of sleep statistic
Sleep deprived statistic
24.3 % of students say that lack of sleep was “more than a little problem" while 33% of graduate students felt tired during the day 5 - 7 days out of the week

Another 5.1 percent said that sleep was “a very big problem” for them, and just over 20 percent of all undergraduate students said they felt tired during the day 5 to 7 days out of a week. Another 33.3 percent of graduate students said the same, meaning about one-fifth to one-third of college students are tired essentially all the time.

Psychology professor at University of St. Thomas in St. Paul, Minnesota, Roxanne Prichard, stated in a report, “Students underestimate the importance of sleep in their daily lives. They forgo sleep during periods of stress, not realizing that they are sabotaging their physical and mental health.”

Tired from working out
Lack of sleep can result in poor sports performance in athletes

Lack of sleep can result in several consequences to a student’s physical and mental health, as well as their academic performance. It can lead to impaired concentration levels and reaction times and a reduction in overall alertness. In college athletes, not getting enough sleep can result in poor physical performance as well.

According to the Division of Sleep Medicine at Harvard Medical School, learning is made up of three brain processes, including acquisition of new information, consolidation of memory connections, and recall of stored data. When a person lacks sleep, all three of these processes are disrupted, but particularly noticeable are the effects to acquisition and recall. That is due to increased difficulty in concentration associated with inadequate rest.

Most importantly, though, is the effect to memory consolidation. While the other two categories can be remedied with sleep on subsequent nights, memory consolidation cannot be made up. According to the article published by Harvard Medical School, this means that “the brain will be less able to retain and make use of information gathered on the day before the all-nighter.”


“There is ample evidence to indicate that the lack of adequate nighttime sleep can lead to disturbances in brain function, which in turn, can lead to poor academic performance.”

- Dr. Clete A. Kushida, attending physician at the Stanford Sleep Disorders Clinic


Health and Safety

After several nights of losing even just one or two hours of sleep, a person’s ability to function suffers as though they have not slept at all for one to two days. This continued lack of sleep can lead to what is called microsleep, which refers to brief moments or seconds of sleep that occur when a person is normally awake.

Microsleep is not something that a person can control, and many people are not even aware that it is happening. A common example of this is driving some place and not being able to recall getting to your final destination.

In fact, studies show that sleep deprivation can affect a person’s driving ability just as much as being intoxicated. According to the National Institutes of Health (NIH), drowsy drivers account for an estimated 100,000 car accidents each year, resulting in about 1,500 deaths.

Lack of sleep can also result in the following physical and mental health conditions:
  • More illness, such as colds and the flu
  • Higher levels of stress
  • Feeling sad or depressed
  • Increased weight gain and/or obesity
  • Increased levels of anxiety
  • Worsening chronic lung and heart disease
  • High blood pressure
  • Heart failure
  • Stroke and/or mini-stroke
  • Diabetes
  • Attention-deficit hyperactivity disorder (ADHD)

Sleeping or napping too much can also be a problem. The University of Georgia University Health Center found that 30 to 50 percent of college students nap, but nappers often sleep less at night than non-nappers. The school health center recommends that if a nap is needed, it should be taken early in the day and limited to no more than 20 to 30 minutes.

Oelschlager noted that people who sleep less than the average of eight hours a night are generally found to be “more active, sociable, ambitious and extroverted” than those sleeping more than eight hours a night. Those sleeping too much are typically found to be more “introverted, critical and significant worriers.”

What Can Be Done?

There are some steps that college students can take to ensure they are getting sufficient sleep each night, starting with allowing enough time to sleep. Dr. Jane F. Gaultney said that when 15 college students were asked to sleep as much as possible at night during a study, “daytime sleepiness decreased, and reaction time, mood, and fatigue improved.”

Some sleep tips provided by the National Institutes of Health (NIH) include:
  • Go to bed and wake up at the same time every day
  • Try to keep the same sleep schedule on weeknights and weekends — staying up late and sleeping in late on weekends can disrupt your body clock's sleep–wake rhythm.
  • Use the hour before bed for quiet time — avoid strenuous exercise and bright artificial light, such as from a TV or computer screen
  • Avoid heavy and/or large meals and alcohol within a couple hours of bedtime
  • Avoid nicotine (cigarettes) and caffeine (soda, coffee, tea and chocolate)
  • Spend time outside every day and maintain regular physical activity
  • Keep your bedroom quiet, cool and dark
  • Take a hot bath or use relaxation or meditation techniques before bed
Young student in bed studying
Other tips include:
  • Limit naps
  • Write down stressful thoughts
  • Read a book or listen to music
  • Avoid using your bedroom for stimulating or stressful activities
  • Invest in a comfortable mattress or pillow
  • If you are unable to go to sleep, get out of bed and do something else until you feel tired

How Much Sleep Is Enough?

Most studies and experts recommend at least eight hours of sleep each night for students and even adults; but this recommendation can vary from person to person with some only needing six hours of sleep and others needing up to 10 hours of sleep each night.

Associate professor in the department of psychiatry and behavioral sciences at Stanford University Medical Center and an attending physician at the Stanford Sleep Disorders Clinic, Dr. Clete A. Kushida said that since the necessary amount of sleep can differ from one person to the next, daytime alertness is the most appropriate measure for determining whether an individual is getting enough sleep.


“If you wake up irritable, tired and unenergetic, you are likely not getting enough sleep."

- Dr. James R. Oelschlager of the Florida Institute of Technology Counseling and Psychological Services


Oelschlager said “if you wake up irritable, tired and unenergetic,” you are likely not getting enough sleep. He also pointed out, along with Kushida, that the quality of sleep is often of more importance than the quantity of sleep, which explains why some people can wake after several hours of sleep and still feel tired. While lack of sleep is cumulative, one good night of sleep can make up for several nights of unrest.

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Diet and Exercise

Diet and exercise aren’t just important for keeping off the extra pounds that can come along with a transition into college life. Sometimes, students have certain diet restrictions that make healthy food choices a necessity. And exercise offers benefits beyond just weight loss or maintenance.

An article published in U.S. News & World Report in 2012, reported that exercise makes you “happier and smarter.” Harvard Medical School psychiatrist and author John Ratey said just 10 minutes of physical activity can promote positive changes in your brain. Ratey said, “Exercise is the single best thing you can do for your brain in terms of mood, memory and learning.”

The authors of the article noted that exercise can also do the following:
  • Reverse the negative effects of stress
  • Lift your mood and ward off depression
  • Improve learning
  • Boost self-esteem and improve body image
  • Leave you feeling “euphoric” (intense happiness, excitement or confidence)
  • Maintain brain functioning, including memory and vocabulary skills
  • Lower your risk for Alzheimer’s (progressive disease that destroys memory and other mental functions)

The National Institutes of Health (NIH) said that physically active adults are at a lower risk for depression and declining cognitive functioning (thinking, learning and judgment) as they age. It also lowers a person’s risk for certain disease, such as coronary heart disease (CHD), diabetes and cancer.

According to NIH, exercise actually strengthens the heart and improves lung functioning.

Exercise Benefits Hearts & Lungs

When done regularly, at a moderate to vigorous intensity, exercise strengthens the heart muscle improving its ability to pump blood to the lungs and throughout the body. As a result, more blood is flowing, which raises oxygen levels in the blood.

Exercise also results in the widening of the body’s capillaries (tiny blood vessels), which allows for more oxygen and enhances the body’s ability to rid itself of wastes.

Regular physical activity can improve your health by:
  • Lowering blood pressure
  • Lowering fat in the blood (triglycerides)
  • Raising “good” cholesterol levels (HDL)
  • Managing blood sugar and insulin levels, lowering your risk of type 2 diabetes
  • Reducing levels of C-reactive protein (CRP) in your body — linked to inflammation and CHD
  • Reducing weight and maintaining weight when combined with a healthy diet
  • Helping you give up habits that hurt your health, such as smoking and binge drinking

What’s the Problem?

The National College Health Assessment Report conducted by USC American College Health Association (ACHA) in 2012 reported that 91 percent of undergraduate and 94.6 percent of graduate students believed their general health to be excellent, very good or good. But only 18.8 percent of undergraduate students and 12.1 percent of graduate students reported engaging in moderate exercise at least five days per week, and 29.6 of undergraduate and 27.2 percent of graduate students reported that they participated in vigorous exercise at least three days per week.

Female measuring her waist line
More than 35% of dieters progress into unhealthy dieting and eating disorders

Also, less than 6 percent of undergraduate students and less than 10 percent of graduate students are receiving the recommended five or more servings of fruits or vegetables each day.

On the other hand, too much exercise and not eating enough can result in being underweight, which is also a problem. Extreme dieting can result in an eating disorder, which is a serious medical problem occurring more commonly in females. Types of eating disorders include anorexia nervosa, bulimia nervosa and binge-eating disorder.

The National Eating Disorders Association (NEDA) reported that 35 percent of dieters progress to unhealthy dieting, and another 20 to 25 percent of those individuals develop some form and degree of an eating disorder.

Most eating disorders are developed in adolescence and early adulthood. Often, these disorders go beyond just a problem with food. It is also a need for control over one’s environment, characterized by food restrictions, over-exercising and adopting an unhealthy focus on body weight.

Unhealthy habits linked to diet and exercise among college students may also include the use of diet pills, laxatives, diuretics, and even steroids for college athletes wanting to gain weight fast and hoping to enhance their game performance.

What Can Be Done?

The U.S. Department of Health and Human Services (DOH) recommends 150 minutes per week, or 30 minutes five days per week, of moderate activity, and 75 minutes each week of vigorous activity. Strength training to build muscle and overall body strength should be performed two days a week. This can include exercises such as lifting weights, or doing chin-ups, pull-ups or push-ups.

Walking or biking across campus and to and from classes, doing squats and lifting weights in the dorm room, and/or playing intramural sports are all great ways to stay active in college.

Maintaining a Healthy Diet

The United States Department of Agriculture (USDA) created a site called ChooseMyPlate.gov. It is designed to provide healthy food options that fall within the five basic food groups essential for our health and well-being. As a part of this project, the USDA published some tips for “healthy eating in the dining hall.”

For student athletes or those looking to gain weight, registered dietitian Jessica Crandall suggested to U.S. News & World Report that students don’t just skip out on nutrition and simply indulge in high-fat foods. Crandall said, “It’s not only calories you’re looking for, but overall nutrition” to support a healthy weight long-term.

U.S. News & World Report suggested instead that students opt for “calorie-rich, nutrient-dense, low-volume” foods. Some examples would include olive oil, avocados, nuts, eggs, cheese and granola.

Sexual health icons

Sexual Health

According to a 2013 study published by the National Institutes of Health (NIH), the period between the ages of 18 and 25 is defined as “emerging adulthood.” This is a transition period in which individuals no longer feel like adolescents but also don’t yet quite feel like adults. This period is also characterized by one’s acceptance of personal responsibility, including responsibility for one’s own sexual health.

The World Health Organization (WHO) defines sexual health as “a state of physical, mental and social wellbeing in relation to sexuality. It requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence.”

Sexual Health Knowledge

College students are entering college with limited sexual experience and/or sexual health knowledge. This puts them at an increased risk for unintended pregnancies, sexually transmitted infections (STIs) and human immunodeficiency virus (HIV).

Individuals of the LGBTQ+ (lesbian, gay, bisexual, transsexual and queer) community are facing their own unique obstacles, including an increased risk for sexual assault, according to a new study.

What’s the Problem?

Authors of a 2013 publication by the National Institutes of Health (NIH) found that “college-aged youth are at increased risk of negative outcomes related to sexual health compared to the rest of the population.” While nearly 64 percent of high school seniors reported already having some sort of sexual experience, approximately 50 percent of individuals admitted that their “sexual debut” occurred during their college years.

Up close view of gonnorrhea
One-third of new cases of gonorrhea occur in adults ages 20 - 24

These students are facing a “disproportionate risk of negative health outcomes,” according to the authors of the NIH study. The report found that 29 percent of the specific population was not using condoms and another 11 percent were not using birth control.

The authors stated that with statistics such as these, “it is not surprising that over one-third of new cases of gonorrhea and Chlamydia (both types of sexually transmitted infections, or STIs) occur in young adults between the ages of 20 to 24.”

The CDC attributed the higher prevalence of negative sexual health outcomes in adolescents and young adults to a lack of access to quality resources. In a study conducted by von Sakovsky, results showed that 18 to 28-year-olds did not know where to go or how to find appropriate sexual health resources.

The authors of the NIH publication concluded, “Without access to this information, it is less likely that they will enjoy health sexual relationships, and they may suffer negative academic outcomes that have long-lasting repercussions.”

Sexually Transmitted Infections

New York University published some findings in relation to the prevalence of sexually transmitted infections (STIs) among college students, noting that even though students aged 15 to 24 only represented 25 percent of the sexually experienced population, nearly 50 percent of all STIs are occurring within that age group.

The university also found that “many young people misperceive their vulnerability to infection,” thereby affecting their decisions associated with their sexual behaviors.


“Many young people misperceive their vulnerability to infection, thereby affecting their decisions associated with their sexual behaviors.

- New York University


In 2015, the Centers for Disease Control and Prevention (CDC) found that while both young men and young women “are heavily affected” by STIs, young women face the “most serious long-term health consequences,” including infertility affecting an estimated more than 20,000 women each year.

In the same study, gay and bisexual men were found to account for 82 percent of male cases of syphilis. Syphilis can result in visual impairment and stroke if not adequately treated, and it can also put an infected person at increased risk for acquiring and transmitting HIV. The study data concluded that about half of men who have sex with men who are infected with syphilis also have HIV.

Unplanned Pregnancy

Becoming pregnant in college may not only be an unplanned event, but it can also shift a person’s continued academic plans. A study published by the National Institutes of Health (NIH) in 2013 reported that 61 percent of women who have children after enrolling in community college drop out before earning a degree.

Pregnancy & Health

Pregnancy can result in several health conditions including anemia, fetal problems, gestational diabetes, miscarriage, preeclampsia and preterm labor.

Pregnancy can also result in several health conditions to the mother and the baby, including anemia, fetal problems, gestational diabetes, miscarriage (pregnancy loss), preeclampsia (high blood pressure) and preterm labor. Infections, illnesses, smoking and drinking can also cause concerns for the mother and baby during pregnancy.

According to the Centers for Disease Control and Prevention (CDC), there are several ways to prevent pregnancy, including the use of birth control such as a pill, hormonal IUD (intrauterine device) or implant, patches, shots, vaginal contraceptive rings, diaphragms, condoms, vasectomy (surgical procedure for males) and abstinence.

Once pregnant, a woman can either carry the baby to term or abort the pregnancy. An abortion is a medical procedure that ends the pregnancy by removing the embryo or fetus and placenta from the uterus by way of surgery or medicine. This procedure also comes with its own physical as well as mental risks and complications.

Sexual Assault

In 2016, the CDC reported that more than one in three (37 percent) of female rape victims were raped for the first time between the ages of 18 and 24. In a study of undergraduate women, it was also found that 19 percent experienced attempted or completed sexual assault during their time in college.

Georgetown University in Washington, D.C., defines sexual assault as “a forcible or non-forcible sexual act or sexual contact that occurs without the consent or permission of the other person.” Sexual assault can include sexual penetration, attempted sexual penetration, or any other sexual act or sexual contact.

Sexual Assault Defined

Sexual Assault is defined as a forcible or non-forcible sexual act or sexual contact that occurs without the consent or permission of the other person.

The CDC reported links between a history of nonconsensual sex in both men and women and certain adverse health conditions, such as high cholesterol, stroke and heart disease. Female victims were more likely to report heart attacks and heart disease than non-victims.

Rape can result in physical as well as mental injury to its victims, with 31.5 of women and just over 16 percent of men reporting physical injuries as a result of rape in 2012. Rape was also found to result in about 32,000 pregnancies annually. An estimated 68 percent of female victims who filed a protective order said they were raped by an intimate partner, with 20 percent reporting a resulting pregnancy.

LGBTQ Harassment

An article published in the Journal of Interpersonal Violence in March 2017 stated that previous studies found that “sexual- and gender-minority (LGBTQ+ community) undergraduate students are at greater risk for sexual assault victimization than their [nontransgender] heterosexual peers.”

Authors of the publication found that sexual assault affects 2 to 15 percent of undergraduate students in the U.S., with researchers in 2010 reporting that 5.2 percent of undergraduates who were identified as LGBTQ+ had experienced sexual assault on a college campus.

However, a new study has suggested (not definitively) that the more inclusive the environment, the less likely it is that LGBTQ+ students will experience sexual assault or harassment.

What Can Be Done?

Most agencies and studies on sexual health for college students have determined that this is an area of joint responsibility for both the college campuses and the students. Results of a 2013 study titled College Students’ Sexual Health: Personal Responsibility or the Responsibility of the College? showed that there is a belief that colleges have a responsibility to provide resources, and students have a responsibility to access them.

Did You Know

By making resources and referrals for sexual health available, colleges can better serve students and improve health outcomes.

One participant of the study pointed out that “that’s the purpose of an institution like this, is… education, not just on a school subject level… just on anything on life… sexual awareness is definitely a key component to life and being knowledgeable of that is definitely… something everyone needs to have.” Another participant said, “No one wants to talk about it while you’re growing up because you’re a kid, but once you’re an adult they think you already know it.”

The conclusion was that “by making resources and referrals for sexual health available, colleges can better serve their students, which will result in improved health outcomes.”

The results of the study also showed that across all campuses, students reported that the college had a responsibility to be welcoming of students in the LGBTQ+ community.

Some tips offered by the CDC to engage in safe sex and prevent sexually transmitted infections (STIs) and unintended pregnancies include:
  • Using protection (such as latex condoms)
  • Getting tested
  • If diagnosed, notifying your partner
  • Accessing treatment
  • Abstaining from sexual activity
  • Committing to a long-term mutually-exclusive (monogamous) relationship

The CDC also recommends knowing the numbers to call for help in instances of sexual assault. Aside from 911, several hotlines and other college resources are available to provide emergency response to students who are victims of sexual violence.

Mental health icons

Mental Health

Transitioning to college can be a stressful and emotional time for many students. A 2009 survey showed that 85 percent of college students reported experiencing stress daily, and six out of 10 students said it impacted their ability to get work done on one or more occasions.

Anxiety was the number one mental-health concern in college students in a 2013 survey of counseling center directors conducted by the Association for University and College Counseling Center Directors. Almost 42 percent of college students experienced anxiety, according to the directors, followed by depression at 36.4 percent. Relationship problems ranked at almost 36 percent as well.

Anxiety and mental health statistic
Depression and metnal health statistic
42% of college students experience anxiety while 36.4% experience depression

Seventy percent of the directors surveyed said that the number of students with “severe psychological problems” on the college campuses had increased in the past year. Directors reported that 21 percent of the students seen in counseling centers on campus suffered from “severe mental health concerns,” and another 40 percent had “mild mental health concerns.”

An average of 24.5 percent of students seen in the counseling centers across the various college campuses were taking psychotropic medications (a drug that changes brain function and alters perception, mood and behavior).

The University of Florida Counseling and Wellness Center found that the most common college stressors can include:
  • Academic demands
  • Financial responsibilities
  • Independence
  • New environment
  • Changes in social and family relations
  • Changes in culture
  • Social pressures and expectations
  • Loss of comfort of the familiar
  • Exposure to new people, ideas and situations
  • Preparing for adulthood and life after college

A 1999 U.S. Surgeon General’s Report on Mental Health pointed out the “catch-22” of society’s idea of perceived perfection and the undue pressure it places on individuals to continually perform at a level of constant success. The Surgeon General stated in its report, “Americans are inundated with messages about success – in school, in a profession, in parenting, in relationships – without appreciating that successful performance rests on a foundation of mental health.”

What’s the Problem?

Research shows that half of all lifetime mental disorders first become apparent in mid-adolescence with three-fourths appearing by a person’s mid-20s. This age range includes the entirety of a person’s traditional college years. And mental health problems can negatively affect a student’s grades, relationships, physical health habits, and overall college experience and performance.

A student stressed from studying
Stress is the number one mental health that impacts a college students’ performance

According to a 2005 assessment conducted by the American College Health Association (ACHA), students with mental-health problems said their academic performance was affected as a result, including dropping a course, receiving a lower grade in a class, on an exam or on a project, and/or receiving an incomplete.

Campus Health and Safety found that four out of five of the leading factors found to negatively impact college students’ performance were related to mental health, including stress (number one), sleep, concern for a troubled friend or family member, and depression or anxiety disorder. Researchers have found that students with mental-health problems tend to have lower grades than their peers, and approximately 5 percent never finish school.

Students with mental-health disorders can also experience various physical ailments, including obesity, metabolic syndrome, diabetes mellitus, diabetic ketoacidosis (potentially fatal condition where the body produces excess blood acids), cardiovascular diseases, viral diseases, respiratory diseases, cancer, sexual dysfunction and pregnancy complications, and oral health problems.

An article in World Psychiatry noted that the lifespan of people suffering from severe mental illness (SMI) is typically shorter than the general population mainly due to physical illness associated with mental-health problems.

Sleep Disturbances

As a result of mental-health disorders, students may also experience sleep disturbances, which in turn can worsen the effects of a mental health disorder.

Additional school difficulties, other than reduced academic performance, may include poor attendance, lack of socialization, various behavioral problems, and lack of attention and/or ability to concentrate.

In 2008, the ACHA reported that 45 percent of college students suffering from mental health problems felt “so depressed that it was difficult to function.”

Campus Health and Safety also noted the consequences to future employers and our society due to mental-health problems that go undiagnosed and untreated in college students. Studies have shown that students who make it to graduation can have negative early work experiences that result in a loss of job skills and competencies. Workers may also be less productive and take more time away from work, resulting in a burden to the employer.

Suicide

Suicide is currently the second-leading cause of death among young people (individuals aged 15 to 34). According to National Data on Campus Suicide and Depression, one in every 12 college students makes a suicide plan, and approximately 50 percent of students reported feeling “hopeless” in the past year.

But according to a 2015 ACHA assessment, two-thirds of students who are struggling mentally and emotionally fail to seek treatment.

The U.S. Department of Health & Human Services provides some common warning signs of suicide including:
  • Talking about wanting to die
  • Looking for ways to die
  • Talking about feeling hopeless; having no reason to live
  • Talking about feeling trapped; in unbearable pain
  • Talking about being a burden to others
  • Increasing the use of drugs and alcohol
  • Acting anxious or irritated; exhibiting abnormal risk-taking or extreme behavior
  • Sleeping too much or too little
  • Withdrawing; feeling isolated
  • Showing rage; seeking revenge
  • Mood swings
  • Eating changes
  • Loss of energy; loss of interest

What Can Be Done?

The National Center for Mental Health Checkups at Columbia University says that identification and treatment of mental-health disorders often improves academic success. A study published by the National Institutes of Health (NIH) in 2014 said that mental-health problems in college students can persist for years, so the earlier the intervention the better the overall prognosis for the progression and trajectory of the disorder.


“A collaborative relationship between university health centers and behavioral health services may lead to an increase in identification and referrals for behavioral health treatments of students with mental health problems.”

- Authors of NIH Study


The authors of the study concluded, “A collaborative relationship between university health centers and behavioral health services may lead to an increase in identification and referrals for behavioral health treatments of students with mental health problems.”

Treatment may include therapy, medications (such as anti-depressants or mood stabilizers), abstaining from alcohol and drug use, and in some instances, even therapeutic exercises or meditation. Sometimes, treatment involves some combination of therapy and medication.

How to improve mental health

Sleep, exercise, nutrition, an appropriate life-balance and responsible alcohol use all tie back into a person’s overall mental health as well.

The University of Florida also pointed out the importance of support from family and friends in protecting a student’s mental health. The university found that 63 percent of students turned to a family member or members when experiencing emotional difficulties, while an even larger group of students (75 percent) would turn to a friend.

USA Today College provided some tips for dealing with depression and/or suicidal thoughts in yourself or someone else, including choosing your words carefully, knowing the facts, listening to others, maintaining awareness of your attitude, educating and supporting others, focusing on the positive, being inclusive, and eliminating the stigma surrounding mental health disorders.

Alcohol & drugs icons

Alcohol and Drugs

A national survey conducted in 2015 found that nearly 60 percent of college students aged 18 to 22 drank alcohol in the past month, and almost two out of three of those students engaged in binge drinking during the same time frame. The National Institute on Alcohol Abuse and Alcoholism concluded that “drinking at college has become a ritual that students often see as an integral part of their higher education experience.”

Did You Know

Since 2006, illicit drug use among college students had been steadily rising with an increase in daily marijuana use.

In 2014, Michigan News at the University of Michigan reported that illicit drug use among college students had been steadily rising since 2006. The article attributed much of the rise to the increased use of marijuana stating that “daily marijuana use is now at the highest rate among college students in more than three decades.”

Michigan News said that about 51 percent of all college students enrolled full time have used an illicit drug at some point throughout their lives, and nearly 40 percent have used one or more such drugs in the past year.

Nonmedical use of Adderall (an amphetamine used by students to stay awake) is believed to be the second most commonly used illicit drug on college campuses. One in every nine students enrolled full time in college in 2013 reported using Adderall at some point within the last 12 months. The use of stimulants such as Adderall and Ritalin doubled from 2008 to 2013.

Common Illicit Drugs

Other frequently used illicit drugs among college students include ecstasy, hallucinogens, and narcotics, such as heroin, Vicodin and Oxycontin.

Michigan News reported that the use of other drugs such as salvia (an herb in the mint family), crack cocaine, powder cocaine, tranquilizers and hallucinogens other than LSD (such as magic mushrooms), actually decreased. But following that article, in 2015, the National Institute on Drug Abuse reported that cocaine use was back on the rise among full-time college students after steadily falling for the previous six years. The institute stated that it remained high, at above 4 percent, at the time of the publication of the study results.

The Drug Enforcement Administration (DEA) released data reporting that in 2010 a little over one-fourth of first-time drug users said they began abusing drugs with the nonmedical use of prescription drugs. This includes the use of prescription and non-prescription painkillers, with one in every 20 people in the United States age 12 or older (approximately 12 million people) reporting to have inappropriately used painkillers.

Over-the-counter (OTC) cough or cold medicines are also routinely used by about 12 percent of teens in an effort to “get high.”

Experts provided some reasons to the DEA why teens might use prescription drugs to get high including:
  • Partying
  • Self-medication
  • Escape and boredom
  • Preservation of relationships/peer pressure
  • Competing for college admission and achievement
  • Balance between obligations and demands – both academic and extracurricular
  • Stress
  • Desire for “ideal” physical appearance

What’s the Problem?

The National Institute on Alcohol Abuse and Alcoholism said that “harmful and underage college drinking are significant public health problems” that take a toll on students academically and socially. The NIH reported that about one in four college students experience academic consequences from drinking, including missing a class or classes, falling behind in a class or classes, doing poorly on exams or papers, and receiving lower grades.

Female stressed from using drugs
Nonmedical use of prescription drugs are becoming an increasing use problem among college students

Other consequences of college drinking reported by the NIH include suicide attempts, health problems, injuries, unsafe sex and driving under the influence, as well as other behaviors that can result in police involvement.

When it comes to college drug use, the National Council on Alcoholism and Drug Dependence said that national survey data shows that students attending college are at a significantly higher risk of using marijuana for the first time than students not enrolled in college.

A study published by the National Institutes of Health (NIH) also showed that nonmedical use of prescription drugs is becoming an increasing illicit drug-use problem among college students nationally. The publication concluded that “college students are exposed to a great deal of misinformation about nonmedical prescription stimulant use due to the popularity of enticing myths.”

The authors found that either students were being told that such medications were “performance enhancers” or “smart drugs” or they were being told that effects of nonmedical use of such drugs are benign. But the study found that nonmedical prescription drug users typically have lower grade-point averages (GPAs) than non-users, and nonmedical stimulant users are more likely to be heavy drinkers and users of other illicit drugs as well.

Even though nonprescription drug use and the sharing of prescription drugs is illegal, a study found that of 81 percent of college students with ADHD, 62 percent gave their medication to someone without a prescription.

Hazing

Drinking is often involved with hazing incidents as well. Hazing is defined by Babson College in Wellesley, Mass. as “any activity expected of someone joining or participating in a group that humiliates, degrades, abuses or endangers them regardless of a person’s willingness to participate.”

The college noted that 82 percent of deaths from hazing involve alcohol. Most incidents, especially those involving deaths, also end in some form of academic expulsion, suspension or banishment from clubs and extracurriculars, and/or criminal penalties, including jail time.

Binge Drinking

The National Institute on Alcohol Abuse and Alcoholism attributes many college alcohol problems to binge drinking. The institute defines binge drinking as “a pattern of drinking that brings blood alcohol concentration (BAC) levels to 0.08 g/dL.”

Did You Know

Not only can binge drinking affect a person’s health it can lead to car accidents, DUI arrests, and sexual assaults.

This equates to about four drinks for most women and five drinks for most men within a two-hour time frame.

Not only can binge drinking affect a person’s health but it can result in car accidents, drunk-driving arrests (DUIs), sexual assaults and injuries. Over time, drinking in excess can cause damage to the liver and other organs.

The institute found that about 1,825 college students between the ages of 18 and 24 die from unintentional injuries resulting from alcohol use, including car crashes. About 696,000 individuals within the same age-range are assaulted by another student who has been drinking, with about 97,000 students reporting sexual assault or date rape that involved alcohol.

It was reported that about 20 percent of college students actually meet the criteria for an alcohol use disorder (AUD). AUD is a medical diagnosis characterized as “problem drinking that becomes severe,” according to the NIH.

Drug Misuse/Addiction

Taking a drug without a prescription can result in unintended side effects. Certain drugs can interact with certain medical conditions causing potentially harmful effects, according to the DEA. Even over-the-counter (OTC) drug labels contain specific information about appropriate uses of the drugs and warnings associated with improper or unsafe uses of the medications. Mixing two or more drugs, whether prescription or OTC drugs, can result in unexpected side effects as well, including slowed reactions when operating a motor vehicle.

Negative effects can intensify when mixed with alcohol as well.

Substance Abuse Stats

According to the National Center on Addiction and Substance Abuse, almost one in four college students meet the medical criteria for substance abuse or dependence.

Overdose

The DEA reported that the number of deaths caused by overdoses of prescription painkillers more than tripled in the past decade. More than 40 people die every day from overdoses of drugs such as Vicodin (hydrocodone), Oxycontin (methadone, oxycodone) and oxymorphone.

Also, a CDC press release in 2012 found that there was a 91 percent increase in drug poisoning deaths among teens aged 15 to 19 between 2000 and 2009 due to prescription drug overdose.

Deaths Due to Drugs

The DEA concluded that in the United States, deaths due to drugs now outnumber deaths due to gunfire.

CDC Director Thomas Frieden said, “Overdoses involving prescription pain killers are at epidemic levels and now kill more Americans than heroin and cocaine combined.”

What Can Be Done?

The National Institutes of Health (NIH) created some strategies to eliminate substance abuse, including dispelling myths regarding nonmedical prescription drug use, promoting awareness of legal risks of prescription drug diversion (sharing), developing campus actions plans, de-stigmatizing college students who choose not to divert prescription medications or engage in illicit drug use, and developing early intervention strategies to assess risk and prevent progression to serious substance abuse and dependence problems.

The institute also points out that higher-risk groups, such as first-year students, student athletes and members of Greek organizations, should be individually targeted with intervention strategies. The NIH said that programs should be designed to “change students’ knowledge, attitudes and behaviors related to alcohol (and drug use) so that they drink less, take fewer risks and experience fewer consequences.”

Signs of alcohol poisoning that college students should be aware of include:
  • Mental confusion, stupor or coma
  • Person cannot be awakened
  • Vomiting
  • Slow or irregular breathing
  • Hypothermia (low body temperature) – bluish or pale skin

Drug addiction is a chronic disease characterized by compulsive or difficult-to-control drug use, despite potentially harmful consequences. While the initial decision to use the drug is often voluntary, repeated exposure leads to brain changes that interfere with a person’s self-control. These brain changes can be persistent, requiring ongoing treatment.

Author

Kristin Compton is a medical writer with a background in legal studies. She has experience working in law firms as a paralegal and legal writer. She also has worked in journalism and marketing. She’s published numerous articles in a northwest Florida-based newspaper and lifestyle/entertainment magazine, as well as worked as a ghost writer on blog posts published online by a Central Florida law firm in the health law niche. As a patient herself, and an advocate, Kristin is passionate about “being a voice” for others.


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