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Photo of young people in a fitness class, squatting. Focus is on a young woman in front with her hair in a bun.

Fitness facilities top the list of what students say colleges and universities are doing well in terms of health and wellness, while dining hall food options top the list of what needs work.

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Half of students say their physical health and wellness adversely impacts their academic success. The number is higher for certain groups of students, including those with physical disabilities or chronic illnesses, those with mental health conditions, and even two-year college students relative to four-year students. These are all new findings from the most recent Student Voice survey on health and wellness from Inside Higher Ed and College Pulse.

The survey, conducted in April and early May, asked 3,000 two- and four-year college students at 158 institutions questions about their experiences with stress, mental health and physical wellness. Here are some additional findings about health, specifically (with additional details and analysis below):  

  • Reducing stress is students’ top health and wellness goal (from a list of 13 potential goals), followed by eating a healthier diet, getting more sleep and getting more exercise.
  • Fitness facilities top the list of what colleges and universities are doing well in terms of health and wellness, while dining hall food options top the list of what needs work.
  • About a quarter of students approve of their wellness facilities, and a quarter say these need improvement, with differences across institution types.
  • Only about half of students say they have access to campus dining halls when they want and need food, and four in 10 students agree that there are healthy options in their campus dining halls.

One Student’s Voice

Porter Bischoff, a senior at Utah Valley University studying biology, is intimately acquainted with some of these issues. He’s known since he was diagnosed with Type 1 diabetes at age 11 that he wants to be a doctor, in order to help other diabetics. (“I’ve had some really great experiences with medical people and some really terrible experiences and would love to pass on the great experiences,” he says.)

Having developed a passion for scientific research at UVU, Bischoff plans on pursuing a Ph.D. in addition to a medical degree when he graduates. This is a challenging path forward for anyone, and Bischoff faces specific hurdles due to his diabetes.

Take Bischoff’s monthly medical costs, which exceed $500, for example. This represents a significant share of the money he makes working 30 hours per week on campus, and he’s still got to cover the rest of his expenses. This means always looking for side gigs, which cuts into time for other things (although he still makes time for research, national diabetes advocacy and preparing to apply to medical school).

Another constant challenge: keeping his blood glucose levels in check. Bischoff needs to leave class at times to eat or drink something, and when this problem arises at night, his sleep is compromised—as is his well-being the next day.

“I’ve never wanted a pass because I have diabetes. I don’t want to walk in and say, ‘Hi, I’m Porter, I’m the diabetic in the room,’ and have that be my moniker,” he says. “If I can go a whole semester without anyone knowing I’m diabetic—not because I’m embarrassed by it, but because it means it didn’t hold me back—that’s kind of what my goal is.”

At the same time, he says, across higher education, “there does need to be more understanding as to how having those chronic experiences can negatively impact you.”

This doesn’t mean setting different expectations for a student with health issues, he adds. Rather, it should mean, “Let’s make sure that he has all the tools that he needs to succeed.” (For the record: Bischoff says he’s felt generally supported during his time at UVU, and that COVID-19 seemed to unlock new levels of empathy among professors for students struggling with their health in different ways.)

The Wellness-Success Link

Among Student Voice survey respondents with physical disabilities or chronic illnesses (n=421), in particular, nearly three in four say their physical health and wellness negatively impacts their ability to focus, learn and do well in class a great deal or somewhat.

A quarter of students with a mental health condition (n=1,079) say their physical health and wellness adversely impacts their academics a great deal, and 37 percent say it impacts them some, underscoring the connection between physical and mental health.

Additionally, 57 percent of students who report experiencing chronic stress in college (n=1,670) say their physical health is interfering with their academic success to some degree, versus 40 percent of students who haven’t experienced chronic stress.

Two-year students (n=600) are likelier than four-year students to say that their physical health impedes their academic success, as well, at 57 percent versus 48 percent, respectively.

The Student Voice finding on reducing stress also resonates strongly with Bischoff, who sees a clear link between all three of the survey subtopics—stress, mental health and physical wellness—in his own life.

“A lot of my issues go back to stress,” he says. “If I could decrease that, I think I would be more healthy … Frankly, what I’m going through right now is trying to figure out, ‘What is Porter’s best way to make sure that I can stay not too stressed?’ because otherwise I could burn out.”

What are students’ other top health goals? Six in 10 students each want to eat a healthier diet, get more sleep and get more exercise. Nearly half of students want to stick to a regular sleep schedule. About four in 10 want to spend more time outside, lose weight or get stronger. Around a third want to practice mindfulness more often or eat at consistent meal times.

Other goals are to:

  • Address disordered eating behaviors: 14 percent of students over all say this, with women more likely than men to say so (18 percent versus 8 percent, respectively)
  • Gain weight: 8 percent
  • Address a drug or alcohol problem: 5 percent

As reported earlier on this survey, students with financial aid (n=1,825) are more likely than those without (n=791) to say their mental health is poor or fair, rather than excellent or good. Relatively more students with financial aid than without want to do the following:

  • Reduce stress (74 percent versus 67 percent, respectively)
  • Get more sleep (62 percent versus 54 percent)
  • Stick to a regular sleep schedule (49 percent versus 39 percent)

‘Upstream’ Solutions

Kevin Kruger, president of the National Association of Student Personnel Administrators, says institutions are increasingly aware of the interplay between stress, mental health and physical health—and many are investing in wellness resources in order to get in front of what’s been described as the college mental health crisis.

“In the science of how we think about mental health today, one component is clearly psychological services, but those tend to be reactive and sort of downstream solutions,” Kruger says. “So much of the conversation right now is about getting upstream of this problem. And upstream solutions are all about well-being.”

These solutions include promoting students’ sleep, exercise, stress management and nutrition, in addition to other wellness-themed initiatives and services, Kruger continues. He notes that more and more institutions are hiring assistant vice presidents or chancellors of health, safety and well-being, whose purviews tend to include counseling and health services as well recreation and wellness.

“It’s a fantastic idea, because you’re thinking about how you can create synergy around these items.”

Kruger adds that many colleges and universities have invested substantially in related facilities upgrades in recent years, too. Yet this can be something of a balancing act, as some institutions have been publicly criticized for offering expensive if popular amenities (rock-climbing walls are a “poster child” in this debate, he says).

Of course, many institutions—including community colleges—historically lack resources and are limited in terms of what they can offer students, even though they’re facing the same pressures to promote student wellness, Kruger says. This can exacerbate existing disparities in student experiences and in student success.

Asked which physical health- and wellness-related services their colleges or universities are getting right, Student Voice survey respondents’ top five choices are as follows:

  1. Fitness facilities
  2. Dining facilities
  3. Wellness facilities
  4. Sexual health services and resources
  5. Fitness class offerings

Among students with physical disabilities or chronic illnesses, in particular, top offerings are fitness facilities, with nearly half of students saying this. Dining facilities, sexual health services, wellness facilities and accommodating food allergies are next, with about one in four students citing each of these services.

For students with mental health conditions, the top-rated services are fitness facilities, followed by sexual health services and resources, dining facilities, wellness facilities, and accommodating food allergies, in that order.

Two-year college students are actually about as likely as four-year college students to agree that wellness class offerings are going well, with about 15 percent of students saying this. Regarding wellness facilities (and per Kruger’s point about institutional resources), 28 percent of four-year students say their institutions are getting it right, compared to 23 percent of two-year students. But four-year students are nearly twice as likely to commend their institutions’ fitness facilities than two-year students, at 56 percent versus 29 percent, respectively.

Students at public and private institutions rate their services similarly, meanwhile.

What needs work? Students say these are the top five physical health and wellness services that need improvement on their campuses:

  1. Dining hall food options
  2. Dining facilities
  3. Disordered eating resources
  4. Drug or alcohol dependency resources
  5. Wellness facilities

There are notable differences between groups of students:

  • A third of women say disordered eating resources need improvement, compared to two in 10 men.
  • A quarter of women versus 17 percent of men say sexual consent training needs more work.
  • LGBTQIA+ students (n=829) are likelier than straight students to say that wellness resources and wellness class offerings need improvement, at three in 10 students versus two in 10 students, respectively, for each.
  • LGBTQIA+ students are also likelier than straight students to say that sexual health resources and services and sexual consent training need work, at three in 10 students versus two in 10 students, respectively, for each.
  • A quarter of two-year students say dining food hall options need work, compared to half of four-year students. Same for dining facilities.
  • Jewish, Muslim and especially Orthodox Christian students are likelier than other students to flag accommodating religious dietary requirements as needing improvement on their campuses, with about a third of Jewish and Muslim students and nearly half of Orthodox Christian students saying this.

For students whose health goals include addressing disordered eating behaviors (n=427), 50 percent say dining hall food options need improvement and 50 percent say disordered eating resources need improvement.

Among students with physical disabilities or chronic illnesses, top campus areas for improvement include dining food hall options, dining facilities, wellness class offering and wellness facilities.

Students with mental health conditions flag these areas for improvement: dining hall food options, dining facilities, disordered eating resources, drug and alcohol dependency resources, and wellness facilities, with half to a third of these students selecting each of these.

Richard Allegra, associate director of education and outreach services at the Association on Higher Education and Disability (AHEAD), says that advocates in his field have long worked toward basic access goals, “so just getting in the door and getting through.” Consequently, he says, the student success paradigm—including wellness elements—have taken a back seat. That’s changing, however, and Allegra encourages campus access and disability offices to work with counseling and wellness centers to support all students.

Food Access and Options

What about food access and options, which are undeniably a part of wellness? Students have mixed opinions and experiences with access to campus dining halls when they need and want food, whether there are healthy options in their campus dining halls, whether there is a variety and quality of foods, and whether dining halls sufficiently accommodate dietary restrictions and food allergies.

Students at private nonprofit institutions are likelier than students at publics to agree that they have access to campus dining halls when they need and want food (56 percent versus 50 percent, respectively), and that there are healthy options in their dining halls (46 percent versus 37 percent, respectively). But they’re also more likely to say that their campus dining halls don’t have quality food.

Two-year students are much less likely than four-year students to agree that they have access to campus dining halls when they need and want food (44 versus 54 percent, respectively), and that there are healthy options in their campus dining halls (25 percent versus 43 percent). They’re also less likely to agree that their campus dining halls have a wide variety of foods and that their dining halls sufficiently accommodate dietary restrictions and food allergies.

Working-class students are less likely to agree they have access to campus dining halls when they need and want food than are middle-class students (46 versus 57 percent). And women are less likely than men to say they have access to campus dining halls when they need and want food (49 percent versus 57 percent, respectively), and that there are healthy options (36 percent versus 45 percent).

Over all, Markie Pasternak, senior manager of higher education at the mental health advocacy organization Active Minds, says that beyond offering “attractive” services and facilities, promoting wellness mean giving all students “ease of access to make wellness a priority.”

She adds, “What we know about habit formation and creation is that the ease of creating the habit, or doing the healthy thing even though it’s not the most attractive thing, is going to be a factor in whether or not the student chooses to do it.”

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