2010 College Student Health Survey Report

Transcription

1 Boynton Health Service 21 College Student Health Survey Report Health and Health-Related Behaviors Minnesota Postsecondary Student Vetera

2 21 College Student Health Survey Report

3 Health and Health-Related Behaviors Minnesota Postsecondary Student Vetera Introduction iii Survey Methodology Analysis Summary v v vi 1 Health Iurance and Health Care Utilization 1 Mental Health 7 Tobacco Use 15 Alcohol Use and Other Drug Use 21 Personal Safety and Financial Health 29 Nutrition and Physical Activity 37 Sexual Health 43 Implicatio 47 Appendices 49 Appendix 1 Colleges and Universities Participating in the 21 College Student Health Survey 49 Appendix 2 21 College Student Health Survey Demographics Based on Student Respoe 5 Glossary 51 References 53

4 ii Health and Health-Related Behaviors Minnesota Postsecondary Student Vetera

5 Introduction Q: A: What do the following health conditio and health-related behaviors have in common? Health Iurance and Health Care Utilization Mental Health Tobacco Use Alcohol and Other Drug Use Personal Safety and Financial Health Nutrition and Physical Activity Sexual Health They all affect the health and academic achievement of students, including military vetera returning to college. Introduction iii

6 In August 29, when the Post-9/11 Vetera Educational Assistance Act of 28 took effect, more than 2 million vetera gained access to affordable college education benefits. 1 The bill s passage and subsequent influx of military vetera on college campuses present both a challenge and an opportunity for educational ititutio to serve vetera in their traition from service member to student. For educational ititutio to meet the needs of student vetera, issues unique to student vetera must be identified. In spring 21, Boynton Health Service, in partnership with Minnesota State Colleges and Universities, conducted a compreheive survey of a randomly selected group of students attending seventeen colleges and universities in Minnesota. To gather information specific to vetera attending college, all vetera enrolled at and identified by the seventeen postsecondary ititutio in Minnesota (2,18 vetera) were also invited to complete the survey. This report presents the health and health-related behavior data collected from vetera attending the seventeen Minnesota colleges and universities that participated in the spring 21 College Student Health Survey. Boynton Health Service and Minnesota State Colleges and Universities administrators hope the information in this report will help college and university leaders develop programs and policies addressing the unique needs of student vetera enrolled in their schools. This report presents data collected from vetera, not Boynton Health Service s interpretation of the data. In many itances, comparison data based on the aggregate student population that also completed the 21 College Student Health Survey is included. The general student data are included solely for comparison; the student data have been adjusted to account for the gender and age differences between the vetera and the student population. For unadjusted prevalence rates for the aggregate student population, please refer to the 21 College Student Health Survey Report: Health and Health-related Behaviors, Minnesota Postsecondary Students. 2 The information in this report highlights the health and health-related behaviors of vetera currently enrolled in a Minnesota college or university. Data presented in this report should not be extrapolated to vetera not currently enrolled in a postsecondary ititution. Vetera enrolled in a college or university may be at very different points in their traition back to civilian life and therefore may have health and health-behavior rates that are not comparable to vetera not currently enrolled in a postsecondary ititution. Additional data analysis to examine whether veteran health profiles differ from those of the general student population is ongoing. iv Health and Health-Related Behaviors Minnesota Postsecondary Student Vetera

7 Survey Methodology Over 13, undergraduate and graduate students enrolled in seventeen postsecondary ititutio in Minnesota completed the 21 College Student Health Survey, developed by Boynton Health Service. As an incentive, all students who responded to the survey were entered into a drawing for gift certificates valued at $3, (one), $1, (one), and $5 (one) at a variety of stores and drawings for eleven ipod touches. Randomly selected students were contacted through multiple mailings and s: 21 College Student Health Survey Methodology Highlights Invitation postcard Invitation Reminder postcard and multiple reminder s 34,97 students from 17 Minnesota colleges and universities were randomly selected to participate in this survey. A total of 34,97 undergraduate and graduate students from seventeen colleges and universities in Minnesota were invited to participate in 13,7 completed the survey. the 21 College Student Health Survey (see Appendix 1 for a list of participating schools). 4.2% of the students responded. In addition to the 34,97 randomly selected students, an oversample of 2,18 students who attended one of these seventeen Minnesota schools Vetera Methodology Highlights and were identified as vetera of the United States Armed Forces were also invited to participate in the survey. Because survey respoes were anonymous, the final veteran participation rate is based on self-reported 2,18 vetera attending 17 Minnesota colleges and universities were identified to participate in this survey. veteran status. This report is based on the 2,18 identified vetera from the seventeen participating colleges and universities in the state of Minnesota. $$ $ $ $ $$ $ $$$ $ $ $ $ $ $ $ $$ $$ $ $$ $ $ $ $ $ $ Do Good. Win BIG! $ $ $ $ $ $ $ $ $$ $ $ $ $$$ $$$ $ $$ $ $ $$ $ $ $ $ $ Fill out an online survey from your college for a chance ch! to win gift cards and an ipod tou TM $ 39.9% of the vetera responded. $ YOU have been selected by your college to participate in the 21 College Student Health Survey. Boynton Health Service University of Minnesota 41 Church Street S.E. Minneapolis, MN PAID MPLS., MN PERMIT NO. 155 Just for completing the survey, you will be entered into a grand prize drawing. Three lucky students will CHA-CHING! win gift cards $3,, $1,, and $5 to any Your odds are combination of the following stores: Target, 1 in 1, or Best Buy, Macy s, Home Depot, IKEA, The Apple Store, better! Tiffany & Co., Sports Authority, Scheel s, and Cabela s. $ NONPROFIT ORG. U.S. POSTAGE $ $$ Plus, every week, students who completed the survey will have a chance to win an ipod touch! The sooner you fill out your survey, the more chances you have to win! $ $$$ $ $. Do Good February 16! 3 students will win an ipod touch y 23! $ Februar 2 students will win an ipod touch Win BIG! March 2! 1 student will win an ipod touch March 9 3 students will win grand prizes!.edu/healthsurvey -hand side to begin, go to you see on the right password. To learn more or ame and password d to change your aske and enter the usern be will entering, you 21. 9, h Marc of this card. Upon, completed by noon Survey must be 21 College Student Health Survey Questio? Katherine Lust, Ph.D., Survey Administrator Boynton Health Service klust@bhs.umn.edu, (612) UP $ $ 869 completed the survey. 21 College Student Health Survey Postcard Survey v

8 Survey Analysis Summary The information presented in this report documents the prevalence of various diseases, health conditio, and health-related behaviors across seven areas: Health Iurance and Health Care Utilization Mental Health Tobacco Use Alcohol and Other Drug Use Personal Safety and Financial Health Nutrition and Physical Activity Sexual Health The prevalence of a disease, health condition, or health-related behavior is defined as the total number of occurrences in a population (in this case, college students) at a given time, or the total number of occurrences in the population divided by the number of individuals in that population. Prevalence is useful because it is a measure of the commonality of a disease, health condition, or health-related behavior. For example, the College Student Health Survey asked students if they had ever been diagnosed with depression within their lifetime. For the purpose of illustration, if 1 students completed the survey and 1 of them reported they had been diagnosed with depression within their lifetime, then the lifetime prevalence of depression among this population of students is 1.% (1/1). This report presents the actual rates reported among the vetera who participated in the survey. Comparison data collected from the general student population have been adjusted to correct for the differences in age and gender between vetera and the student population. The veteran survey sample comprises approximately 25.7% females and 74.3% males, with an average age of 29.4 years. The aggregate student survey sample comprises approximately 61.3% females and 38.4% males, with an average age of 23.9 years. This adjustment creates a more accurate comparison group for viewing the veteran data. Unadjusted prevalence rates for the student population can be found in the 21 College Student Health Survey Report: Health and Health-related Behaviors, Minnesota Postsecondary Students. 2 vi Health and Health-Related Behaviors Minnesota Postsecondary Student Vetera

9 Health Iurance and Health Care Utilization This section examines the areas of health iurance, health services utilization, and preventive care. Recent research indicates that most young adults in the United States, ages 18 to 24, report good health. The majority of young adults in Minnesota (92.5%) and nationwide (92.2%) report excellent, very good, or good health. 3 At the same time, young adults have relatively low rates of health iurance and preventive care utilization. Among individuals under age 65, 18- to 24-year-olds report the lowest rate of health iurance coverage: in Minnesota 8.9% report some kind of health care iurance, and nationwide the number is 7.3%. 3,4 More young males (33.9%) than young females (25.4%) lack health iurance coverage. 4 Among all age groups, young adults (69.8%) are least likely to identify a usual place for medical care. 4 Information related to health care access among vetera is severely limited. Himmelstein published a study in 27 documenting that in 24, 1,768,377 United States vetera had no health iurance and were not being cared for within the Vetera Administration. 5 According to his study, 12.7% of workingage vetera lack health coverage. 5 Among these uniured vetera, 51.4% had no regular source of care (compared to 8.9% of iured vetera) and 26.5% reported failing to get needed care because of the cost (compared to 4.3% of iured vetera). 5 Health Iurance and Health Care Utilization 1

10 Vetera who completed the 21 College Student Health Survey report an overall uniured rate of 2.8%, which is statistically significantly higher than the uniured rate obtained from the adjusted aggregate data from all students who completed the survey (15.3%, p<.1). Vetera who obtain health care through the Vetera Administration system may not coider themselves as having health iurance. Health Iurance Status Uniured Vetera and All Students by Gender All* Males Females 12.4 Vetera All Students Adjusted Data *Statistically significant. Health Iurance and Health Care Utilization Vetera ages report the highest uniured rate. The highest uniured rate obtained from the adjusted aggregate data from all students who completed the 21 College Student Health Survey also occurs among those ages Health Iurance Status Uniured Vetera and All Students by Age Group * Vetera Age Group All Students Adjusted Data 14. *Iufficient data for vetera. Approximately one-half (48.9%) of all vetera report having a spouse, and 13.4% of these vetera report that their spouse is uniured. The adjusted aggregate data indicate that less than one-half (45.2%) of all students report having a spouse, and 12.9% of these students report that their spouse is uniured. Spouse and Dependent Health Care Coverage Vetera 51.1% Marital Status and Health Care Coverage 48.9% 13.4% of spouses are uniured Approximately one-third (32.%) of vetera who completed the survey report having dependent children. Of these dependent children, 7.9% lack health iurance. In comparison, the adjusted aggregate data show that 26.8% of all students report having dependent children, and 7.5% of these dependent children lack health iurance. Have Spouse Have No Spouse Dependent Children and Health Care Coverage 68.% 32.% 7.9% of dependent children are uniured Have Children Have No Children 2 Health and Health-Related Behaviors Minnesota Postsecondary Student Vetera

11 Health Iurance and Number of Sick Days Past 3 Days Vetera and All Students Vetera 3.7 Iured 2.4 All Students Adjusted Data Uniured 2.8 Number of sick days is a measure of health-related quality of life. Sick days reflect a personal see of poor or impaired physical or mental health or the inability to react to factors in the physical and social environments. 6 Among vetera who completed the survey, those without health iurance report on average 1.2 more sick days in the past 3 days than those with health iurance. The adjusted aggregate survey data obtained from all students show that those without health iurance report on average.4 more sick days in the past 3 days compared to those with health iurance. Health Care Service by Location Vetera (Includes Only Those Vetera Who Report Obtaining a Service in the Past 12 Months) Question asked: Where do you obtain the following health care services while in school? Health Care Service ( of Vetera Who Obtained Service) Routine Doctor s Visit (85.8) Dental Care (84.) Mental Health Service (32.) Testing for Sexually Tramitted Infectio (37.6) Treatment for Sexually Tramitted Infectio (25.4) Testing for HIV (4.4) Emergency Care (85.5) Who Report Obtaining Service Among vetera who completed the 21 College Student Health Survey, the primary locatio for obtaining many health care services appear to be a community clinic and a private practice. Examination of the adjusted aggregate data shows that the primary locatio for all students to obtain many health care services are also a community clinic and private practice. Health Iurance and Health Care Utilization School Health Service Student Coueling Service Hospital Community Clinic HMO Private Practice 3

12 Analysis of the adjusted aggregate data shows that, compared to all students who completed Vaccination Status Vetera and All Students the 21 College Student Health Survey, vetera who completed the survey report obtaining H1N1 influenza vaccinatio and immunizatio for hepatitis A, hepatitis B, and meningitis at higher rates (p<.1) Hepatitis A* Hepatitis B* Meningitis* H1N1 Influenza Past 12 Months* Vetera All Students Adjusted Data Health Iurance and Health Care Utilization Compared to male vetera who completed the 21 College Student Health Survey, female vetera report more days of poor mental health. According to the adjusted aggregate data from all students, females report more days of poor physical health, more days of poor mental health, and more days when poor physical and/or mental health affected daily activities compared to males. *Statistically significant. Average Number of Days Affected by Illness Vetera and All Students by Gender Illness Males Females p-value Poor Physical Health Poor Mental Health <.1 Poor Physical and/or Mental Health Affected Daily Activities Vetera Not statistically significant. Average Number of Days Affected Past 3 Days Males Females All Students Adjusted Data p-value <.1 <.1 <.1 Vetera who completed the 21 College Student Health Survey were asked to report if they have been diagnosed with selected infectious acute illnesses within the past 12 months and within their lifetime. Acute Condition Diagnosis Lifetime and Past 12 Months Vetera and All Students Who Report Being Diagnosed The acute condition diagnosed most frequently within vetera lifetimes is strep throat. Overall, 51.9% of vetera report being diagnosed with at least one acute condition within their lifetime, and 8.2% report being diagnosed with at least one acute condition within the past 12 months. The adjusted aggregate survey data obtained from all students show that 5.2% report they have been diagnosed with at least one acute condition within their lifetime, and 9.% report being diagnosed with at least one acute condition within the past 12 months. Within Acute Condition Lifetime p-value Chlamydia Gonorrhea Hepatitis A Lyme Disease Mononucleosis Pubic Lice Strep Throat Syphilis Urinary Tract Infection <.1 <.5 <.5 At Least One of the Above Acute Conditio Vetera Not statistically significant. Within Past 12 Months All Students Adjusted Data p-value <.1 <.5 4 Health and Health-Related Behaviors Minnesota Postsecondary Student Vetera

13 Chronic Condition Diagnosis Lifetime and Past 12 Months Vetera and All Students Acute Condition Alcohol Problems Allergies Asthma Cancer Diabetes Type I Diabetes Type II Drug Problems (Other Than Alcohol) Genital Herpes Genital Warts/ Human Papilloma Virus Hepatitis B Hepatitis C High Blood Pressure High Cholesterol HIV/AIDS Obesity Repetitive Stress Injury Tuberculosis At Least One of the Above Chronic Conditio Vetera Not statistically significant. Who Report Being Diagnosed Within Lifetime p-value <.1 < <.5 <.5 Within Past 12 Months All Students Adjusted Data p-value <.1 Chronic conditio are ongoing health concer for vetera and all students. Surveillance of these conditio provides a picture of longer term health care needs for college students. The most common chronic condition diagnosed in vetera who completed the 21 College Student Health Survey is allergies. More than one-half (53.1%) of all vetera report being diagnosed with at least one chronic condition within their lifetime, and approximately one-fifth (2.5%) report being diagnosed with at least one chronic condition within the past 12 months. The adjusted aggregate survey data obtained from all students show that 56.8% report being diagnosed with at least one chronic condition within their lifetime, and 2.3% report being diagnosed with at least one chronic condition within the past 12 months. Health Iurance and Health Care Utilization 5

14 Health Iurance and Health Care Utilization 6 Health and Health-Related Behaviors Minnesota Postsecondary Student Vetera

15 Mental Health This section examines areas related to the mental and emotional status of college and university students. Recent research shows that young adults in the United States have relatively high rates of mental health problems compared to other age groups. Based on the results of the National Comorbidity Survey Replication Study using the American Psychiatric Association s Diagnostic and Statistical Manual of Mental Disorders-IV criteria, 58.7% of 18- to 29-year-olds have been diagnosed with a mental disorder within their lifetime, and 43.8% of 18- to 29-year-olds have been diagnosed with a mental disorder within the previous year. 7 Among all age groups, 18- to 25-year-olds have the highest past-year prevalence of serious mental illness, i.e., mental illness that results in functional impairment, (7.4%) and the highest past-year prevalence of major depressive episode (8.7%). 8 More than one in ten (1.8%) young adults between the ages of 18 and 25 have received treatment for a mental health problem in the previous year. 8 As a group, vetera may face an even greater challenge in making the adjustments necessary to succeed in college. For some vetera there may be some lingering psychological issues related to their military service, which affect their mental well-being. A recent Department of Defee Task Force report documented that among U.S. troops returning from Iraq and Afghanistan, nearly two-fifths of soldiers, one-third of Marines, and one-half of National Guard members report symptoms of psychological problems. 9 Some vetera choose to struggle with their mental health issues in isolation due to concern over the stigma associated with disclosing mental health symptoms and asking for help within the military culture. 1 Offering resources to all students struggling with mental health problems is important, whether or not these students are vetera. However, the unique life experiences of vetera require colleges to think critically about the types of programs and services they offer and whether they meet the particular needs of vetera. Mental Health A report published in 26 presents the results of a population-based analysis of 33,95 Army and Marine troops who completed a Post-Deployment Health Assessment between May 23 and April The report documents that 19.1% of Operation Iraqi Freedom (OIF) vetera and 11.3% of Operation Enduring Freedom (OEF) vetera reported some mental health issue (e.g., anxiety, depression, and post-traumatic stress disorder) and 9.8% of OIF vetera and 4.7% of OEF vetera reported symptoms of post-traumatic stress disorder. 11 In addition, the mental health symptoms that many soldiers experience often increase three or four months after their return. 12 7

16 For vetera who completed the 21 College Student Health Survey, depression, anxiety, and post-traumatic stress disorder are the most frequently reported mental health diagnoses within their lifetime. The adjusted aggregate data show that compared to all students who completed the survey, vetera have similar diagnosis rates for most mental health conditio within their lifetime. However, male and female vetera report being diagnosed with post-traumatic stress disorder within their lifetime at higher rates than all male and female students who completed the survey. Mental Health Condition Diagnosis Lifetime Vetera and All Students by Gender Who Report Being Diagnosed Mental Health Condition Males p-value Females p-value Anorexia Anxiety Attention Deficit Disorder Bipolar Disorder Bulimia Depression Obsessive-Compulsive Disorder Panic Attacks Post-Traumatic Stress Disorder < <.1 Seasonal Affective Disorder < Social Phobia/ Performance Anxiety Vetera All Students Adjusted Data Mental Health The most frequently reported mental health diagnoses within the past 12 months for vetera who completed the survey are anxiety, depression, and post-traumatic stress disorder. For both males and females, vetera have similar diagnosis rates for most mental health conditio within the past 12 months compared to all students. However, male and female vetera report being diagnosed with depression and post-traumatic stress disorder within the past 12 months at higher rates than all male and female students who completed the survey, male vetera have a higher rate of anxiety diagnosis within the past 12 months than all male students, and female vetera have a higher rate of bulimia diagnosis within the past 12 months than all female students. Not statistically significant. Mental Health Condition Diagnosis Past 12 Months Vetera and All Students by Gender Who Report Being Diagnosed Mental Health Condition Males p-value Females p-value Anorexia Anxiety < Attention Deficit Disorder Bipolar Disorder Bulimia <.5 Depression < <.5 Obsessive-Compulsive Disorder Panic Attacks Post-Traumatic Stress Disorder 5..7 < <.1 Seasonal Affective Disorder Social Phobia/ Performance Anxiety Vetera All Students Adjusted Data Not statistically significant. 8 Health and Health-Related Behaviors Minnesota Postsecondary Student Vetera

17 Any Mental Health Condition Diagnosis Lifetime Vetera and All Students by Gender Vetera* All Students Adjusted Data* Among all vetera, 33.5% report being diagnosed with at least one mental health condition within their lifetime. Female vetera report a higher rate of being diagnosed with a mental health condition within their lifetime compared to male vetera (p<.1). The adjusted aggregate survey data show that vetera have a higher though not statistically significantly different rate of being diagnosed with any mental health condition within their lifetime compared to all students (33.5% vs. 3.7%, respectively). Males Females *Statistically significant. Any Mental Health Condition Diagnosis Past 12 Months Vetera and All Students by Gender Female vetera report a higher rate of being diagnosed with a mental health condition within the past 12 months compared to male vetera (p<.1). The adjusted aggregate survey data show that vetera have a statistically higher rate of being diagnosed with any mental health condition within the past 12 months compared to all students (15.4% vs. 11.7%, respectively, p<.1). Mental Health Vetera* All Students Adjusted Data* Males Females *Statistically significant. 9

18 Mental Health The most commonly experienced stressors among vetera who completed the 21 College Student Health Survey are the death of someone close to them, lack of health care coverage, and roommate/ housemate conflict. A total of 44.4% of vetera report experiencing one or two stressors within the past 12 months, and 23.3% report experiencing three or more stressors over that same time period. The adjusted aggregate data from all students who completed the survey show that 44.5% of all students report experiencing one or two stressors within the past 12 months, and 21.5% report experiencing three or more stressors within that same time period. Mental Health Stressors Vetera and All Students Stressor Getting Married Failing a Class Serious Physical Illness of Someone Close to You Death of Someone Close to You Being Diagnosed With a Serious Physical Illness Being Diagnosed With a Serious Mental Illness Divorce or Separation From Your Spouse Termination of Personal Relatiohip (Not Including Marriage) Attempted Suicide Being Put on Academic Probation Excessive Credit Card Debt Excessive Debt Other Than Credit Card Being Arrested Being Fired or Laid Off From a Job Roommate/Housemate Conflict Parental Conflict Lack of Health Care Coverage Issues Related to Sexual Orientation Zero of the Above Stressors One or Two of the Above Stressors Three or More of the Above Stressors Who Report Experiencing Within Past 12 Months p-value <.1 <.1 Vetera All Students Adjusted Data Not statistically significant. Over the same 12-month period, vetera who experienced three or more stressors tend to have statistically significantly higher rates of current tobacco use (p<.1), high-risk drinking (p<.1), and credit card debt (p<.1) compared to vetera who experienced two or fewer stressors. The adjusted aggregate data obtained from all students who participated in the survey show that students who experienced three or more stressors tend to have statistically significantly higher rates of current tobacco use, high-risk drinking, credit card debt, and gambling compared to students who experienced two or fewer stressors. Mental Health Stressors and Risky Behavior Vetera Current Tobacco Use Any Use Past 3 Days* High-Risk Drinking 5+ Drinks/Sitting Past 2 Weeks* Two or Fewer Stressors High Credit Card Debt Balance $3,+* Any Gambling Past 12 Months Three or More Stressors *Statistically significant. 1 Health and Health-Related Behaviors Minnesota Postsecondary Student Vetera

19 Ability to Manage Stress Past 12 Months Vetera In an attempt to measure effectiveness in managing stress, students were asked to rate their stress level and their ability to manage stress, each on a scale of 1 to 1. The reported stress level is then divided by the reported ability to manage stress. Any result greater than 1 mea a student is not effectively managing his or her stress. Slightly less than one-fifth (19.4%) of vetera who completed the 21 College Student Health Survey report they are unable to manage their stress level. Additional analysis shows that 16.8% of male vetera and 26.6% of female vetera report they are unable to manage their stress level. 19.4% 8.6% The adjusted aggregate survey data show that 19.% of all students report they are unable to manage their stress level. Managed Stress (Index 1) Unmanaged Stress (Index >1) Stress and Mental Health, Acute, and Chronic Condition Diagnosis Vetera Condition Any Acute Condition Any Chronic Condition Anxiety Depression Obsessive-Compulsive Disorder Panic Attacks Social Phobia/ Performance Anxiety Who Report Being Diagnosed Within the Past 12 Months p-value <.1 <.1 <.1 <.1 <.1 <.1 <.1 Unmanaged stress levels are associated with rates of diagnosis for various health conditio. For example, 21.6% of vetera with unmanaged stress levels report being diagnosed with anxiety within the past year compared to only 5.5% of vetera with managed stress levels reporting the same diagnosis (p<.1). The adjusted aggregate data show the same type of relatiohip between ability to manage stress and various health conditio among all students. Mental Health Managed Stress (Index 1) Unmanaged Stress (Index >1) Post-Traumatic Stress Disorder Diagnosis Past 12 Months Vetera by Operation Iraqi Freedom and Operation Enduring Freedom Service Status and Gender Males* 1.5 Served in Iraq or Afghanistan *Statistically significant Females* 2.3 Did Not Serve in Iraq or Afghanistan Differences in reported rates of post-traumatic stress disorder diagnosis exist among vetera. Male vetera who served in either Iraq or Afghanistan have a higher past-12-month diagnosis rate of post-traumatic stress disorder compared to males vetera who did not serve in Iraq or Afghanistan (p=.1). Similarly, female vetera who served in either Iraq or Afghanistan have a higher past-12-month diagnosis rate of posttraumatic stress disorder compared to females vetera who did not serve in Iraq or Afghanistan (p<.1). Among all vetera, 51.8% report that they served in Iraq or Afghanistan. 11

20 Among vetera who completed the 21 College Student Health Survey, females report being diagnosed with depression within their lifetime at a higher rate compared to males (p<.1). Depression Diagnosis Lifetime Vetera and All Students by Gender Vetera* All Students Adjusted Data* Males Females *Statistically significant. Mental Health Male vetera report being diagnosed with depression within the past 12 months at a statistically significantly higher rate than female vetera (p<.1). According to the adjusted aggregate survey data, female students report being diagnosed with depression within the past 12 months at a higher rate than male students (p<.1). Depression Diagnosis Past 12 Months Vetera and All Students by Gender Vetera* All Students Adjusted Data* Males Females *Statistically significant. Overall, 9.6% of vetera who completed the 21 College Student Health Survey report they currently are taking medication for depression. Female vetera report using medication for depression at a statistically higher rate than male vetera (p=.1). According to the adjusted aggregate survey data, female students report using medication for depression at a higher rate than male students (p<.1). Currently Taking Medication for Depression Vetera and All Students by Gender Vetera* All Students Adjusted Data* Males Females *Statistically significant. 12 Health and Health-Related Behaviors Minnesota Postsecondary Student Vetera

21 Currently Taking Medication for Mental Health Problems Other Than Depression Vetera and All Students by Gender Female vetera report a higher but not statistically significantly different rate of medication use for mental health problems other than depression than male vetera. Overall, 7.5% of vetera report being on medication for a mental health problem other than depression. 2 Vetera All Students Adjusted Data* Males Females *Statistically significant. Eating Disorder Diagnosis Lifetime Vetera and All Students by Gender Vetera* All Students Adjusted Data* Among vetera who completed the 21 College Student Health Survey,.2% of males compared to 4.9% of females report being diagnosed with anorexia and/or bulimia within their lifetime (p<.1). The adjusted aggregate data obtained from all students who participated in the survey show that.5% of all males and 4.1% of all females report being diagnosed with anorexia and/or bulimia within their lifetime (p<.1). Mental Health Males Females *Statistically significant. Number of Days of Adequate Sleep Past Seven Days Vetera 19.5% 3.3% 2.3% 29.9% 5.2% of student vetera get adequate sleep 3 or fewer days a week Approximately one-half (5.2%) of all vetera report they received enough sleep so they felt rested when they woke up in the morning on three or fewer days over the previous seven days. The adjusted aggregate data show that 48.8% of all students who completed the 21 College Student Health Survey report they received adequate sleep on three or fewer days over the previous seven days. -1 Day per Week 4-5 Days per Week 2-3 Days per Week 6-7 Days per Week 13

22 Receiving adequate sleep appears to affect vetera ability to manage their stress level. Only 62.3% of vetera who report receiving -1 day per week of adequate sleep also report the ability to manage their stress, whereas 93.5% of vetera who report 6-7 days per week of adequate sleep also report the ability to manage their stress (p<.1). A similar association between sleep and stress is seen in the adjusted aggregate survey data from all students. Who Report They Manage Their Stress Level Adequate Sleep and Stress Vetera Days per Week Mental Health 14 Health and Health-Related Behaviors Minnesota Postsecondary Student Vetera

23 Tobacco Use Recent research shows that current cigarette use by America of all ages peaks among young adults ages at 37.1%, while 18- to 2-year-olds are not far behind at 33.5%. 8 Nearly one in three (3.%) full-time college students smoked cigarettes at least one time in the previous year, less than one in five (17.9%) smoked cigarettes at least one time in the previous 3 days, and approximately one in ten (9.2%) smoke cigarettes daily. 13 Among young adults ages 18-25, 5.4% used smokeless tobacco in the previous month. 8 Current cigarette smokers are more likely to use other tobacco products, alcohol, or illicit drugs than nomokers. 8 Among all current smokers, 42.5% have tried to quit and have stopped smoking for at least one day in the preceding 12 months. 14 Of the 15 million college students in the United States, an estimated 1.7 million will die prematurely due to smoking-related illnesses. 15 Clearly the current level of tobacco use among college students poses a major health risk. Several studies have documented higher rates of tobacco use among vetera compared to the civilian population. According to the Department of Vetera Affairs (VA) National Smoking and Tobacco Use Cessation Program directive, the prevalence of smokers in the VA is 22.% compared to 2.9% in the general population. 16 A National Survey on Drug Use and Health report estimates that 18.1% of vetera smoke cigarettes on a daily basis, compared to 14.3% of nonvetera. 17 In a study of U.S. military personnel serving in the first Gulf War, 7.% of respondents indicated they started smoking for the first time and 56.% of preexisting regular smokers stated they increased coumption while deployed. 18 Tobacco Use 15

24 The current tobacco use rate for all vetera who completed the 21 College Student Health Survey Current Tobacco Use Vetera and All Students by Gender is significantly higher than the current tobacco use rate among all students who completed the survey (35.% vs. 27.7%, respectively, p<.1). Male vetera report a statistically significantly higher rate of current tobacco use compared to female vetera (4.2% vs. 2.6%, respectively, p<.1) Definition: Current Tobacco Use Any tobacco use in the past 3 days. Tobacco use includes both smoking and smokeless tobacco. All* Males* Females Vetera All Students Adjusted Data *Statistically significant. The daily tobacco use rate for all vetera who completed the 21 College Student Health Survey Daily Tobacco Use Vetera and All Students by Gender Tobacco Use is statistically significantly higher than the daily tobacco use rate among all students who completed the survey (16.4% vs. 12.3%, respectively, p<.1). The daily tobacco use rate for male vetera is higher but not statistically significantly different that the rate for female vetera (18.% vs. 12.1%, respectively) All* Males* Females Vetera All Students Adjusted Data *Statistically significant. Overall, 15.8% of male vetera report using smokeless tobacco during the past 3 days compared to 1.3% of female vetera (p<.1). The current smokeless tobacco use rate for all vetera who completed the 21 College Student Health Survey is statistically significantly higher than the current smokeless tobacco use rate among all students who completed the survey (12.% vs. 7.6%, respectively, p<.1). Current Smokeless Tobacco Use Vetera and All Students by Gender All* Males* Females.7 Vetera All Students Adjusted Data *Statistically significant. 16 Health and Health-Related Behaviors Minnesota Postsecondary Student Vetera

25 Quit Attempts Past 12 Months Vetera: Current Smokers 4.7% 59.3% 45.8% 54.2% 4.7 = Average Number of Quit Attempts 1-5 = Range of Quit Attempts Among those who report using smoking tobacco in the past 3 days, 4.7% of vetera, compared to 4.4% of all students who completed the survey, do not coider themselves smokers. Among those who do coider themselves smokers, 54.2% of vetera, compared to 51.9% of all students, made at least one attempt to quit smoking over the past 12 months. These vetera made an average of 4.7 quit attempts during that same 12-month period, while all students who coider themselves smokers made an average of 3.9 quit attempts. Coider Themselves Smokers Do Not Coider Themselves Smokers Attempted to Quit Have Not Attempted to Quit Number of Cigarettes Smoked Vetera: Current Tobacco Users 13.2% 3.% Weekday 56.8% 11.5% 38.1% 5.4% Weekend Day Among vetera who report using tobacco over the past 3 days, the proportion who report smoking half a pack of cigarettes or more per day increases from 43.2% on a weekday to 49.6% on a weekend day. The adjusted aggregate survey data from all students who currently use tobacco show that the proportion of students who report they smoke half a pack of cigarettes or more per day increases from 39.4% on a weekday to 44.1% on a weekend day. Tobacco Use Less Than.5 Pack per Day.5-1 Pack per Day More Than 1 Pack per Day Average Number of Cigarettes Average Number of Cigarettes Smoked Vetera: Current vs. Daily Tobacco Users Weekday Weekend Day Vetera who are current tobacco users smoke similar average numbers of cigarettes per weekday and per weekend day. Vetera who are daily tobacco users smoke fewer but not a statistically significantly different average numbers of cigarettes per weekday compared to per weekend day. The adjusted aggregate survey data from all students show a statistically significantly higher average number of cigarettes smoked on weekdays compared to on weekend days for both current and daily tobacco users. Current Tobacco Users Daily Tobacco Users 17

26 Vetera who used tobacco in the past 3 days report the most common locatio of their use where they live (outside), in a car, on campus (outside), and bars/restaurants. The most common locatio obtained from the adjusted aggregate data from all students who completed the 21 College Student Health Survey were the same as reported by vetera. Tobacco Use Location Vetera and All Students: Current Tobacco Users Who Indicate Use Location Iide Outside On Campus Residence Halls Fraternity/Sorority Bars/Restaurants In a Car Where I Live Private Parties Work Site Parking Ramp/Garage Other 7. * 3.3 * * * 1.4 * * * * * * 3.4 Vetera All Students Adjusted Data *Location not included in question. Tobacco Use For both vetera who are nomokers and vetera who are smokers, on campus (outside) is the most commonly cited location for exposure to secondhand smoke. Approximately one-third (31.8%) of vetera report never being exposed to secondhand smoke. Adjusted aggregate data from all students who completed the survey show that 33.8% report never being exposed to secondhand smoke. Secondhand Smoke Exposure Vetera Who Indicate Exposure Location Iide Outside On Campus Residence Halls Fraternity/Sorority Bars/Restaurants In a Car Where I Live Private Parties Work Site Parking Ramp/Garage Other 1.8 *.3 * * * 2. * * * * * * 23.8 Nomoker Smoker *Location not included in question. 18 Health and Health-Related Behaviors Minnesota Postsecondary Student Vetera

27 Secondhand Smoke Exposure Per Week Vetera: Nomokers vs. Current Smokers 2.9%.8% 23.5% 72.8% 16.4% 7.3% 28.3% 48.% For vetera who are nomokers, 3.7% report being exposed to secondhand smoke 2 or more hours per week. For vetera who are current smokers, 23.7% they report being exposed to secondhand smoke 2 or more hours per week. Nomokers Current Smokers Hours 2-6 Hours Less Than 3 Minutes-1 Hour 7 or More Hours Tobacco Use Status and High-Risk Drinking Vetera All Students Non-Tobacco Users Tobacco Users Vetera who use tobacco have a higher rate of high-risk drinking compared to vetera who are non-tobacco users (58.1% vs. 27.9%, respectively, p<.1). This same relatiohip between tobacco use and high-risk drinking is seen in the adjusted aggregate data from all students who completed the 21 College Student Health Survey. Definition: High-Risk Drinking Coumption of five or more alcohol drinks at one sitting within the past two weeks for both males and females. A drink is defined as a bottle of beer, wine cooler, glass of wine, shot glass of liquor, or mixed drink. Tobacco Use Tobacco Use Status and Current Marijuana Use Vetera All Students Non-Tobacco Users Tobacco Users Similar to the relatiohip between high-risk drinking and tobacco use, the use of marijuana in the past 3 days is higher among vetera who are tobacco users (12.5%) compared to vetera who are non-tobacco users (2.5%) (p<.1). A similar relatiohip between tobacco use and current marijuana use is seen in the adjusted aggregate data from all students who completed the survey. 19

28 The use of other illegal drugs is also associated with tobacco use. Vetera who are tobacco users use illegal drugs other than marijuana at nearly four times the rate of non-tobacco users (8.9% vs. 2.3%, respectively, p<.1). The relatiohip between tobacco use and other illegal drug use seen in the adjusted aggregate data from all students who completed the survey is similar to that seen among the vetera Tobacco Use Tobacco Use Status and Other Illegal Drug Use (Not Marijuana) Past 12 Months Vetera All Students Non-Tobacco Users Tobacco Users 2 Health and Health-Related Behaviors Minnesota Postsecondary Student Vetera

29 Alcohol Use and Other Drug Use American college students coume alcohol and other drugs at very high rates. More than four in five (85.3%) full-time college students have coumed alcohol at least one time, and more than two in three (69.%) full-time college students coume alcohol monthly. 13 The rate of binge drinking (couming five or more alcoholic beverages in a row in the previous two weeks) peaks between ages 21 and 25 at 46.% and is 33.7% among 18- to 2-year-olds. 8 Young adults ages 18 to 22 who are enrolled in college full time are more likely than their peers who are not enrolled in college full time to coume alcohol monthly and to binge drink. 8 Approximately one-half (49.5%) of full-time college students have used an illicit drug at least once in their lifetime, more than one-third (35.2%) of full-time college students have used an illicit drug at least once in the past year, and nearly one in five (18.9%) full-time college students have used an illicit drug in the last month. 13 Marijuana is the illicit drug of choice for full-time college students, with nearly half (46.8%) of students having used the drug at least once in their lifetime and almost one-third (32.3%) having used it in the past year. 13 Among full-time college students, 5.7% have used amphetamines, 4.4% have used cocaine, and.3% have used heroin in the previous year. 13 The National Survey on Drug Use and Health, an annual survey spoored by the Substance Abuse and Mental Health Services Administration, examined differences in alcohol and drug use among vetera and nonvetera in two separate reports released in November 25. The rates of alcohol and marijuana use were higher among vetera compared to nonvetera. The report estimated a pastmonth alcohol use rate among vetera of 56.6%, compared to a rate of 5.8% among nonvetera, with 22.6% of vetera also reporting they coumed five or more drinks at one sitting over that same time period and 21.6% of nonvetera reporting having engaged in that same type of behavior. 17 The second report, which highlighted the use of marijuana and other illicit drugs, estimated the rates of marijuana use within the past 3 days to be 3.5% among vetera and 3.% among nonvetera. The use of illicit drugs within the past 3 days was slightly lower among vetera than among nonvetera (1.7% vs. 1.9%, respectively). 19 Alcohol Use and Other Drug Use 21

30 The rates for any use of alcohol in the past 12 months are similar for male and female vetera who Alcohol Use Past 12 Months Vetera and All Students by Gender completed the 21 College Student Health Survey (86.4% vs. 85.2%, respectively). The rate for any use of alcohol within the past year is statistically significantly higher among vetera (86.2%) compared to the adjusted aggregate data from all students who completed the survey (82.2%) (p<.1). 2 Definition: Past-12-Month Alcohol Use Any alcohol use within the past year. All* Males* Females Vetera All Students Adjusted Data *Statistically significant. Alcohol Use and Other Drug Use Among vetera who completed the 21 College Student Health Survey, the rate for use of alcohol in the past 3 days is statistically significantly higher for males compared to females (78.3% vs. 69.5%, respectively, p=.1). Analysis of the adjusted aggregate data shows that vetera report a higher rate of alcohol use within the past 3 days compared to all students who completed the survey (76.1% vs. 72.4%, respectively, p<.5). Definition: Current Alcohol Use Any alcohol use within the past 3 days. Male vetera who completed the 21 College Student Health Survey coume approximately two times the number of drinks per week than female vetera coume (6.2 vs. 3.2, respectively, p<.1). Analysis of the adjusted aggregate data shows that male vetera report couming a higher average number of drinks per week compared to all males who completed the survey (6.2 vs. 5.4, respectively, p=.1). Female vetera report couming a higher but not statistically significantly different average number of drinks per week compared to all females who completed the survey (3.2 vs. 2.8, respectively). Average Number of Drinks Current Alcohol Use Vetera and All Students by Gender All* Males* Females Vetera *Statistically significant. Average Number of Drinks per Week Vetera and All Students by Gender All Students Adjusted Data All* Males* Females Vetera *Statistically significant. All Students Adjusted Data Health and Health-Related Behaviors Minnesota Postsecondary Student Vetera

31 High-Risk Drinking Vetera and All Students by Gender All* Males* Females Vetera *Statistically significant. All Students Adjusted Data Male vetera report a higher rate of high-risk drinking compared to female vetera (43.2% vs. 25.5%, respectively, p<.1). Among all students who completed the 21 College Student Health Survey, males report a higher rate of high-risk drinking compared to females (p<.1). Analysis of the adjusted aggregate data shows that male vetera report a higher high-risk drinking rate compared to all males who completed the survey (43.2% vs. 38.2%, respectively, p<.5). Female vetera report a similar high-risk drinking rate compared to all females who completed the survey (25.5% vs. 25.7%, respectively). High-Risk Drinking Vetera by Age Group Among vetera who completed the 21 College Student Health Survey, the peak years for engaging in high-risk drinking are between ages 21 and 27. Among all students who completed the survey, the peak years for engaging in high-risk drinking are also between ages 21 and Age Group Blood Alcohol Content Blood alcohol content (BAC) measures the percentage of alcohol in a person s blood. The calculation of BAC is based on a formula that takes into account the following factors: Gender Current body weight Amount of alcohol coumed (number of drinks) Time period of coumption Concentration of alcohol in the beverage coumed (based on the alcohol content of one typical can of beer containing 4.5% alcohol) The blood alcohol content of a student on the most recent socializing/partying occasion was calculated based on awers to four different survey questio (gender, current body weight, amount of alcohol coumed, and time period of coumption). It should be noted that the BAC calculated in this study is an estimate. This information is self-reported, and students tend to underestimate the actual amount of alcohol they coume. Alcohol Use and Other Drug Use 23