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Executive Summary
Spring 2016
American College Health Association
National College Health Assessment II
ACHA-NCHA II
Copyright 2016
Table of Contents
I. Introduction
II. Findings
A. General Health of College Students
B. Disease and Injury Prevention
C. Academic Impacts
D. Violence, Abusive Relationships and Personal Safety
E. Tobacco, Alcohol, and Marijuana Use
F. Sexual Behavior
G. Nutrition and Exercise
H. Mental Health
I. Sleep
3
4
5
5
6
10
12
13
16
17
ACHA, the nation's principal advocate and leadership organization for college and university
health, represents a diverse membership that provides and supports the delivery of health care
and prevention and wellness services for the nation's 20 million college students. For more
information about the association's programs and services, visit www.acha.org, and www.achancha.org.
Introduction
The ACHA-National College Health Assessment II (ACHA-NCHA II) is a national
research survey organized by the American College Health Association (ACHA) to
assist college health service providers, health educators, counselors, and administrators
in collecting data about their students' habits, behaviors, and perceptions on the most
prevalent health topics.
ACHA initiated the original ACHA-NCHA in 2000 and the instrument was used nation
wide through the spring 2008 data collection period. The ACHA-NCHA now provides
the largest known comprehensive data set on the health of college students, providing
the college health and higher education fields with a vast spectrum of information on
student health. A revised survey, the ACHA-NCHA-II, has been in use since the fall
2008 data collection period.
Please note the ACHA-NCHA II is not appropriate for trend comparison with items
from the original ACHA-NCHA survey. Directly comparing pre- and post-redesign
estimates on similar data points, without taking into account the impact of the surveys
redesign, can lead to an erroneous conclusion.
Notes about this report:
1. Missing values have been excluded from analysis and only valid percents are
included in this document.
2. Students responding "not applicable" were excluded from several analyses, which
are specifically noted throughout this document. This will often explain differences
observed between this document and the full data report.
3. A note about the use of sex and gender in this report: Survey responses are
reported by sex based on the responses to questions 47a, 47b, and 47c. For the
purpose of the ACHA-NCHA report documents, respondents are reported as male or
female only when their responses to these three questions are consistent with one
another. If students' gender identity is consistent with their sex at birth AND the
student selects "no" for transgender, then respondents are designated as either male or
female. If respondents select "yes" for transgender OR their sex at birth is not
consistent with their gender identity, then they are designated as non-binary. A
respondent that skips any of the three questions is designated as unknown. Totals
displayed in this report include non-binary and unknown students.
For additional information about the surveys development, design, and methodology,
email Mary T Hoban, PhD, MCHES, (mhoban@acha.org), E. Victor Leino, PhD
(vleino@acha.org), or visit www.acha-ncha.org.
Findings
A. General Health of College Students
59.0 % of college students surveyed (
their health as very good or excellent .
21.4
7.8
14.0
8.1
6.3
2.2
1.1
7.5
1.0
0.9
0.9
0.7
%
%
%
%
%
%
%
%
%
%
%
%
Hepatitis B or C:
High blood pressure:
High cholesterol:
HIV infection:
Irritable Bowel Syndrome:
Migraine headache:
Mononucleosis:
Pelvic Inflammatory Disease:
Repetitive stress injury:
Sinus infection:
Strep throat:
Tuberculosis:
Urinary tract infection:
0.8
2.7
2.0
0.6
3.3
8.9
3.3
0.5
2.1
21.1
16.2
0.6
11.3
%
%
%
%
%
%
%
%
%
%
%
%
%
9.1
3.2
1.0
4.3
0.6
2.0
6.3
1.2
2.2
%
%
%
%
%
%
%
%
%
Findings continued
College students reported the following behaviors within the last 12 months:
Percent (%)
Never*
Rarely or
sometimes*
Mostly or
always*
0.3
0.4
5.1
94.5
48.2
49.1
23.9
27.0
84.7
7.8
5.7
86.5
85.0
59.0
13.7
27.3
* Students responding "N/A, did not do this activity within the last 12 months" were excluded.
Findings continued
C. Academic Impacts
Within the last 12 months, students reported the following factors affecting their individual
academic performance, defined as: received a lower grade on an exam, or an important project;
received a lower grade in the course; received an incomplete or dropped the course;
or experienced a significant disruption in thesis, dissertation, research, or practicum work;
(listed alphabetically):
Alcohol use:
Allergies:
Anxiety:
Assault (physical):
Assault (sexual):
Attention Deficit/Hyperactivity Disorder:
Cold/Flu/Sore throat:
Concern for a troubled friend
or family member:
Chronic health problem or serious illness:
Chronic pain:
Death of a friend or family member:
Depression:
Discrimination:
Drug use:
Eating disorder/problem:
Finances:
6.8
1.8
20.7
1.2
1.3
6.9
10.5
%
%
%
%
%
%
%
7.3
2.6
1.7
5.8
11.8
1.7
3.2
1.5
4.9
%
%
%
%
%
%
%
%
%
Gambling:
Homesickness:
Injury:
Internet use/computer games:
Learning disability:
Participation in extracurricular
activities:
Pregnancy (yours or partner's):
Relationship difficulties:
Roommate difficulties:
Sexually transmitted disease/
infection (STD/I):
Sinus infection/Ear infection/
Bronchitis/Strep throat:
Sleep difficulties:
Stress:
Work:
Other:
A physical fight
A physical assault (not sexual assault)
A verbal threat
Sexual touching without their consent
Sexual penetration attempt without their consent
Sexual penetration without their consent
Stalking
An emotionally abusive intimate relationship
A physically abusive intimate relationship
A sexually abusive intimate relationship
Male
Female
Total
15.8
5.2
32.0
2.9
1.4
1.0
2.2
2.6
0.7
0.5
4.5
2.9
17.6
11.3
6.5
3.6
7.2
13.5
2.0
1.8
10.3
4.2
25.9
7.6
4.2
2.7
5.2
8.4
1.5
1.5
0.5
4.0
1.3
7.8
2.6
%
%
%
%
%
7.0
1.1
8.6
4.6
%
%
%
%
1.1 %
2.6
17.7
26.5
15.8
1.2
%
%
%
%
%
Findings continued
College students reported feeling very safe :
Percent (%)
Male
Female
Total
86.9
41.2
80.7
15.2
83.2
28.3
34.9
25.3
29.6
5.7
3.4
4.5
Actual Use
Percent (%)
Perceived Use
Male
Female
Total
Never used
Used, but not in the last 30 days
Used 1-9 days
Used 10-29 days
Used all 30 days
72.4
14.6
9.4
1.0
2.6
81.5
10.8
5.2
1.1
1.4
76.0
13.2
7.6
1.2
2.0
10.9
14.4
48.6
14.7
11.4
4.8
7.8
43.9
22.0
21.5
8.0
10.7
46.7
18.0
16.5
12.9
7.7
10.8
74.7
87.4
81.3
E-Cigarette
Actual Use
Perceived Use
Male
Female
Total
Never used
Used, but not in the last 30 days
Used 1-9 days
Used 10-29 days
Used all 30 days
78.9
15.3
4.6
0.7
0.5
88.3
9.3
2.0
0.2
0.2
82.9
12.5
3.5
0.6
0.4
12.0
12.8
49.6
15.3
10.2
5.0
9.6
43.6
20.0
21.8
8.7
11.3
45.9
18.0
16.1
5.8
2.5
4.6
75.2
85.3
80.0
Percent (%)
Actual Use
Perceived Use
Male
Female
Total
Never used
Used, but not in the last 30 days
Used 1-9 days
Used 10-29 days
Used all 30 days
68.8
24.5
5.0
0.7
1.0
76.3
20.1
2.7
0.9
0.0
72.5
22.3
3.8
1.0
0.4
14.0
16.3
51.4
12.7
5.7
6.2
12.4
50.2
19.6
11.5
10.2
13.5
51.0
17.0
8.4
6.7
3.6
5.2
69.8
81.3
76.3
Findings continued
Alcohol
Actual Use
Perceived Use
Male
Female
Total
Never used
Used, but not in the last 30 days
Used 1-9 days
Used 10-29 days
Used all 30 days
16.7
9.4
50.5
20.3
3.1
13.4
10.7
56.5
18.7
0.7
15.3
10.0
53.4
19.4
1.9
3.6
1.5
41.8
40.1
13.0
1.4
1.8
25.1
48.3
23.4
3.0
1.7
32.4
44.5
18.4
73.9
75.9
74.7
94.9
96.8
95.3
Percent (%)
Marijuana
Actual Use
Perceived Use
Male
Female
Total
Never used
Used, but not in the last 30 days
Used 1-9 days
Used 10-29 days
Used all 30 days
56.3
19.0
12.5
6.5
5.8
58.2
22.3
13.9
3.6
2.0
56.7
20.6
13.2
5.0
4.5
10.3
8.8
49.2
22.9
8.8
4.9
8.2
37.5
30.1
19.3
8.0
8.0
42.9
27.0
14.2
24.8
19.5
22.7
80.9
86.9
84.0
Percent (%)
Estimated Blood Alcohol Concentration (or eBAC) of college students reporting 1 or more drinks
the last time they "partied" or socialized. Students reporting 0 drinks were excluded from the analysis.
Due to the improbability of a student surviving a drinking episode resulting in an extremely high eBAC,
all students with an eBAC of 0.50 or higher are also omitted from these eBAC figures. eBAC is
an estimated figure based on the reported number of drinks consumed during the last time they
"partied" or socialized, their approximate time of consumption, sex, weight, and the average rate
of ethanol metabolism.
Estimated BAC
< .08
< .10
Mean
Median
Std Dev
Percent (%)
Male
Female
Total
34.6
43.6
46.3
53.4
41.3
49.3
0.13
0.12
0.10
0.11
0.10
0.09
0.12
0.10
0.10
Findings continued
Reported number of drinks consumed the last time students "partied" or socialized. Only students
reporting one or more drinks were included.
Number of drinks*
4 or fewer
5
6
7 or more
Percent (%)
Mean
Median
Std Dev
Male
Female
Total
24.1
7.1
7.9
60.9
47.4
12.4
9.5
30.7
36.6
10.2
8.7
44.5
8.31
8.00
5.04
5.30
5.00
3.45
6.69
6.00
4.50
Reported number of times college students consumed five or more drinks in a sitting
within the last two weeks:
Percent (%)
Male
Female
Total
16.9
23.9
30.5
22.4
6.2
12.8
38.0
32.2
14.8
2.2
14.6
31.5
31.7
18.2
4.0
Percent of college students who reported using prescription drugs that were not prescribed
to them within the last 12 months:
Male
Female
Total
Antidepressants
Erectile dysfunction drugs
Pain killers
Sedatives
Stimulants
1.4
0.2
5.8
3.6
15.3
3.3
0.0
5.4
3.1
13.0
2.8
0.5
6.0
3.4
14.6
18.4
17.6
18.8
Percent (%)
Findings continued
College students reported doing the following most of the time or always when they "partied"
or socialized during the last 12 months:*
Percent (%)
Male
Female Total
16.0
16.5
14.8
19.8
65.1
18.6
44.4
10.7
73.4
30.1
79.3
24.1
24.9
17.1
31.1
79.9
36.2
55.3
24.9
87.7
44.5
89.9
20.7
21.5
16.0
26.4
72.3
27.5
49.8
19.0
79.8
37.3
83.3
95.2
98.0
96.5
*Students responding "N/A, don't drink" were excluded from this analysis.
College students who drank alcohol reported experiencing the following in the last
12 months when drinking alcohol:*
Male
Female
Total
44.0
47.8
5.2
2.0
1.7
25.4
23.0
5.5
2.3
49.5
47.2
3.9
4.2
0.3
32.0
20.1
0.5
2.6
45.7
46.7
4.7
3.6
1.0
28.8
21.6
3.1
3.0
63.8
67.8
64.8
Percent (%)
*Students responding "N/A, don't drink" were excluded from this analysis.
Findings continued
F. Sexual Behavior
College students reported having the following number of sexual partners (oral sex, vaginal or
anal intercourse) within the last 12 months:
Percent (%)
None
1
2
3
4 or more
Male
Female
Total
29.0
37.6
11.3
6.1
16.0
26.2
41.5
12.8
8.9
10.7
27.3
39.0
12.0
7.8
13.8
Mean
Median
Std Dev
Male
Female
Total
3.25
1.00
6.82
2.17
1.00
2.22
2.74
1.00
4.98
*Students reporting 0 sexual partners within the last 12 months were excluded.
College students reported having oral, vaginal or anal sex in the last 30 days:
Oral sex within the past 30 days
Percent (%)
Male
24.1
29.8
46.1
Female Total
21.1
28.0
50.9
22.6
28.9
48.5
Male
28.1
27.4
44.5
Female Total
25.8
22.4
51.8
26.9
24.5
48.5
10
Male
77.5
17.3
5.2
Female Total
80.5
16.7
2.7
78.1
17.7
4.1
Findings continued
Using a condom or other protective barrier within the last 30 days (mostly or always ):
Percent (%)
Male
Female
Total
4.1
60.7
24.4
3.1
46.8
22.5
3.7
52.9
24.5
*Students responding "Never did this sexual activity" or "Have not done this during the last thirty days" were
excluded from the analysis.
Contraceptive use reported by students or their partner the last time they had vaginal intercourse:
Percent (%)
Male
Female
Total
54.7
45.3
61.6
38.4
57.8
42.2
If YES to contraceptive use the last time student had vaginal intercourse, reported means of birth
control used among college students or their partner to prevent pregnancy:
Percent (%)
74.1
5.7
3.1
1.5
3.1
6.7
72.0
0.5
1.6
0.5
4.8
5.8
32.8
0.5
1.1
73.7
2.9
2.9
0.4
2.5
4.9
59.8
1.2
0.8
0.4
1.7
6.4
46.4
1.7
3.0
73.3
4.0
3.6
0.8
2.9
5.5
65.3
0.8
1.1
0.4
3.5
6.3
39.0
1.3
2.0
59.4
32.1
51.4
36.5
55.0
33.8
17.9 % of sexually active college students reported using (or reported their partner used)
emergency contraception ("morning after pill") within the last 12 months.
(male: 12.0 %;
female:
22.7
%).*
*Students responding "Not sexually active" were excluded from the analysis.
1.1 % of college students who had vaginal intercourse within the last 12 months reported
experiencing an unintentional pregnancy or got someone pregnant within the last 12 months.
(male: 0.7 %;
female:
1.6
%).**
**Students responding "Have not had vaginal intercourse within the last 12 months" were excluded from
the analysis.
11
Findings continued
Male
Female
Total
10.3
66.3
20.1
3.3
6.9
58.9
29.5
4.7
8.5
63.0
24.5
4.0
College students reported the following behaviors within the past 7 days:
Do moderate-intensity cardio or aerobic exercise for at least 30 minutes:
Percent (%)
0 days
1-4 days
5-7 days
Male
Female
Total
19.5
52.8
27.7
16.2
59.8
24.0
17.8
56.7
25.6
0 days
1-2 days
3-7 days
Male
Female
Total
28.4
33.0
38.6
28.7
31.6
39.7
28.8
32.5
38.7
Physical Activity and Public Health: Updated Recommendations for Adults. From the American
College of Sports Medicine and the American Heart Association (2007): Moderate-intensity
cardio or aerobic exercise for at least 30 minutes on 5 or more days per week, or vigorous-intensity
cardio or aerobic exercise for at least 20 minutes on 3 or more days per week.
Students meeting the Recommendations for moderate-intensity exercise, vigorous-intensity
exercise, or a combination of the two (2 moderate-intensity exercise periods = 1 vigorous-intensity
exercise period).
Percent (%)
Guidelines met
12
Male
Female
Total
57.0
60.0
58.3
Findings continued
Estimated average Body Mass Index (BMI): This figure incorporates reported height,
and weight to form a general indicator of physical health. Categories defined by The World Health
Organization (WHO) 2000, reprinted 2004. Obesity: Preventing and Managing the Global
Epidemic. WHO Tech Report Series: 894.
BMI
<18.5 Underweight
18.5-24.9 Healthy Weight
25-29.9 Overweight
30-34.9 Class I Obesity
35-39.9 Class II Obesity
40 Class III Obesity
Percent (%)
Mean
Median
Std Dev
Male
Female
Total
2.8
60.5
27.2
7.2
1.5
0.8
5.4
69.5
18.3
5.4
0.2
1.2
4.1
64.6
23.0
6.5
0.8
0.9
24.65
23.75
4.29
23.53 24.10
22.70 23.30
4.20 4.28
H. Mental Health
Students reported experiencing the following within the last 12 months:
Felt things were hopeless
Percent (%)
Male
Female
Total
No, never
No, not last 12 months
Yes, last 2 weeks
Yes, last 30 days
Yes, in last 12 months
42.6
18.4
16.5
5.6
16.9
26.2
14.0
22.2
11.8
25.8
33.6
16.5
19.6
9.1
21.2
No, never
No, not last 12 months
Yes, last 2 weeks
Yes, last 30 days
Yes, in last 12 months
19.0
5.8
39.8
17.6
17.8
4.0
2.2
61.0
14.1
18.6
11.1
4.1
50.7
16.3
17.8
39.0
59.7
49.9
75.2
93.7
84.9
Male
Female
Total
No, never
No, not last 12 months
Yes, last 2 weeks
Yes, last 30 days
Yes, in last 12 months
25.2
7.8
40.0
13.3
13.6
7.2
4.0
56.3
17.7
14.8
15.3
5.9
48.7
15.9
14.2
No, never
No, not last 12 months
Yes, last 2 weeks
Yes, last 30 days
Yes, in last 12 months
33.2
19.1
18.6
9.4
19.6
17.1
14.8
27.2
17.8
23.1
24.7
16.1
24.2
13.1
21.8
67.0
88.8
78.8
47.7
68.1
59.1
13
Findings continued
Felt very sad
Percent (%)
Male
Female
Total
No, never
No, not last 12 months
Yes, last 2 weeks
Yes, last 30 days
Yes, in last 12 months
34.8
19.3
16.4
9.2
20.3
15.3
13.3
30.9
16.7
23.7
24.5
15.8
25.1
13.1
21.4
No, never
No, not last 12 months
Yes, last 2 weeks
Yes, last 30 days
Yes, in last 12 months
56.1
17.8
8.0
4.9
13.2
40.1
17.3
14.1
9.9
18.6
47.0
16.7
12.2
7.5
16.6
45.9
71.3
59.6
26.1
42.6
36.3
Male
Female
Total
No, never
No, not last 12 months
Yes, last 2 weeks
Yes, last 30 days
Yes, in last 12 months
44.3
13.1
15.0
9.0
18.6
20.8
9.2
32.4
16.8
20.8
32.0
10.6
24.5
12.9
20.0
No, never
No, not last 12 months
Yes, last 2 weeks
Yes, last 30 days
Yes, in last 12 months
43.1
16.9
12.6
11.1
16.2
33.9
20.4
12.7
11.5
21.5
37.5
18.0
13.6
11.3
19.5
42.6
70.0
57.4
40.0
45.7
44.5
Female
Total
No, never
81.4
No, not last 12 months 11.4
Yes, last 2 weeks
1.9
Yes, last 30 days
0.7
Yes, in last 12 months 4.6
77.6
11.0
1.1
2.0
8.3
78.4
11.3
1.8
1.5
7.0
No, never
No, not last 12 months
Yes, last 2 weeks
Yes, last 30 days
Yes, in last 12 months
92.0
6.3
0.5
0.0
1.2
92.1
5.2
0.4
0.4
1.8
91.0
6.2
0.6
0.3
1.8
11.4
10.3
1.7
2.7
2.8
Male
7.3
Male
Female
Total
No, never
87.7
No, not last 12 months 7.0
Yes, last 2 weeks
1.7
Yes, last 30 days
1.0
Yes, in last 12 months 2.7
80.6
11.8
0.9
1.1
5.6
82.6
9.5
2.0
1.1
4.7
7.6
7.8
5.3
Percent (%)
Attempted suicide
14
Percent (%)
Findings continued
Within the last 12 months, diagnosed or treated by a professional for the following:
Percent (%)
Male
Female
Total
Anorexia
Anxiety
Attention Deficit and Hyperactivity Disorder
Bipolar Disorder
Bulimia
Depression
Insomnia
Other sleep disorder
Obsessive Compulsive Disorder
Panic attacks
Phobia
Schizophrenia
Substance abuse or addiction
Other addiction
Other mental health condition
0.2
8.0
6.3
1.0
0.7
6.3
2.9
1.5
2.2
3.2
1.2
0.2
0.7
0.5
1.5
1.6
18.9
5.2
0.9
2.3
15.1
3.6
2.9
2.0
9.5
0.9
0.0
0.7
0.5
2.7
1.4
14.8
6.3
1.5
2.0
12.0
3.9
2.7
2.8
7.3
1.7
0.5
1.4
0.9
2.9
83.1
9.0
4.4
73.8
9.9
11.7
76.6
9.4
9.1
4.6
8.7
7.8
Within the last 12 months, any of the following been traumatic or very difficult to handle:
Percent (%)
Male
Female
Total
Academics
Career-related issue
Death of family member or friend
Family problems
Intimate relationships
Other social relationships
Finances
Health problem of family member or partner
Personal appearance
Personal health issue
Sleep difficulties
Other
46.8
22.7
16.9
18.9
27.5
20.8
27.0
13.3
14.6
12.1
20.1
6.6
58.5
31.5
22.1
34.7
38.2
32.6
38.2
22.5
36.6
24.3
35.0
11.8
52.6
27.7
20.0
27.8
33.5
27.5
32.8
19.3
26.4
19.2
28.7
9.6
32.0
16.0
14.3
37.6
16.6
12.8
11.4
59.3
24.1
13.8
12.9
49.2
15
Findings continued
Within the last 12 months, how would you rate the overall level of stress experienced:
Percent (%)
No stress
Less than average stress
Average stress
More than average stress
Tremendous stress
Male
Female
Total
3.6
12.1
43.1
34.9
6.3
0.7
2.5
34.6
49.0
13.3
2.2
7.5
37.6
42.8
9.9
I. Sleep
Past 7 days, getting enough sleep to feel rested in the morning:
Percent (%)
0 days
1-2 days
3-5 days
6+ days
Male
Female
Total
10.1
27.6
50.0
12.3
13.8
38.4
41.1
6.7
12.1
33.3
45.5
9.1
Past 7 days, how often felt tired, dragged out, or sleepy during the day:
Percent (%)
0 days
1-2 days
3-5 days
6+ days
Male
Female
Total
11.4
39.2
36.3
13.1
4.5
24.7
46.7
24.0
7.7
31.0
42.4
18.9
Past 7 days, how much of a problem with sleepiness during daytime activities:
Percent (%)
No problem
A little problem
More than a little problem
A big problem
A very big problem
16
Male
Female
Total
12.1
54.2
22.5
7.5
3.6
6.3
45.8
23.7
16.7
7.6
9.1
49.1
23.6
12.4
5.8
63.2
33.3
2.9
0.6
Gender*
Female:
Male:
Non-binary
50.7 %
47.4 %
1.9 %
%
%
%
%
Student status:
1st year undergraduate:
2nd year undergraduate:
3rd year undergraduate:
4th year undergraduate:
5th year or more undergraduate:
Graduate or professional:
Not seeking a degree:
Other:
35.9
21.2
16.9
18.0
7.1
0.6
0.1
0.2
Full-time student:
Part-time student:
Other student:
97.1 %
2.5 %
0.5 %
Relationship status:
Not in a relationship:
In a relationship but not living together:
In a relationship and living together:
55.5 %
39.3 %
5.2 %
Marital status:
Single:
Married/Partnered:
Separated/Divorced/Other:
95.6 %
3.4 %
1.0 %
7.3
86.7
5.4
0.2
0.3
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
4.9 %
%
%
%
%
%
%
%
%
%
%
Housing:
Campus residence hall:
Fraternity or sorority house:
Other university housing:
Parent/guardian home:
Other off-campus housing:
Other:
%
%
%
%
%
%
30.1
3.3
5.6
18.7
40.9
1.4