A C H A N C H A III

II
American College Health Association National College Health Assessment

SPRING 2023
Reference Group Executive Summary
Table of Contents
I. Introduction and Notes 1

II. Findings
A. General Health and Campus Climate 3
B. Nutrition, BMI, Physical Activity, and Food Security 3
C. Health Care Utilization 4
D. Impediments to Academic Performance 5
E. Violence, Abusive Relationships, and Personal Safety 7
F. Tobacco, Alcohol, and Other Drug Use 8
G. Sexual Behavior 11
H. Mental Health and Wellbeing 12
I. Acute Conditions 14
J. Ongoing or Chronic Conditions 15
K. Sleep 17

III. Demographics and Sample Characteristics 18

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.acha.org/NCHA.

Suggested citation for this document:

American College Health Association. American College Health Association-National College Health Assessment III: Reference Group
Executive Summary Spring 2023. Silver Spring, MD: American College Health Association; 2023.
Introduction and Notes

The ACHA-National College Health Assessment (ACHA-NCHA) 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 and
behaviors on the most prevalent health topics. 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.

ACHA initiated the original ACHA-NCHA in 2000 and the instrument was used nationwide through the Spring 2008 data collection period. A revised
survey, the ACHA-NCHA-II, was in use from Fall 2008 - Spring 2019 data collection periods. The survey was redesigned again, and data collection with
the ACHA-NCHA III began in Fall 2019.

Please note that it is not appropriate to compare trends between versions of the survey. Directly comparing data points between the Original ACHA-NCHA,
the ACHA-NCHA II, and the ACHA-NCHA III can lead to an erroneous conclusion and is not recommended.

Notes about this report:

1. Missing values have been excluded from analysis and only valid percents are included in this document, unless otherwise noted.

2. The ACHA-NCHA III is programmed differently than earlier versions of the survey. Rather than asking the respondents to answer every question
(and offering a "not applicable" option), display logic was used throughout the survey to determine whether, based on their response to an earlier question,
the student saw a follow-up question. This makes the valid percents of certain questions impossible to apply to the entire sample, as the denominator used
was limited to only the number of students that saw the question. When appropriate, results are also presented using the entire sample as the denominator
to show the proportion of the overall sample that experienced a particular issue. These differences in presentation are carefully noted throughout the
document and will often explain differences observed between this document and the full data report. Please look carefully at descriptions of the data
presented in each table, as well as any footnotes included.

3. About the use of sex and gender in this report: Survey results are reported by sex based on the responses to questions 67A, 67B, and 67C. The
responses to these questions are used to create a new variable called RSEX. RSEX is used for organizing results in the ACHA-NCHA report documents.
Respondents are reported as cis men or cis women only when their responses to 67A, 67B, and 67C are consistent with one another. If gender identity is
consistent with sex at birth AND "no" is selected for transgender, then respondents are designated as either cis men or cis women in RSEX. If respondents
select "yes" for transgender OR their sex at birth is not consistent with their gender identity, then they are designated as transgender/gender non-conforming
in RSEX. A respondent that selects "intersex" for sex at birth, "no" for transgender, and man or woman for gender identity are designated as cis men or cis
women in RSEX. A respondent that selects "intersex" for sex at birth, "yes" for transgender, or selects a gender identity other than man or woman are
designated as transgender/gender non-conforming in RSEX. A respondent that selects “another identity” on 67C is designated missing in RSEX. A
respondent that skips any of the three questions is designated as missing in RSEX. Totals displayed in this report include missing responses. Please see the
ACHA-NCHA III survey codebook for more information about how data on sex and gender are coded.

For additional information about the survey’s development, design, and methodology, email Mary T Hoban, PhD, MCHES, ([email protected]), Christine
Kukich, MS ([email protected]), or visit www.acha-ncha.org.

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We need to draw your attention to an important change in your ACHA‐NCHA Report documents. Beginning in Spring 2021, responses for transgender
and gender‐nonconforming students are readily available directly in the report documents. This represents an important change in the way we have been
reporting ACHA‐NCHA results. We’ve prepared the following information to better explain the specific changes, our reasoning for doing so, and tips for
using these redesigned report documents.

I. What we’ve done to date

ꞏ The ACHA‐NCHA has asked respondents about their gender identity for 12 years.
ꞏ Data on transgender and gender‐nonconforming (TGNC) students was available in the data file, but not displayed explicitly in the report documents
documents in an effort to protect the privacy of TGNC students, particularly those students in smaller campus environments and at schools that
publicly shared their ACHA‐NCHA report documents.
ꞏ We have been trying to find the right balance between protecting students’ privacy and making the results accessible to campus surveyors who may
not use the statistical software that would be required to extract this information directly from the data files. Until now, we’ve erred on the side of
protecting student privacy.

II. Why change?

ꞏ The number of TGNC students in our samples has been increasing over the years. Between 2008 and 2015, the number of students identifying as
TGNC was very small (less than 0.05%). We’ve learned over the years that gender identity is complex and fluid. To better capture this complexity, we
began asking separate questions about sex at birth and gender identity in Fall 2015. Now TGNC students tend to represent 3‐4% of the overall
sample.
ꞏ With greater number of students identifying as TGNC on the ACHA‐NCHA in recent years, we have a better opportunity to understand their needs
and behaviors than we have in years past.
ꞏ A number of health disparities between TGNC students and their cisgender peers have been well documented[1], and schools need readily available
access to this data in order to better address the needs of TGNC students.

III. What’s different about the way we are reporting?

ꞏ First – a note about how we have been reporting ACHA‐NCHA results to date. RSEX is a variable we create based on the responses to the questions
on sex at birth, whether or not a student identifies as transgender, and their gender identity. The RSEX variable had allowed us to sort respondents
into 4 groups for reporting purposes: male, female, non‐binary, and missing. (Details about this variable can be found in all report documents.)

ꞏ The value labels for RSEX have been revised to better represent gender identity rather than sex. A value of “1” has been changed from “Male” to “Cis
Men[2].” A “2” has been changed from “Female” to “Cis Women[3].” The value “3” has been changed from “non‐binary” to “Transgender and
Gender‐Nonconforming” (TGNC), as it’s a more accurate and inclusive term. The value “4” on RSEX remains “missing/unknown” and is used for
students who do not answer all three questions.
ꞏ The “missing/unknown” column in the Data Report document has been replaced with a “Trans/Gender‐Nonconforming” column. Because space
limitations in the report prevent us from displaying all 4 categories plus a total column in the same document, it’s now the “missing/unknown”
column that is not displayed. Now when the Total of any given row is higher than the sum of the cis men, cis women, and TGNC respondents, the
difference can be attributed to “missing/unknown” respondents that selected the response option presented in that row
ꞏ A column for “Trans/Gender‐Nonconforming” has been added the Executive Summary Report document.

IV. Important considerations with this new format

ꞏ Percentages in the Executive Summary may represent a very small number of TGNC students and can limit the generalizability of a particular finding.
To assist with the interpretation of the percentages displayed in the Executive Summary, the total sample size for each group has been added to
every page.
ꞏ We encourage ACHA‐NCHA surveyors to carefully review their report documents, particularly among the student demographic variables, and
consider students who may be inadvertently identified in the results based on a unique combination of the demographic characteristics before
sharing the documents widely or publicly. This is especially true for very small schools, as well as schools that lack diversity in the student
population.
ꞏ Think about the implication of working with and documenting very small samples – from the perspective of making meaningful interpretations, as
well as the privacy of respondents. This is true of all demographic variables, and not limited to gender identity. You may consider a minimum cell size
or another threshold by which you make decisions about making your Institutional Data Report publicly available. It is less of a concern in your
Institutional Executive Summary as we only display the percentages with the overall sample size.

[1] Greathouse M, BrckaLorenz A, Hoban M, Huseman R, Rankin S, Stolzenberg EB. (2018). Queer‐spectrum and trans‐spectrum student experiences in American higher
education: The analysis of national survey findings. New Brunswick, NJ: Tyler Clementi Center, Rutgers University.
[2] Cisgender refers to people whose gender identity matches their sex assigned at birth. Cis men is short for “cisgender men” and is a term used to describe persons who
identify as men and were assigned male at birth.
[3] Cis women is short for “cisgender women” and is a term used to describe persons who identify as women and were assigned female at birth.
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This Executive Summary highlights results of the ACHA-NCHA III Spring 2023 survey for Reference Group consisting of 78024 respondents.
The response rate was 11.0%.

Findings
Cis Men n = 21222
Cis Women n = 50882
A. General Health and Campus Climate Trans/GNC n = 4530

49.7 % of college students surveyed ( 60.1 % cis men, 47.2 % cis women, and 29.5 % transgender/gender non-conforming)
described their health as very good or excellent.

86.5 % of college students surveyed ( 90.1 % cis men, 86.4 % cis women, and 72.2 % transgender/gender non-conforming)
described their health as good, very good or excellent .

Proportion of college students who reported they agree or strongly agree that: Trans/
Cis Men Cis Women Gender Non- Total
Percent (%) conforming
I feel that I belong at my college/university 65.9 64.1 51.6 63.7
I feel that students’ health and well-being is a priority at my college/university 49.4 45.9 30.9 45.8
At my college/university, I feel that the campus climate encourages free and open discussion of students’
health and well-being. 58.0 56.0 42.7 55.5
At my college/university, we are a campus where we look out for each other 46.6 45.3 32.0 44.8

B. Nutrition, BMI, Physical Activity, and Food Security

Trans/
College students reported: Cis Men Cis Women Gender Non- Total
Percent (%) conforming
Drinking 0 sugar-sweetened beverages (per day), on average, in the last 7 days 35.9 29.6 24.9 31.1
Drinking 1 or more sugar-sweetened beverages (per day), on average, in the last 7 days 64.1 70.4 75.1 68.9
Drinking energy drinks or shots on 0 of the past 30 days 68.9 73.4 69.9 71.9
Drinking energy drinks or shots on 1-4 of the past 30 days 16.3 14.8 16.2 15.3
Drinking energy drinks or shots on 5 or more of the past 30 days 14.9 11.9 13.9 12.8
Eating 3 or more servings of fruits (per day), on average, in the last 7 days 17.3 16.8 15.4 17.0
Eating 3 or more servings of vegetables (per day), on average, in the last 7 days 29.1 29.3 28.8 29.2

Estimated 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.
Trans/
Cis Men Cis Women Gender Non- Total
BMI Percent (%) conforming
<18.5 Underweight 4.2 5.8 7.0 5.5
18.5-24.9 Healthy Weight 52.9 57.5 50.4 55.7
25-29.9 Overweight 29.0 20.3 21.2 22.8
30-34.9 Class I Obesity 9.0 9.3 11.5 9.4
35-39.9 Class II Obesity 3.2 4.1 5.3 3.9
≥40 Class III Obesity 1.7 3.0 4.6 2.7

Mean 25.10 24.92 25.70 25.02

Median 24.28 23.30 23.80 23.63
Std Dev 5.18 6.11 6.83 5.93

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Students meeting the recommended guidelines for physical activity
Based on: US Dept of Health and Human Services. Physical Activities Guidelines for Americans , 2nd edition. Cis Men n = 21222
Washington, DC: US Dept of Health and Human Services; 2018 Cis Women n = 50882
Trans/GNC n = 4530
Definitions:
Recommendation for aerobic activity: 150 minutes or more of moderate-intensity physical activity per week or 75 minutes of vigorous-intensity physical
activity or the equivalent combination

Recommendation for strength training: 2 or more days a week of moderate or greater intensity activities that involve all major muscle groups

Active Adults meet the recommendation for strength training AND aerobic activity
Highly Active Adults meet the recommendation for strength training and TWICE the recommendation for aerobic activity (300 minutes or more of moderate-
intensity physical activity per week or 150 minutes of vigorous-intensity physical activity or the equivalent combination)

Trans/
Cis Men Cis Women Gender Non- Total
Percent (%) conforming
Guidelines met for aerobic exercise only 76.3 69.2 62.2 70.8
Guidelines met for Active Adults 52.8 40.4 27.5 43.1
Guidelines met for Highly Active Adults 43.8 31.9 20.8 34.5

Food Security
Based on responses to the US Household Food Security Survey Module: Six-Item Short Form (2012)
from the USDA Economic Research Service.
Trans/
Cis Men Cis Women Gender Non- Total
Percent (%) conforming
High or marginal food security (score 0-1) 57.5 52.8 43.4 53.4
Low food security (score 2-4) 23.2 25.9 26.0 25.2
Very low food security (score 5-6) 19.3 21.3 30.6 21.3

Any food insecurity (low or very low food security) 42.5 47.2 56.6 46.6

C. Health Care Utilization

Trans/
College students reported: Cis Men Cis Women Gender Non- Total
Percent (%) conforming
Receiving psychological or mental health services within the last 12 months 24.1 41.9 65.2 38.4
*The services were provided by:
My current campus health and/or counseling center 42.7 38.6 37.5 39.2
A mental health provider in the local community near my campus 28.0 29.0 33.2 29.3
A mental health provider in my home town 40.7 47.5 47.5 46.3
A mental health provider not described above 14.9 14.8 17.1 15.1
*Only students who reported receiving care in the last 12 months were asked these questions
Trans/
Cis Men Cis Women Gender Non- Total
Percent (%) conforming
Visiting a medical provider within the last 12 months 58.1 75.5 79.9 70.9
*The services were provided by:
My current campus health center 33.6 33.7 37.0 33.9
A medical service provider in the local community near my campus 32.1 33.7 38.3 33.7
A medical service provider in my home town 67.0 72.5 67.8 70.9
A medical service provider not described above 6.9 5.9 8.3 6.3
*Only students who reported receiving care in the last 12 months were asked these questions

4
 Cis Men n = 21222
Cis Women n = 50882
Trans/GNC n = 4530

College students reported: Trans/

Cis Men Cis Women Gender Non- Total
Percent (%) conforming
Flu vaccine within the last 12 month 54.4 58.2 61.8 57.3
Not starting the HPV vaccine series 24.3 16.9 12.2 18.7
Starting, but not completing HPV vaccine series 3.5 4.9 5.5 4.5
Completing HPV vaccine series 42.5 57.8 59.0 53.6
Not knowing their HPV vaccine status 29.7 20.4 23.3 23.2
Ever having a GYN visit or exam (females only) 52.7 39.3
Having a dental exam in the last 12 months 67.4 72.5 64.3 70.5
Being tested for HIV within the last 12 months 10.3 12.6 16.5 12.2
Being tested for HIV more than 12 months ago 9.5 10.5 11.2 10.3
Wearing sunscreen usually or always when outdoors 21.1 48.5 35.4 40.1
Spending time outdoors with the intention of tanning at least once in the last 12 months 34.4 54.2 31.1 47.3

D. Impediments to Academic Performance

Respondents are asked in numerous places throughout the survey about issues that might have negatively impacted their academic performance within the last 12 months.
This is defined as negatively impacting their performance in a class or delaying progress towards their degree. Both types of negative impacts are represented in the figures
below. Please refer to the corresponding Data Report for specific figures on each type of impact. Figures in the left columns use all students in the sample as the
denominator. Figures in the right columns use only the students that experienced that issue (e.g. students who used cannabis, reported a problem or challenge with finances,
or experienced a particular health issue) in the denominator.
(items are listed in the order in which they appear in the survey)

Negatively impacted academic performance Negatively impacted academic performance

among all students in the sample among only students that experienced the issue
Trans/ Trans/
Cis Men Cis Women Gender Non- Total Cis Men Cis Women Gender Non- Total
Percent (%) conforming conforming
Alcohol use 2.3 1.9 2.7 2.1 3.3 2.5 3.6 2.8
Cannabis/marijuana use 2.8 1.6 4.8 2.1 8.4 4.4 9.8 5.9

Problems or challenges in the last 12 months

Career 13.9 13.8 18.2 14.0 38.0 37.0 40.8 37.6
Finances 15.8 17.1 24.3 17.1 36.2 33.2 40.7 34.5
Procrastination 45.5 46.3 60.4 46.6 65.1 62.8 72.0 64.0
Faculty 7.3 7.1 12.2 7.4 57.8 56.2 61.3 57.1
Family 8.4 12.3 20.3 11.7 30.8 30.6 35.7 31.2
Intimate Relationships 11.9 12.5 14.5 12.4 33.0 32.4 32.9 32.6
Roommate/housemate 5.3 7.2 10.2 6.8 24.8 24.0 29.8 24.6
Peers 4.7 5.4 9.9 5.5 24.2 22.5 28.4 23.4
Personal appearance 5.0 7.3 11.5 6.9 13.2 12.7 16.6 13.2
Health of someone close to me 9.0 12.0 15.8 11.4 26.8 28.4 31.8 28.3

Death of a family member, friend, or someone close to me 7.9 11.1 13.8 10.3 37.3 43.4 52.3 42.6
Bullying 1.6 2.4 4.1 2.3 33.6 33.2 36.5 34.0
Cyberbullying 0.9 0.9 2.0 1.0 30.8 29.9 31.7 30.8
Hazing 0.6 0.4 0.8 0.5 42.0 42.7 53.0 43.8
Microaggression 2.3 3.3 10.2 3.5 17.6 17.0 21.5 18.0
Sexual Harassment 0.7 2.7 5.4 2.3 22.5 21.5 27.5 22.4
Discrimination 2.7 3.1 9.0 3.4 27.1 26.5 32.2 27.6

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 Cis Men n = 21222
Cis Women n = 50882
Trans/GNC n = 4530

Negatively impacted academic performance Negatively impacted academic performance

among all students in the sample among only students that experienced the issue
Trans/ Trans/
Cis Men Cis Women Gender Non- Total Cis Men Cis Women Gender Non- Total
Percent (%) conforming conforming
Acute Diagnoses in the last 12 months
Bronchitis 0.9 2.0 2.2 1.7 45.0 52.4 59.0 51.4
Chlamydia 0.1 0.2 0.3 0.2 12.9 18.1 24.1 17.3
Chicken Pox (Varicella) 0.1 0.0 0.2 0.1 23.7 5.8 38.5 14.3
Cold/Virus or other respiratory illness 10.7 19.3 20.2 16.9 41.5 49.9 55.5 48.6
Concussion 1.1 1.8 2.3 1.6 58.0 65.0 70.7 64.0
Gonorrhea 0.1 0.0 0.2 0.1 15.9 15.1 29.0 16.9
Flu (influenza or flu-like illness) 5.5 8.2 8.6 7.4 47.8 56.9 63.5 55.2
Mumps 0.1 0.0 0.3 0.0 16.9 13.6 52.2 20.3
Mononucleosis (mono) 0.7 1.0 1.2 0.9 55.7 62.4 60.7 60.7
Orthopedic injury 2.3 3.0 4.7 2.9 30.8 32.9 49.3 33.7
Pelvic Inflammatory Disease 0.1 0.1 0.4 0.1 23.0 38.0 44.7 35.9
Pneumonia 0.5 0.7 1.0 0.7 51.0 59.7 63.8 57.9
Shingles 0.1 0.1 0.3 0.1 27.9 24.3 48.3 27.5
Stomach or GI virus or bug, food poisoning or gastritis 2.2 5.0 6.2 4.2 38.7 46.2 52.9 45.5
Urinary tract infection 0.2 2.9 3.0 2.1 28.0 22.3 30.5 23.0

Trans/ Trans/
Cis Men Cis Women Gender Non- Total Cis Men Cis Women Gender Non- Total
Percent (%) conforming conforming
Any ongoing or chronic medical conditions diagnosed
or treated in the last 12 months 19.3 32.1 55.8 29.8 29.8 41.1 63.8 40.1

Other impediments to academic performance

Assault (physical) 0.4 1.0 1.6 0.8 15.0 29.4 29.4 26.2
Assault (sexual) 0.4 2.8 5.7 2.3 20.3 33.6 44.8 33.8
Allergies 2.8 3.6 4.5 3.4 9.2 9.8 11.3 9.8
Anxiety 22.8 37.1 54.9 34.0 44.6 51.6 64.4 51.2
ADHD or ADD 10.0 12.1 30.8 12.6 64.5 67.9 77.4 68.5
Concussion or TBI 1.3 1.9 2.8 1.8 47.5 53.4 57.3 52.5
Depression 16.9 25.2 51.3 24.3 53.1 58.6 70.6 58.8
Eating disorder/problem 1.8 4.8 8.9 4.2 26.0 26.7 30.0 27.0
Headaches/migraines 5.7 13.5 17.5 11.5 24.8 34.7 39.1 33.3
Influenza or influenza-like illness (the flu) 4.5 6.8 8.2 6.2 32.2 38.3 44.1 37.3
Injury 2.5 2.7 4.5 2.7 21.7 26.6 34.3 25.9
PMS 0.1 13.0 15.1 9.5 20.8 29.8 39.3 30.5
PTSD 1.7 4.4 12.8 4.2 44.0 45.8 55.3 47.2
Short-term illness 3.6 6.3 9.7 5.7 27.8 32.9 41.7 32.6
Upper respiratory illness 5.4 10.9 13.2 9.4 27.3 33.6 38.8 32.7
Sleep difficulties 19.6 23.8 38.6 23.4 45.5 47.0 57.3 47.5
Stress 29.8 43.3 58.9 40.2 46.1 53.7 67.9 53.0

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 Cis Men n = 21222
Cis Women n = 50882
Trans/GNC n = 4530
E. Violence, Abusive Relationships, and Personal Safety
Within the last 12 months, college students reported experiencing: Trans/
Cis Men Cis Women Gender Non- Total
Percent (%) conforming
A physical fight 3.8 1.3 2.8 2.1
A physical assault (not sexual assault) 2.5 2.0 3.7 2.3
A verbal threat 13.2 10.3 20.8 11.8
Sexual touching without their consent 3.2 7.4 10.1 6.4
Sexual penetration attempt without their consent 1.0 2.6 3.7 2.2
Sexual penetration without their consent 0.8 1.9 3.1 1.7
Being a victim of stalking 2.1 5.0 7.6 4.4
A partner called me names, insulted me, or put me down to make me feel bad 9.4 10.8 10.8 10.4
A partner often insisted on knowing who I was with and where I was or tried to limit my contact with
family or friends 5.4 5.6 5.8 5.6

A partner pushed, grabbed, shoved, slapped, kicked, bit, choked or hit me without my consent 2.8 2.7 3.4 2.8

A partner forced me into unwanted sexual contact by holding me down or hurting me in some way 1.1 1.7 2.9 1.7
A partner pressured me into unwanted sexual contact by threatening me, coercing me, or using alcohol or
other drugs 1.6 3.3 5.4 3.0

College students reported feeling very safe :

Trans/
Cis Men Cis Women Gender Non- Total
Percent (%) conforming
On their campus (daytime) 79.6 69.5 62.7 71.8
On their campus (nighttime) 45.8 18.5 18.7 26.1
In the community surrounding their campus (daytime) 50.7 37.3 31.3 40.6
In the community surrounding their campus (nighttime) 26.7 10.1 9.4 14.7

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 Cis Men n = 21222
Cis Women n = 50882
Trans/GNC n = 4530

F. Tobacco, Alcohol, and Other Drug Use

Ever Used *Used in the last 3 months
Trans/ Trans/
Cis Men Cis Women Gender Non- Total Cis Men Cis Women Gender Non- Total
Percent (%) conforming conforming
Tobacco or nicotine delivery products (cigarettes, e-
cigarettes, Juul or other vape products, water pipe or
hookah, chewing tobacco, cigars, etc.) 35.4 33.0 35.0 33.7 23.3 20.5 22.2 21.2
Alcoholic beverages (beer, wine, liquor, etc.) 68.2 73.7 73.4 72.0 62.2 68.1 65.2 65.9
Cannabis (marijuana, weed, hash, edibles, vaped cannabis,
etc.) [Please report nonmedical use only.] 41.6 45.2 58.4 45.0 28.0 30.3 44.8 30.4
Cocaine (coke, crack, etc.) 8.1 6.6 7.9 7.1 2.6 1.8 2.3 2.0
Prescription stimulants (Ritalin, Concerta, Dexedrine,
Adderall, diet pills, etc.) [Please report nonmedical use
only.] 9.6 7.7 10.1 8.4 3.1 2.4 3.8 2.7
Methamphetamine (speed, crystal meth, ice, etc.) 1.6 1.0 2.0 1.3 0.3 0.1 0.6 0.2

Inhalants (poppers, nitrous, glue, gas, paint thinner, etc.) 6.1 3.3 9.1 4.5 2.1 1.0 4.0 1.5
Sedatives or Sleeping Pills (Valium, Ativan, Xanax,
Klonopin, Librium, Rohypnol, GHB, etc.) [Please report
nonmedical use only.] 5.7 4.9 7.8 5.3 1.6 1.6 2.7 1.7
Hallucinogens (Ecstasy, MDMA, Molly, LSD, acid,
mushrooms, PCP, Special K, etc.) 14.0 10.2 18.8 11.8 5.2 3.4 8.2 4.2
Heroin 0.8 0.5 1.4 0.6 0.2 0.1 0.5 0.1
Prescription opioids (morphine, codeine, fentanyl,
oxycodone [OxyContin, Percocet], hydrocodone
[Vicodin], methadone, buprenorphine [Suboxone], etc.)
[Please report nonmedical use only.] 4.5 3.1 5.8 3.7 0.6 0.4 1.2 0.5
*These figures use all students in the sample as the denominator, rather than just those students who reported lifetime use.

Substance Specific Involvement Scores (SSIS) from the ASSIST

*Moderate risk use of the substance *High risk use of the substance
Trans/ Trans/
Cis Men Cis Women Gender Non- Total Cis Men Cis Women Gender Non- Total
Percent (%) conforming conforming
Tobacco or nicotine delivery products 16.1 14.2 16.4 14.8 1.2 1.1 1.5 1.2
Alcoholic beverages 11.7 11.7 12.1 11.6 1.5 1.1 1.6 1.2
Cannabis (nonmedical use) 17.6 19.0 30.9 19.2 1.6 1.0 3.2 1.3
Cocaine 1.5 1.1 1.4 1.2 0.1 0.1 0.2 0.1
Prescription stimulants (nonmedical use) 1.5 1.4 2.1 1.4 0.1 0.0 0.5 0.1
Methamphetamine 0.3 0.2 0.5 0.3 0.1 0.0 0.2 0.1
Inhalants 0.9 0.4 1.6 0.6 0.1 0.0 0.2 0.1
Sedatives or Sleeping Pills (nonmedical use) 1.0 1.0 1.9 1.1 0.1 0.1 0.4 0.1
Hallucinogens 2.4 1.6 4.3 2.0 0.1 0.0 0.3 0.1
Heroin 0.2 0.1 0.4 0.2 0.1 0.0 0.3 0.1
Prescription opioids (nonmedical use) 0.5 0.5 0.9 0.5 0.1 0.0 0.3 0.1
*These figures use all students in the sample as the denominator, rather than just those students who reported lifetime use.

8
 Cis Men n = 21222
Cis Women n = 50882
Trans/GNC n = 4530

*Proportion of students who were prescribed a medication and used more than prescribed or more often than prescribed in the past 3 months
Trans/
Cis Men Cis Women Gender Non- Total
Percent (%) conforming
Prescription stimulants 2.0 1.5 2.4 1.7
Prescription sedatives or sleeping pills 1.2 1.1 2.1 1.2
Prescription opioids 0.4 0.3 0.7 0.4
*These figures use all students in the sample as the denominator, rather than just those students who reported having a prescription. Note that
the title of this table was changed in Fall 2022, but the figures remain the same.

*Tobacco or nicotine delivery products used in the last 3 months

Trans/
Cis Men Cis Women Gender Non- Total
Percent (%) conforming
Cigarettes 11.0 8.4 12.3 9.3
E-cigarettes or other vape products (for example: Juul,
etc.) 15.5 16.3 16.3 15.9
Water pipe or hookah 2.3 1.6 2.1 1.8
Chewing or smokeless tobacco 3.8 0.6 1.0 1.5
Cigars or little cigars 5.3 1.0 1.8 2.2
Other 1.0 0.3 0.8 0.5
*These figures use all students in the sample as the denominator, rather than just those students who reported
tobacco or nicotine delivery product use in the last 3 months.

Students in Recovery

2.5 % of college students surveyed ( 2.8 % cis men, 2.0 % cis women, and 5.7 % transgender/gender non-conforming)
indicated they were in recovery from alcohol or other drug use.

When, if ever, was the last time you:

Drank Alcohol *Used Cannabis/Marijuana
Trans/ Trans/
Cis Men Cis Women Gender Non- Total Cis Men Cis Women Gender Non- Total
Percent (%) conforming conforming
Never 24.2 19.1 19.0 20.6 53.6 49.5 36.9 50.0
Within the last 2 weeks 48.2 50.9 43.0 49.6 17.8 18.2 30.5 18.8
More than 2 weeks ago but within the last 30 days 8.3 10.2 11.4 9.8 3.8 4.4 6.0 4.3
More than 30 days ago but within the last 3 months 8.2 9.2 11.9 9.1 5.9 6.5 7.7 6.4
More than 3 months ago but within the last 12 months 6.2 6.5 8.5 6.5 7.0 7.9 8.7 7.7
More than 12 months ago 4.9 4.0 6.2 4.4 11.9 13.5 10.1 12.8
*Students were instructed to include medical and non-medical use of cannabis.

Driving under the influence

14.5 % of college students reported driving after having any alcohol in the last 30 days.*
*Only students who reported driving in the last 30 days and drinking alcohol in the last 30 days were asked this question.

29.5 % of college students reported driving within 6 hours of using cannabis/marijuana in the last 30 days.*
*Only students who reported driving in the last 30 days and using cannabis in the last 30 days were asked this question.

Estimated Blood Alcohol Concentration (or eBAC) of college students. 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 drank alcohol in a social setting, their approximate time of consumption, sex, weight, and the average rate of ethanol
metabolism. Only students who reported drinking alcohol within the last 3 months answered these questions.

Trans/
Cis Men Cis Women Gender Non- Total
Estimated BAC Percent (%) conforming
< .08 84.1 82.0 85.4 82.7
< .10 88.6 87.3 89.1 87.7

Mean 0.04 0.04 0.04 0.04

Median 0.02 0.02 0.02 0.02
Std Dev 0.05 0.05 0.05 0.05

9
 Cis Men n = 21222
Cis Women n = 50882
Trans/GNC n = 4530
*Reported number of drinks consumed the last time students drank alcohol in a social setting.

Trans/
Cis Men Cis Women Gender Non- Total
Number of drinks Percent (%) conforming
4 or fewer 69.9 82.3 83.3 79.2
5 8.2 7.5 6.3 7.6
6 6.7 4.3 4.1 4.9
7 or more 15.2 5.8 6.2 8.3

Mean 3.9 2.9 2.8 3.1

Median 3.0 2.0 2.0 2.0
Std Dev 3.8 2.3 2.5 2.8
*Only students who reported drinking alcohol in the last three months were asked this question.

Reported number of times college students consumed five or more drinks in a sitting
within the last two weeks:
*Among those who reported drinking alcohol
Among all students surveyed within the last two weeks
Trans/ Trans/
Cis Men Cis Women Gender Non- Total Cis Men Cis Women Gender Non- Total
Percent (%) conforming conforming
Did not drink alcohol in the last two weeks (includes non-
drinkers) 51.9 49.1 57.1 50.5
None 23.1 27.3 26.1 26.0 48.0 53.6 60.9 52.5
1-2 times 18.3 18.7 13.4 18.2 38.0 36.7 31.3 36.7
3-5 times 5.6 4.3 2.7 4.6 11.7 8.5 6.3 9.2
6 or more times 1.1 0.6 0.6 0.8 2.4 1.2 1.5 1.5
*Only students who reported drinking alcohol in the last two weeks were asked this question.

*College students who drank alcohol reported experiencing the following in the last 12 months when drinking alcohol:

Trans/
Cis Men Cis Women Gender Non- Total
Percent (%) conforming
Did something I later regretted 18.4 19.9 17.4 19.4
Blackout (forgot where I was or what I did for a large period of time and cannot remember, even when
someone reminds me) 10.9 11.0 9.4 10.8
Brownout (forgot where I was or what I did for short periods of time, but can remember once someone
reminds me) 19.9 23.0 20.0 21.9
Got in trouble with the police 0.9 0.6 0.9 0.7
Got in trouble with college/university authorities 1.0 0.6 1.2 0.8
Someone had sex with me without my consent 0.7 1.8 2.2 1.6
Had sex with someone without their consent 0.2 0.2 0.6 0.2
Had unprotected sex 10.8 11.0 9.0 10.8
Physically injured myself 6.0 6.9 8.4 6.8
Physically injured another person 0.7 0.4 0.8 0.5
Seriously considered suicide 2.7 2.2 6.8 2.6
Needed medical help 1.1 1.0 1.5 1.0

Reported two or more of the above 22.3 24.1 22.6 23.5

*Only students who reported drinking alcohol in the last 12 months were asked these questions.

10
 Cis Men n = 21222
Cis Women n = 50882
Trans/GNC n = 4530
G. Sexual Behavior
When, if ever, was the last time you had: Oral sex Vaginal intercourse
Trans/ Trans/
Cis Men Cis Women Gender Non- Total Cis Men Cis Women Gender Non- Total
Percent (%) conforming conforming
Never 36.6 34.6 34.5 35.3 43.3 36.0 47.8 38.9
Within the last 2 weeks 29.4 31.5 27.7 30.6 29.7 35.9 22.7 33.3
More than 2 weeks ago but within the last 30 days 7.1 8.2 7.6 7.8 5.2 6.9 5.5 6.3
More than 30 days ago but within the last 3 months 8.6 9.4 10.5 9.2 6.8 7.7 7.2 7.4
More than 3 months ago but within the last 12 months 9.1 8.6 9.9 8.8 7.1 6.9 6.9 7.0
More than 12 months ago 9.2 7.8 9.8 8.3 7.9 6.6 9.9 7.1

Anal intercourse
Trans/
Cis Men Cis Women Gender Non- Total
Percent (%) conforming
Never 78.4 82.6 76.0 81.1
Within the last 2 weeks 4.3 1.6 3.9 2.5
More than 2 weeks ago but within the last 30 days 1.7 1.0 1.8 1.2
More than 30 days ago but within the last 3 months 2.7 1.9 3.4 2.2
More than 3 months ago but within the last 12 months 3.8 3.4 4.6 3.6
More than 12 months ago 9.0 9.5 10.2 9.4

*College students who reported having oral sex, or vaginal or anal intercourse within the last 12 months reported having the following
number of sexual partners:
Trans/
Cis Men Cis Women Gender Non- Total
Percent (%) conforming
None 0.5 0.3 0.5 0.4
1 69.0 72.8 62.1 71.1
2 11.0 11.7 15.8 11.8
3 6.6 6.0 7.1 6.2
4 or more 12.8 9.1 14.6 10.5

Mean 2.2 1.7 2.3 1.9

Median 1.0 1.0 1.0 1.0
Std Dev 4.0 1.9 3.9 2.8
*Only students who reported having oral sex, or vaginal or anal intercourse in the last 12 months were asked this question.

College students who reported having oral sex, or vaginal or anal intercourse within the last 30 days who reported using a condom or
another protective barrier most of the time or always:

Trans/
Cis Men Cis Women Gender Non- Total
Percent (%) conforming
Oral sex 5.2 4.7 4.2 4.8
Vaginal intercourse 42.0 36.3 40.3 37.8
Anal intercourse 29.1 19.1 28.3 24.5
*Only students who reported having oral sex, or vaginal or anal intercourse in the last 30 days were asked these questions.

College students who reported having vaginal intercourse (penis in vagina) within the last 12 months were asked if they or their partner used
any method to prevent pregnancy the last time they had vaginal intercourse:

Trans/
Cis Men Cis Women Gender Non- Total
Percent (%) conforming
Yes, used a method of contraception 81.8 84.4 81.1 83.5
No, did not want to prevent pregnancy 3.6 2.4 2.5 2.7
No, did not use any method 12.7 12.6 14.9 12.7
Don't know 1.9 0.6 1.5 1.0
*Only students who reported having oral sex, or vaginal or anal intercourse in the last 12 months were asked this question.

11
 Cis Men n = 21222
Cis Women n = 50882
Trans/GNC n = 4530

*Those students who reported using a contraceptive use the last time they had vaginal intercourse, reported they (or their partner) used the following
methods:
Trans/
Cis Men Cis Women Gender Non- Total
Percent (%) conforming
Birth control pills (monthly or extended cycle) 40.1 39.0 28.5 38.8
Birth control shots 1.9 1.6 1.8 1.7
Birth control implants 7.8 7.3 8.4 7.5
Birth control patch 1.0 1.0 1.2 1.0
The ring 1.6 2.3 2.2 2.1
Emergency contraception ("morning after pill" or "Plan B") 5.2 5.5 4.4 5.4
Intrauterine device 15.4 18.7 21.5 18.0
Male (external) condom 54.3 45.9 53.4 48.3
Female (internal) condom 0.3 0.2 0.8 0.3
Diaphragm or cervical cap 0.1 0.0 0.1 0.1
Contraceptive sponge 0.0 0.0 0.1 0.0
Withdrawal 15.8 21.4 17.0 19.8
Fertility awareness (calendar, mucous, basal body temperature) 3.4 5.8 6.4 5.2
Sterilization (hysterectomy, tubes tied, vasectomy) 2.7 2.9 4.7 3.0
Other method 1.1 1.0 3.3 1.2

Male condom use plus another method 29.2 29.3 31.5 29.4
Any two or more methods (excluding male condoms) 17.2 20.5 18.8 19.6
*Only students who reported they or their partner used a method the last time they had vaginal intercourse were asked these questions.

College students who reported having vaginal intercourse (penis in vagina) within the last 12 months were asked if they or their partner used emergency
contraception ("morning after pill" or "Plan B") in the last 12 months:
Yes ( 16.4 % cis men, 19.1 % cis women, 16 % trans/gender non-conforming)

College students who reported having vaginal intercourse (penis in vagina) within the last 12 months were asked if they experienced an unintentional
pregnancy or got someone pregnant within the last 12 months:
Yes ( 1.1 % cis men, 1.3 % cis women, 2.2 % trans/gender non-conforming)

H. Mental Health and Wellbeing

Kessler 6 (K6) Non-Specific Psychological Distress Score (Range is 0-24)

Trans/
Cis Men Cis Women Gender Non- Total
Percent (%) conforming
No or low psychological distress (0-4) 33.5 24.4 8.8 25.9
Moderate psychological distress (5-12) 51.1 54.0 48.9 52.9
Serious psychological distress (13-24) 15.4 21.6 42.2 21.2

Mean 7.40 8.57 11.61 8.45

Median 7.00 8.00 12.00 8.00
Std Dev 5.10 5.17 5.24 5.25

UCLA Loneliness Scale (ULS3) Score (Range is 3-9)

Trans/
Cis Men Cis Women Gender Non- Total
Percent (%) conforming
Negative for loneliness (3-5) 51.0 50.1 33.6 49.2
Positive for loneliness (6-9) 49.0 49.9 66.4 50.8

Mean 5.43 5.47 6.26 5.51

Median 5.00 5.00 6.00 6.00
Std Dev 1.92 1.85 1.89 1.88

12
Diener Flourishing Scale – Psychological Well-Being (PWB) Score (Range is 8-56)
(higher scores reflect a higher level of psychological well-being) Cis Men n = 21222
Trans/ Cis Women n = 50882
Cis Men Cis Women Gender Non- Total Trans/GNC n = 4530
conforming
Mean 44.46 45.39 40.73 44.82
Median 47.00 47.00 42.00 47.00
Std Dev 9.04 8.27 9.45 8.66

The Connor-Davison Resilience Scale (CD-RISC2) Score (Range is 0-8)

(higher scores reflect greater resilience)
Trans/
Cis Men Cis Women Gender Non- Total
conforming
Mean 6.24 6.00 5.43 6.03
Median 6.00 6.00 6.00 6.00
Std Dev 1.54 1.54 1.71 1.57

Self injury
11.0 % of college students surveyed ( 7.0 % cis men, 10.7 % cis women, and 31.2 % trans/gender non-conforming)
indicated they had intentionally cut, burned, bruised, or otherwise injured themselves within the last 12 months.

*Of those reporting this issue, it caused

Within the last 12 months, have you had problems or challenges with any of the following: moderate or high distress
Trans/ Trans/
Cis Men Cis Women Gender Non- Total Cis Men Cis Women Gender Non- Total
Percent (%) conforming conforming
Academics 44.3 48.0 60.0 47.8 82.4 88.7 89.1 87.0
Career 37.0 37.8 45.0 38.0 72.6 76.5 76.2 75.5
Finances 44.1 52.1 60.0 50.3 72.9 78.7 83.7 77.7
Procrastination 70.6 74.4 84.5 73.9 59.0 66.4 72.3 64.9
Faculty 12.9 12.7 20.1 13.3 49.8 54.9 57.3 53.8
Family 27.6 40.8 57.7 38.2 57.2 68.2 74.2 66.6
Intimate relationships 36.6 39.0 44.7 38.6 62.5 64.7 66.5 64.3
Roommate/housemate 21.7 30.3 34.9 28.2 47.8 59.2 59.3 56.8
Peers 19.6 24.6 35.6 23.9 39.7 46.9 49.2 45.5
Personal appearance 38.8 57.9 69.8 53.3 45.5 59.8 62.5 57.2
Health of someone close to me 34.1 42.9 50.1 40.9 56.8 65.0 64.8 63.1
21.3 25.9 26.7 24.7 65.7 75.9 75.7 73.4
Death of a family member, friend, or someone close to me
Bullying 4.8 7.2 11.3 6.9 48.7 57.5 61.5 56.5
Cyberbullying 2.8 2.9 6.5 3.2 43.2 52.0 52.4 50.1
Hazing 1.5 1.0 1.5 1.2 45.1 49.5 60.6 49.1
Microaggression 13.0 19.9 47.7 19.8 28.7 37.4 44.0 37.0
Sexual Harassment 3.2 12.8 19.9 10.6 42.6 53.8 59.8 53.6
Discrimination 10.1 11.8 28.3 12.4 42.3 49.7 59.0 49.5
*Only students who reported a problem or challenge in the last 12 months were asked about level of distress.

Students reporting none of the above 10.1 5.6 1.9 6.7

Students reporting only one of the above 10.0 6.4 2.5 7.1
Students reporting 2 of the above 12.3 9.0 4.6 9.6
Students reporting 3 or more of the above 67.6 79.0 91.1 76.6

13
Suicide Behavior Questionnaire-Revised (SBQR) Screening Score (Range is 3-18) Cis Men n = 21222
Cis Women n = 50882
Trans/ Trans/GNC n = 4530
Cis Men Cis Women Gender Non- Total
Percent (%) conforming
Negative suicidal screening (3-6) 76.9 72.8 37.6 71.7
Positive suicidal screening (7-18) 23.1 27.2 62.4 28.3

Mean 5.04 5.31 8.22 5.42

Median 4.00 4.00 8.00 4.00
Std Dev 2.91 3.05 3.83 3.16

Suicide attempt
2.3 % of college students surveyed ( 2.6 % cis men, 1.9 % cis women, and
5.1 % trans/gender non-conforming) indicated they had attempted suicide within the last 12 months.

Within the last 30 days, how would you rate the overall level of stress experienced:

Trans/
Cis Men Cis Women Gender Non- Total
Percent (%) conforming
No stress 3.1 0.7 0.8 1.4
Low 30.4 17.3 12.3 20.6
Moderate 47.0 51.1 47.6 49.7
High 19.5 30.9 39.4 28.3

I. Acute Conditions
College students reported being diagnosed by a healthcare professional within the last 12 months with:

Trans/
Cis Men Cis Women Gender Non- Total
Percent (%) conforming
Bronchitis 2.2 3.9 3.7 3.4
Chlamydia 1.0 1.2 1.4 1.2
Chicken Pox (Varicella) 0.5 0.4 0.6 0.4
Cold/virus or other respiratory illness (for example: sinus
infection, ear infection, strep throat, tonsillitis,
pharyngitis, or laryngitis) 26.1 39.3 36.7 35.4
Concussion 2.0 2.9 3.5 2.7
Gonorrhea 0.7 0.4 0.7 0.5
Flu (influenza) or flu-like illness 11.9 14.7 13.8 13.9
Mumps 0.3 0.2 0.6 0.3
Mononucleosis (mono) 1.3 1.6 2.0 1.6
Orthopedic injury (for example: broken bone, fracture,
sprain, bursitis, tendinitis, or ligament injury) 7.6 9.2 9.6 8.8
Pelvic Inflammatory Disease 0.3 0.4 0.8 0.4
Pneumonia 0.9 1.3 1.6 1.2
Shingles 0.5 0.4 0.7 0.5
Stomach or GI virus or bug, food poisoning or gastritis 5.8 10.9 11.9 9.6
Urinary tract infection 0.9 13.3 10.1 9.7

14
 Cis Men n = 21222
Cis Women n = 50882
J. Ongoing or Chronic Conditions Trans/GNC n = 4530

The questions for the ongoing or chronic conditions are presented differently in this report than the order they appear in the survey. In the survey, all items appear in
a single list, ordered alphabetically. In this report, the conditions are presented in groups to ease burden on the reader. The findings are divided into mental health
conditions, STIs and other chronic infections, and other ongoing or chronic conditions in this report.

*Of those ever diagnosed, those reporting

College students reported ever being contact with healthcare or MH professional
Mental Health diagnosed with the following: within last 12 months
Trans/ Trans/
Cis Men Cis Women Gender Non- Total Cis Men Cis Women Gender Non- Total
Percent (%) conforming conforming

ADD/ADHD - Attention Deficit/Hyperactivity Disorder 12.0 12.6 29.6 13.5 60.4 76.7 77.9 72.8
Alcohol or Other Drug-Related Abuse or Addiction 1.7 1.3 3.6 1.6 44.8 43.3 50.3 44.7
Anxiety (for example: Generalized Anxiety, Social
Anxiety, Panic Disorder, Specific Phobia) 18.9 40.4 62.6 35.8 68.0 78.7 82.7 77.6
Autism Spectrum 2.6 1.3 12.5 2.4 39.9 58.9 62.8 54.3
Bipolar and Related Conditions (for example: Bipolar I, II,
Hypomanic Episode) 1.5 2.9 7.8 2.8 62.9 76.3 75.0 73.9
Borderline Personality Disorder (BPD), Avoidant
Personality, Dependent Personality, or another personality
disorder 0.6 1.5 6.2 1.5 55.6 70.4 70.9 68.7
Depression (for example: Major depression, persistent
depressive disorder, disruptive mood disorder) 16.0 30.1 57.4 27.9 67.2 77.9 80.2 76.5
Eating Disorders (for example: Anorexia Nervosa, Bulimia
Nervosa, Binge-Eating) 1.4 8.4 15.5 6.9 44.8 54.2 53.8 53.6
Gambling Disorder 0.2 0.1 0.4 0.1 25.0 23.1 50.0 27.8
Insomnia 4.3 7.8 16.7 7.4 51.8 59.7 60.6 58.6
Obsessive-Compulsive and Related Conditions (for
example: OCD, Body Dysmorphia, Hoarding,
Trichotillomania and other body-focused repetitive
behavior disorders) 2.7 7.5 14.7 6.6 55.4 68.1 68.6 66.8
PTSD (Posttraumatic Stress Disorder), Acute Stress
Disorder, Adjustment Disorder, or another trauma- or
stressor- related condition 3.2 9.4 22.8 8.6 66.3 73.0 77.8 73.0
Schizophrenia and Other Psychotic Conditions (for
example: Schizophrenia, Schizoaffective Disorder,
Schizophreniform Disorder, Delusional Disorder) 0.4 0.2 2.0 0.4 54.1 53.4 71.6 60.1
Tourette’s or other neurodevelopmental condition not
already listed 0.5 0.4 2.0 0.5 32.7 47.1 52.8 45.1
Traumatic brain injury (TBI) 1.3 1.2 2.2 1.3 34.4 41.2 34.0 38.7
*Only students who reported ever being diagnosed were asked about contact with a healthcare or mental health professional within the last 12 months.

Trans/
Cis Men Cis Women Gender Non- Total
Percent (%) conforming
Students reporting none of the above 68.5 50.7 25.8 54.0
Students reporting only one of the above 13.4 14.7 11.5 14.1
Students reporting both Depression and Anxiety 11.8 26.2 51.0 23.8

Students reporting any two or more of the above

(excluding the combination of Depression and Anxiety) 6.4 8.4 11.7 8.1

15
 Cis Men n = 21222
Cis Women n = 50882
Trans/GNC n = 4530

*Of those ever diagnosed, had contact with

College students reported ever being healthcare or MH professional within last 12
STI's/Other chronic infections diagnosed with the following: months
Trans/ Trans/
Cis Men Cis Women Gender Non- Total Cis Men Cis Women Gender Non- Total
Percent (%) conforming conforming
Genital herpes 0.6 1.3 1.3 1.1 36.6 45.3 42.1 44.1
Hepatitis B or C 0.4 0.2 0.3 0.3 43.1 36.4 46.2 40.1
HIV or AIDS 0.2 0.1 0.5 0.2 64.0 34.2 56.5 51.3
Human papillomavirus (HPV) or genital warts 0.7 2.4 1.4 1.9 29.7 47.2 50.0 45.4
*Only students who reported ever being diagnosed were asked about contact with a healthcare or mental health professional within the last 12 months.

*Of those ever diagnosed, had contact with

College students reported ever being healthcare or MH professional within last 12
Other Chronic /Ongoing Medical Conditions diagnosed with the following: months
Trans/ Trans/
Cis Men Cis Women Gender Non- Total Cis Men Cis Women Gender Non- Total
Percent (%) conforming conforming
Acne 23.9 32.0 31.0 29.7 29.4 45.9 30.4 41.2
Allergies - food allergy 9.7 14.1 17.9 13.1 24.1 33.6 24.3 30.9
Allergies - animals/pets 12.1 14.6 17.4 14.2 19.2 28.7 21.9 26.0
Allergies - environmental (for example: pollen, grass, dust,
mold) 25.7 31.6 34.3 30.2 22.3 30.5 22.8 28.0
Asthma 14.2 16.3 20.7 16.0 25.8 39.4 33.9 35.6
Cancer 0.8 0.9 0.9 0.8 60.9 63.0 62.2 62.3
Celiac disease 0.4 1.3 1.7 1.1 40.7 58.1 44.0 54.3
Chronic pain (for example: back or joint pain, arthritis,
nerve pain) 4.6 8.6 16.5 8.0 64.0 72.0 68.9 70.4
Diabetes or pre-diabetes/insulin resistance 2.1 3.1 3.8 2.9 74.7 74.2 63.3 73.5
Endometriosis 0.1 2.6 3.3 2.0 15.4 62.6 60.8 61.5

Gastroesophageal Reflux Disease (GERD) or acid reflux 3.8 6.4 8.5 5.8 46.5 54.8 47.0 52.5

Heart & vascular disorders (for example: atrial fibrillation

or other cardiac arrhythmia, mitral valve prolapse or other
valvular heart disease, congenital heart condition) 2.0 2.7 3.9 2.6 53.3 61.1 56.6 59.3
High blood pressure (hypertension) 4.5 2.6 3.3 3.1 65.6 71.2 61.5 68.5
High cholesterol (hyperlipidemia) 3.3 3.5 3.6 3.5 63.7 66.0 64.8 65.4

Irritable bowel syndrome (spastic colon or spastic bowel) 2.6 6.5 8.7 5.6 49.1 57.5 53.1 56.0
Migraine headaches 6.1 15.1 19.7 12.9 38.7 53.2 49.0 50.9
Polycystic Ovarian Syndrome (PCOS) 0.1 5.0 5.5 3.7 18.8 71.6 63.1 70.3
Sleep Apnea 2.9 1.7 3.2 2.2 56.5 52.5 42.1 52.9
Thyroid condition or disorder 1.3 4.5 4.0 3.6 71.7 79.7 75.8 78.6
Urinary system disorder (for example: bladder or kidney
disease, urinary reflux, interstitial cystitis) 0.6 1.8 2.0 1.5 57.8 57.3 59.1 57.5
*Only students who reported ever being diagnosed were asked about contact with a healthcare or mental health professional within the last 12 months.

16
 Cis Men n = 21222
Cis Women n = 50882
Students who reported being diagnosed with diabetes or pre-diabetes/insulin resistance, indicated they had: Trans/GNC n = 4530

Trans/
Cis Men Cis Women Gender Non- Total
Percent (%) conforming
Type I Diabetes 31.0 18.9 24.6 21.9
Type II Diabetes 32.3 18.5 16.4 21.1
Pre-diabetes or insulin resistance 52.1 73.6 76.5 69.9
Gestational Diabetes 1.8 8.4 9.6 7.2

K. Sleep
Reported amount of time to usually fall asleep at night (sleep onset latency):

Trans/
Cis Men Cis Women Gender Non- Total
Percent (%) conforming
Less than 15 minutes 46.6 40.4 30.6 41.4
16 to 30 minutes 27.6 28.1 27.8 28.0
31 minutes or more 25.7 31.5 41.6 30.6

Over the last 2 weeks, students reported the following average amount of sleep
(excluding naps):
On weeknights On weekend nights
Trans/ Trans/
Cis Men Cis Women Gender Non- Total Cis Men Cis Women Gender Non- Total
Percent (%) conforming conforming
Less than 7 hours 42.5 41.6 45.7 42.1 20.0 20.2 19.9 20.2
7 to 9 hours 56.7 57.1 52.9 56.6 72.3 71.0 66.4 71.0
10 or more hours 0.8 1.4 1.4 1.2 7.7 8.9 13.7 8.8

Students reported the following on 3 or more of the last 7 days:

Felt tired or sleepy during the day Got enough sleep so that they felt rested
Trans/ Trans/
Cis Men Cis Women Gender Non- Total Cis Men Cis Women Gender Non- Total
Percent (%) conforming conforming
0 days 6.4 2.6 2.2 3.7 13.6 18.8 24.4 17.7
1-2 days 29.8 19.3 13.9 21.9 35.3 40.9 39.9 39.2
3-5 days 43.1 45.5 38.9 44.4 38.6 32.7 28.8 34.1
6-7 days 20.7 32.5 45.0 30.0 12.4 7.6 6.9 8.9

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Demographics and Sample Characteristics
Age Students describe themselves as
18 - 20 years: 40.9 % Straight/Heterosexual: 71.0 %
21 - 24 years: 32.8 % Asexual: 1.3 %
25 - 29 years: 14.2 % Bisexual: 13.3 %
30+ years: 12.1 % Gay: 2.2 %
Mean age: 23.4 years Lesbian: 2.5 %
Median age: 21.0 years Pansexual: 2.8 %
Queer: 3.7 %
Gender* Questioning: 2.6 %
Cis Women: 65.2 % Identity not listed above: 0.6 %
Cis Men: 27.2 %
Transgender/Gender Non-conforming: 5.8 %
* See note on page 2 regarding gender categories

Student status Housing

1st year undergraduate: 19.7 % Campus or university housing: 35.4 %
2nd year undergraduate: 16.7 % Fraternity or sorority residence: 1.1 %
3rd year undergraduate: 17.9 % Parent/guardian/other family: 14.4 %
4th year undergraduate: 13.9 % Off-campus: 47.6 %
5th year or more undergraduate: 3.2 % Temporary or "couch surfing": 0.4 %
Master's (MA, MS, MFA, MBA, etc.): 16.8 % Don't have a place to live: 0.1 %
Doctorate (PhD, EdD, MD, JD, etc.): 10.5 % Other: 1.2 %
Not seeking a degree: 0.3 %
Other: 1.0 %
Students describe themselves as
Full-time student: 90.8 % American Indian or Native Alaskan 2.5 %
Part-time student: 8.7 % Asian or Asian American 19.8 %
Other student: 0.5 % Black or African American 5.8 %
Hispanic or Latino/a/x 14.7 %
Visa to work or study in the US: 15.0 % Middle Eastern/North African (MENA)
or Arab Origin: 2.1 %
Relationship status Native Hawaiian or Other
Not in a relationship: 51.0 % Pacific Islander Native: 0.6 %
In a relationship but not married/partnered: 38.0 % White: 60.8 %
Married/partnered: 11.0 % Biracial or Multiracial: 5.0 %
Identity not listed above: 1.4 %
Primary Source of Health Insurance
College/university sponsored SHIP plan: 20.8 % If Hispanic or Latino/a/x, are you
Parent or guardian's plan: 54.4 % Mexican, Mexican American, Chicano: 61.4 %
Employer (mine or my spouse/partners): 8.6 % Puerto Rican: 7.7 %
Medicaid, Medicare, SCHIP, or VA: 9.6 % Cuban: 3.0 %
Bought a plan on my own: 2.5 % Another Hispanic, Latino/a/x, or
Don't have health insurance: 2.1 % Spanish Origin: 34.4 %
Don't know if I have health insurance: 0.7 %
Have insurance, but don't know source: 1.2 % If Asian or Asian American, are you
East Asian: 52.3 %
Student Veteran: 2.1 % Southeast Asian: 23.6 %
South Asian: 26.2 %
Parent or primary responsibility for someone Other Asian: 1.8 %
else's child/children under 18 years old: 5.9 %

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 First generation students 33.7 % Participated in organized college athletics:
(Proportion of students for whom no Varsity: 4.3 %
parent/guardian have completed a Club sports: 6.8 %
bachelor's degree) Intramurals: 8.9 %

Do you have any of the following? Member of a social fraternity or sorority:

Attention Deficit/Hyperactivity Disorder Greek member: 6.8 %
(ADD or ADHD): 15.9 %
Autism Spectrum Disorder: 3.3 %
Deaf/Hearing loss: 2.2 %
Learning disability: 4.6 %
Mobility/Dexterity disability: 1.4 %
Blind/low vision: 3.5 %
Speech or language disorder: 1.0 %

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Demographics of Participating Institutions
One hundred twenty-seven postsecondary institutions self-selected to participate in the
Spring 2023 ACHA National College Health Assessment and 79,137 surveys were
completed by students on these campuses. For the purpose of forming the Reference
Group, only institutions located in the United States that surveyed all students or used a
random sampling technique, and used the ACHA-NCHA III (currently only offered as a
web survey) are included in the analysis, yielding a final data set consisting of 78,024
students at 125 schools. Demographic characteristics of the 125 campuses follow.

Demographical Characteristics of the 125 US Postsecondary Institutions

Included in the Spring 2023 ACHA-NCHA III Reference Group
Campus Characteristic n
Type of Institution
Public 80
Private 45
2-year 11
4-year or above 114
Location of Campus
Northeast (CT, ME, MA, NH, NJ, NY, PA, RI, VT) 27
Midwest (IL, IN, IA, KS, MI, MN, MO, NE, ND, OH, SD, WI) 17
South (AL, AR, DE, DC, FL, GA, KY, LA, MD, MS, NC, OK, SC,
TN, TX, VA, WV) 25
West (AK, AZ, CA, CO, HI, ID, MT, NV, NM, OR, UT, WA, WY) 56
Campus Size
< 2,500 students 30
2,500 – 4,999 students 23
5,000 – 9,999 students 21
10,000 – 19,999 students 13
20,000 students or more 38
Campus Setting
Very large city (population over 500,000) 24
Large city (population 250,000-499,999) 12
Small city (population 50,000-249,999) 46
Large town (population 10,000-49,999) 25
Small town (population 2,500-9,999) 14
Rural community (population under 2,500) 4
Carnegie Classification
Associates Colleges 11
Baccalaureate Colleges 19
Baccalaureate/Associates Colleges 4
Masters Colleges and Universities 27
Doctoral Universities 64
Special Focus Institutions 0

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Demographical Characteristics of the 125 US Postsecondary Institutions Included
in the Spring 2023 ACHA-NCHA III Reference Group
Campus Characteristic n
ACHA Membership Status
Institutional Member 99
Nonmember 26
Religious Affiliation
No 108
Yes 17
If yes:
Catholic 9
Protestant or Other Christian 8
Postsecondary Minority Institution (US Department of Education)
No 101
Yes 24
*If yes:
Historically Black College or University (HBCU) 0
Hispanic-serving Institution (HSI) 12
Tribal College or University 2
Predominately Black Institution 0
Asian American and Native American Pacific Islander-serving 13
Alaska Native-serving or Native Hawaiian-serving Institution 0
Native American-serving Nontribal Institution 4

*institutions may hold more than one type of minority status

NOTE: In an effort to protect the identity of the participating institutions,

the minority institution status variables have been recoded into a single
dichotomous (yes/no) variable in the Reference Group SPSS data files.
Secondary researchers with access to the blind data files will not be able to
ascertain which type of minority status designation an institution holds.

Spring 2023
Institutions
Number of institutions 125

Number of students 78,024

Mean response proportion 11%

Median response proportion 10%

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