Researchers analyze risk perception of chronic health conditions among college students

Study at two Texas universities shows need to educate students on cardiometabolic risks associated with cigarette smoking, especially male and minority students
July 14, 2020

Chronic health conditions like high blood pressure, heart disease and type 2 diabetes are leading to increased mortality among young adults in the United States and carry billions of dollars in medical costs each year. The risks posed by these conditions can be modified through improved lifestyle choices, especially when healthy behaviors are started in early adulthood. However, research has found that college students often develop poor eating and activity habits and that college graduates make up about 15 percent of adults who currently smoke. Additionally, not much is known about how risk perception relates to health behaviors in this population. Thus, it is crucial to better understand the extent of unhealthy behaviors and perceptions of cardiometabolic risks such as obesity, high blood pressure and cardiovascular disease among college students to develop targeted interventions.

A new study published in the American Journal of Health Education measured health indicators and cardiometabolic risk perception among college students. Matthew Lee Smith, PhD, of the Texas A&M University School of Public Health and co-director of the Center for Population Health and Aging, and doctor of public health student Oluyomi Oloruntoba, together with researchers from the University of Cincinnati (Merianos, Gittens) and California State University, Stanislaus (Jacobs), used survey data from more than 1,300 students at two universities in Texas to evaluate their hypotheses.

The researchers hypothesized that students who were overweight or obese and students who smoked cigarettes would have viewed the risks of obesity, high blood pressure and cardiovascular as being less severe. The researchers collected data on age, sex and race and ethnicity as well as height and weight for determining whether the students were overweight or obese. The survey also asked how many days of a typical week the students smoked one or more cigarettes and how severe they viewed obesity, high blood pressure and cardiovascular disease on a scale of one to 10, with 10 being the most severe.

The students surveyed had an average age of almost 21, and the majority of the respondents were female and non-Hispanic white. Approximately 23 percent were overweight and 15 percent were obese, with 47 percent of the respondents reporting they smoked one or more cigarettes in an average week. This is approximately three times the national average; however, many of the students who smoke only on occasion often do not identify as smokers. The risk perception scores were relatively high overall, at 6.1 for high blood pressure and around 7.2 for both obesity and cardiovascular disease.

Although the risk perception was high overall, the researchers observed differences between different groups. In contrast with the hypothesis that overweight and obese students would perceive these risks as being less severe, those students reported higher perceived severity for obesity. There were no significant differences in perceived severity of high blood pressure and cardiovascular disease between the different body mass index groups. Female students and nonsmokers reported higher risk perception for all three cardiometabolic risks. Additionally, Hispanic and Asian/Pacific Islander students reported lower risk severity for both diabetes and high blood pressure.

These findings indicate several areas of interest for the design of health interventions targeting college students. “The high rate of smoking and likelihood that social smokers may not identify as smokers could make typical smoking cessation interventions less effective and warrants the need for tailored solutions,” Smith said. Additionally, the differences in risk perception between male and female students and between racial and ethnic groups point to possible cultural differences and a need for better targeted education efforts.

Although these findings are notable, the researchers acknowledge that the study carries a few limitations. For instance, because the survey was conducted at one time and in two universities in Texas, the findings might not be generalizable over time or in different areas. They also note that future research should expand on types of tobacco used and the use of alcohol and other drugs.

The results of this study will be useful for informing further research and developing health education practices. The findings could help health educators working with college students target groups that are less likely to correctly perceive the severity of cardiometabolic risks and make better use of resources that are already available on college campuses. Providing better health education for college students, who are at a critical point in developing health behaviors, could help those young adults stay healthy as they venture out into the world.

— Rae Lynn Mitchell

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