Unhealthy behavior clustering and mental health status in United States college students



Publication Details

Jao, N. C., Robinson, L. D., Kelly, P. J., Ciecierski, C. C. & Hitsman, B. (2019). Unhealthy behavior clustering and mental health status in United States college students. Journal of American College Health, 67 (8), 790-800.


Objective: Examine the association of health risk behavior clusters with mental health status among US college students.

Participants: 105,781 US college students who completed the Spring 2011 National College Health Assessment.

Methods: We utilized the latent class analysis to determine clustering of health risk behaviors (alcohol binge drinking, cigarette/marijuana use, insufficient physical activity, and fruit/vegetable consumption), and chi-square and ANOVA analyses to examine associations between the class membership and mental health (mental health diagnoses, psychological symptoms, and self-injurious thoughts/behaviors).

Results: Three classes were identified with differing rates of binge drinking, substance use, and insufficient physical activity but similar rates of insufficient fruit/vegetable consumption. Students classified with the highest rates of binge drinking and cigarette/marijuana use had the highest rates across all mental health variables compared to other classes.

Conclusions: Students who reported engaging in multiple health risk behaviors, especially high alcohol and cigarette/marijuana use, were also more likely to report poorer mental health.

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