Effects of a Student Lifestyle on Health

Effects of a Student Lifestyle on Health An investigation into the effects of a student lifestyle on health Results and discussion The questionnaires were sent out to the student population in the manner described. A total of 240 were distributed and we received back 120 of these – a 50% return rate. Of these 120 (n), 68 (56%) were from male respondents and 52 (44%) were from females this approximately reflects the male / female ratio of students at the University. We shall consider each question in turn. Questionnaire I Age. As could easily be predicted, the vast majority of respondents were from the 18-21 yr. age range 100 (83%) in total, with the remainder scattered over the range 22-32 yrs., again this roughly equates with the student age profile of the University campus. 108 (90%) were full time students with only 12 (10%) being part time We decided to make a preliminary breakdown into sports and non-sports related courses. We felt that this was better for our purposes than specifying each individual course studied, as it lent itself to clearer analysis. 24 (20%) were on sports related courses and 96 (80%) were not. It would be a useful breakdown of male / female in these two groups if you have the information. In terms of hours studied, the results were rather surprising as 29 (24%) admitted to studying less than 6 hrs a week, the biggest cohort of 50 (41%) admitted to 6-10 hours a week and only one (a female) felt that she was studying more than 21 hours a week. The relevance of this is that, in the context of exercise and health, it would be difficult for any of these students to present a convincing argument that they did not exercise because they were committing too much time to their studies. They clearly had plenty of uncommitted non-study time on their hands. Perhaps a bar chart would be appropriate here. Smoking. Given the data presented earlier our results were not totally in line with the national averages. Our cohort had 64 smokers (53%) of which 60% were men. If our cohort had followed the national patterns then we would have expected 42% of men and 39% of women in this age range to be smokers. The reasons for this are not clear from our survey One possible explanation may be the unexpectedly high response to our question about stress levels (see on) With regard to the number of cigarettes smoked the range was surprisingly narrow with over 75% of smokers admitting to smoking 15 or less per day and only 2 admitted to smoking over 30 a day The length of time that each had smoked was less than four years in 75% of smokers. Although we do not have the data, we should perhaps not be surprised at that as we have already mentioned, the majority (83%) of our group were under the age of 22yrs. You might like to break down the ages of the smokers further to see if you can demonstrate that the majority started smoking when they got to university – the figures should bear this out. This figure is quite significant when we compare it against the number who profess to be concerned about their fitness (see on) as we have highlighted above that smoking is one of the greatest impediments to general good health. Drinking. 112 (93%) of our respondents said that they did drink alcohol with only 8 (6%) stating that they were teetotal. Of much greater interest was the amount that was drunk. Given that the current recommended weekly intake is 21 units for men and 14 units for women, 75 of our respondents admitted to drinking more than that (66% of drinkers) with the biggest groups 38 in total, drinking in the range of 26-35 units on a weekly basis. It has to be said that it was rather worrying that 15 of our respondents (13% of drinkers) admitted to regularly drinking over 41 units a week and 3 of those were women. 7 a+b) When contrasted against the figures for drinking before coming to University, it can be seen that there is a marked increase in the quantity of alcohol consumed since the transition to the â€Å"student lifestyle†. There may of course be many factors at work here. Sudden relaxation of parental control, the availability of more money, and being older may all play a part. It is also possible that the influence of peer pressure is a significant factor here. It is probably also significant that only two of the group actually admitted to drinking more than 30 units a week before coming to university which certainly is in marked contrast to our findings. the enquiry into illicit drugs brought out an interesting response. We had considered the possibility that students may not be willing to openly discuss their use of illicit substances and mainly it was for this reason that we elected to make the questionnaire anonymous. We received a definitive answer in every case and 42 of out cohort (35%) currently use drugs of some sort while at university. This compares to a much lower figure of 20 (16%) who used drugs before arriving at university and the student lifestyle. From this evidence it would appear that the fact that someone comes to university is associated with a doubling of the incidence of recreational drug use. Again we can only postulate about the reasons for this. In much the same way that there was a marked increase in the use of alcohol after the transition to university life, it is possible that the factors which we suggested may have been responsible for this increase may also be the same factors that are relevant in the i ncrease in drug use. 8b) The breakdown of admitted drug use is interesting not only for its description of the actual drugs used but also for the pattern of sex distribution that it reveals. There is clearly multi-drug usage as 42 respondents admitted to using drugs and there are 85 different admissions of type. We do not have the figures to tell us if the majority of drug use is single use with a comparatively few users accounting for the polypharmacy or whether most drug users are using multiple types of drugs. The majority of use is in the category of so-called recreational drugs 71 reports (88% of total drug use) and only 14 reports of cocaine use (12% of total drug use). It certainly is a clear trend that the drug use amongst men is greater than that amongst women. Of the admitted drug users (by type) 53 (62% of use) was by men and 27 (38%) was by women, this compares with the prevalence of men in our sample (56%) and women (44%). When these results are compared with the responses of drug use prior to arrival at university, it can be seen that the pattern of drug use is different. Cannabis and Ecstasy form the preponderance of drug use in this age group and the incidence of cocaine use is clearly much less. It would therefore appear that cocaine tends to be used by an older age group and this may or may not be an influence of life at university. It is not the function of this survey to pontificate on the apparent rights and wrongs of drug use. We are trying to define and delineate the effects of a student lifestyle on health and there is considerable evidence (see above) that drug use is certainly not conducive to health. Perhaps we should confine ourselves to the comment that there is certainly a public health issue here. 10) The psychological aspects of â€Å"the student life style† also produced some unexpected surprises. With specific regard to anxiety there is an immediate problem seen in the results. In 10a) the students were asked if they felt stressed while at university. 72 (60%) responded â€Å"yes† but when asked to grade the severity of their stress 109 (90%) indicated that they had experienced a degree of stress. This may represent a difficulty in perception. Some people may be able to relate to the experience of minor degrees of stress and regard it as â€Å"normal† rather than â€Å"feeling stressed† which is a term that they may reserve for higher levels of actual perceived stress. We would have to regard this as a criticism of the actual wording of the question, in which 10a) might have been better phrased as â€Å"have you ever felt any degree of stress while at university?† when, presumably, the two figures would then have matched. It is certainly significant that the majority of the â€Å"yes† respondents were women. The majority of the studies done on the subject of stress (see above) show that women will report feeling stressed more frequently than their male counterparts. Many reasons and hypotheses have been advanced for this observation. It may well be that men are physiologically better equipped to deal with stress than women. There does not, however, appear to be any evidence to back up this point. It has been shown that men are less likely to seek help for psychological (and indeed physical) symptoms than women – quite often to their own detriment. Any sociologist will tell you that in our current social climate the gender roles of the two sexes are programmed differently during rearing. Boys are expected and encouraged to be stoical and brave, hiding their emotions whereas it is generally considered far more acceptable for girls to exhibit emotional liability. It is therefore not unexpected to find that at the highest end of the reported stress range. The proportion of women is greater than men. Equally the converse is also true that men are over represented at the lower-stress and no-stress levels. The pre-university results are not as diverse as they appear to be in other areas of enquiry. This should not altogether surprise us as we have to bear in mind the fact that all of the students who have made the transition from school to university will, almost without exception, have been through the A-level system, which is an inherently stressful experience. It is interesting to note that the sex differences are almost identical in this group when compared to the university group. Again this reflects the findings of other, more general, studies on the subject. 12) With regard to the comments made about the discrepancy of the figures in the questions about anxiety (11a and 11b) we can see that there is exactly the same disagreement in the questions about depression (12a) and 12b). When asked the direct question about whether they had felt depressed while at university 98 (81%) said â€Å"no†, but when asked to grade their degree of depression only 34 (28%) indicated that they had not felt depressed to any degree. This apparent discrepancy can presumably be analysed along the same lines as our suggestions with regard to anxiety. This is given further credence by the observation that in the group who admitted to experiencing depression, women were represented at nearly double the relative frequency of the men. When we look at the group admitting to severe depression the proportion rises to over three times the relative frequency. When compared to the responses that were reported before coming to university we can see however, that this time (compared to the anxiety situation) there is a marked difference as very many fewer respondents admitted to feelings of depression in their pre-university life. We do know that levels of depression reach a peak in the early twenties ( most markedly in men) and therefore we would expect to find lower levels in younger age groups. We also have other environmental factors in play as the majority of pre-university or school age pupils, will normally be living in the comparative security of a family lifestyle with all its attendant support networks hopefully in place. At university however, the situation is generally quite different with young people thrust into a different, and possibly alien environment, with no pre-existing support networks to fall back on for advice. This is clearly a fertile breeding ground for reactive depression and also endogenous depression if there is a predisposition for it. 14) This section is even more subjective than the preceding two as it deals with the question of self confidence ( you might like to see if your results show a correlation between the people doing sports related courses and high self-confidence rating because the chances are that there will be – see on) the self-assessed results in this section show a fairly predictable Gaussian distribution curve with the highest concentration in the middle ranges of self confidence and a slight preponderance towards the above average assessment. One always has to approach self-assessments with a fair degree of scepticism but one could reasonably expect a higher than average number of self-confident people at university as they clearly would have to have a fair degree of self-confidence to take the necessary exams and to put themselves forward in the first place. One interesting point in the analysis is shown by the fact that there is an increased correlation in a high self confidence rating and the participation in a sports-related course. We can only conjecture why this might be but, in order to excel in sports it is usually totally counter-productive to be shy and retiring, so perhaps we could postulate a preponderance of certain personality types in a sports-related field. 15) there is very little difference in the ratings of self-confidence before and after coming to university. If anything, there is a slight increase in the perceived ratings. This may well correlate with the feelings of independence and the necessity to be responsible for one’s own actions at university. The increase in the ratings may simply reflect the confidence that comes with experience of the independence of the â€Å"student lifestyle† which most of our respondents clearly have had. 16) When designing the questionnaire we considered the problems that may arise with questions of a personal or sexual nature. We are therefore very heartened by the fact that the vast majority of respondents found that they could give us answers in this section with 115 (95%) responding positively. Sadly, the results do tend to bolster the tabloid editors portrayal of promiscuity which we referred to in the section on sexually transmitted diseases of our respondents, only 4 (3%) admitted to being a virgin (or celibate). The biggest group – 25 (21%) had only one partner since being at university, but it was something of a surprise to see that the next biggest group of 20 (17%) had five partners since arriving at university. 10 of our sample (12%) admitted to having 10 or more partners while being at university. We do not presume to make any moral judgements on this set of results but it would be fair to say that to have 10 or more different sexual partners within a three year spell at university (and some may have had ten partners in less than that time) does put the respondents in a high risk group for sexual health problems (see conclusions) With the single exception of the lowest degrees of promiscuity (Groups admitting to one or no partners at all), men outnumbered women in all the groups. It is hard to fully explain this anomaly. A logical evaluation would suggest that there are three possibilities, either it is an unexpected statistical quirk, it reflects the fact that normal sexual activity is carried out by most men but a few very promiscuous women or that there is an unexpectedly high amount of male homosexual activity going on within the university. The author could not possibly comment on which eventuality is the most likely. 17) When compared to the figures obtained for sexual activity before coming to university we can see that there is a marked difference. The degree of promiscuity is much lower pre-university. This may well be a reflection of the age and circumstance of the pre-university respondents, quite apart from the independence factor that becomes more apparent after arriving at university. We can also see that the number of celibates pre-university is also much higher. This again, is probably a reflection of the perception of independence found at university. 18) In continuation of the issues discussed in section 16, the issues of sexual health are tackled here. The question is purposely blunt – â€Å"Have you ever had a sexually transmitted disease?† In our sample 6 (5% of sexually active respondents) had admitted to having one. This may very well not be accurate, as any experienced health professional will tell you that there are a lot a sexually transmitted diseases that are asymptomatic or may clear up spontaneously. Male monillia is often both trivial and self-curing and may only show as a transient blotchy rash of 24-36 hours duration. Male and female chlamydia may be completely asymptomatic in both sexes and the sufferers may truthfully respond that they do not think that they have a sexually transmitted disease. The fact of the matter is that both monilliasis in the female and Chlamydia in both sexes, can have serious repercussions with regard to fertility in the future. As we have flagged up in our earlier discussions, high levels of promiscuity are a potential problem for the overall sexual health of the student body. Questionnaire II BMI was worked out from the statistics of height and weight supplied by each respondent. The first inference of note is that there is a predictable Gaussian curve for both male and female distributions of BMI with the mean for males (predictably) coming to the right of the female peak ( a graph showing the two distributions would be helpful here) although the male curve actually has two maxima, this is almost certainly a statistical quirk due to the relatively small number of the sample. There are only three respondents that fall into the clinically obese range (25 and over) and only two – both female – who would be considered clinically underweight with a BMI of 15 (WHO definitions). This distribution is approximately the distribution that one would expect from the population as a whole in this age range. The first question asks respondents to rate their degree of physical activity. This set of answers should be analysed in conjunction with the responses to questions 3a-6 and the knowledge that 24 (20%) are on sports related courses and we would therefore expect them to be physically active in the pursuance of their course in any event. As we can see 32 (26%) take less exercise than the Government recommended target of 30 mins. five times a week and a further 49 (40%) just straddling the target level. If we arbitrarily equate â€Å"very physically active† with doing in excess of 80 minutes of exercise a day, â€Å"fairly physically active† with doing more than 40 mins a day, together with â€Å"not very physically active† doing more than 20 minutes a day then we can see a marked discrepancy straight away. Those who professed to be very physically active were 22 (18%) but this compares with 13 (10%) who actually do more than 80 mins. exercise a day. In the fairly physically active group there were 58 respondents (48%) but this corresponds to 39 (32%) who actually take more than 40 minutes of exercise a day. For those 25 (20%) who profess to be not very physically active they correlate with 49 (40%) who straddle the Government guidelines by taking between 21-40 minutes exercise a day. The group with the lowest professed activity – 15 (12%) correlate with the 32 (26%) who do virtually no physical activity at all. Immediately one can see that there is a discrepancy here. Those who feel that they take a lot of activity tend to overestimate the amount of exercise that they actually do, equally there are a second group who, say that they are not very active when the figures suggest that the actually-inactive group is much bigger than the professed-inactive group. Professed Actual Activity (n) Activity (n) Very active 22 13 Fairly active 58 39 Not very active 25 49 Inactive 15 32 All in all it would appear that the respondents have an ability to feel that they are actually doing more exercise than they actually are doing. Equally you could argue that we are making the criteria too strict and that we are being over-ambitious in our expectations of what amount of exercise people of this age should be doing. Perhaps the best independent arbiter should be the Government’s own documents and consultation papers quoted elsewhere in this piece (Game Plan and At least five a week). It can be seen that approximately 50% of our respondents do not meet these criteria. 3b 4a 4b You have given me no information here and I have no real idea of what the results might actually show. I would suggest that you base your analysis along the lines of my previous answer (which may have to be modified in the light of whatever your figures show) 2a+b) The weight of our respondents seems to have remained remarkably steady with 103 (85%) remaining effectively unchanged. We note that in the case of the 17 (14%) where the weight has changed we did not ask them to specify whether this was up or down. If this is analysed in conjunction with 2b) where 2 respondents indicated that this was an intentional change and 15 said that it was unintentional, the normal inference would be that people who have elected to change their weight intentionally might normally have been expected to loose weight however, in this particular cohort with a strong sporting interest, it is possible that this group may have been trying to put weight on. And equally the converse may also be true, we do not have enough information to make this judgement. 5) when asked if they thought that they got enough exercise to keep them healthy 62 (51%) of our respondents thought that they did. Interestingly 10 (12%) didn’t know. This is presumably a reflection of public education issues although you could take the opposing view that the message has got through to the other 88% who felt that they did know. 88 (73%) of our respondents felt that they wanted to increase the amount of exercise that they did. We are not in a position to say whether these are the ones who felt that they did not do enough exercise to start with or whether they are the ones who already exercise and feel that they need to do more. Presumably, for those on a sports related course there is always the incentive to try to make yourself even fitter. 44(36%) of our sample visited the gym on a regular basis. We can reasonably assume that at least 24 of these will be on the sports related courses as one can assume that they would be visiting the gym regularly as part of their course so at least another 20 were actively trying to get fitter. We can see that there is a preponderance of males in this group (33m to 12f). With regard to this question you might like to see if the 32 negative respondents correlate highly with the active or non active groups. You could then draw appropriate conclusions here. For example if they were the predominantly the active group then you might conclude that they didn’t feel the need for sedentary activities or conversely, if they were the inactive group it may be that their sedentary activities precluded them from activity. 11-14 The diet related questions are perhaps better considered as one entity. The most interesting comparisons come from the pre-university and at university comparisons as one can see that there is a marked change in the eating activity of our respondents It is something of a surprise that 81 (67%) of our respondents used a fast-food outlet less than twice a week. The general perception of the student lifestyle is frequent use of such facilities. This clearly is not borne out by our survey. A worryingly large number of students eat less than the recommended amount of fruit and vegetables with 83 (69%) and 86 (71%) respectively taking less than the WHO recommended minimum. This contrasts dramatically with the results in the pre-university question where it can be seen that the amount of fruit and vegetables eaten (presumably primarily under parental influence) is much higher. In terms of health, this is an important finding as fruit and vegetables are a major source of roughage, vitamins and anti-oxidants (and of course many other essential nutrients) that are essential for health in general. A reduction in intake therefore jeopardises the overall healthy diet. 13. It is an interesting comment that 36 (30%) of our respondents said that they were concerned about their diet. One would have thought that with the independence of student life, if they were concerned that they now actually had the means to do something about it. Clearly this is a sweeping statement that does not take into account a mass of other obvious factors such as the finances involved in buying comparatively expensive items such as fruit. Conclusions There are many conclusions that one can draw from the figures presented above. Top of our list should be a consideration of the shortcomings of the survey which obviously will have a bearing on the conclusions that we feel able to draw from our figures. It is acknowledged that the survey is comparatively small. Although we can hope that it may be representative of the student body, it small size precludes rigorous statistical analysis. It is certainly possible to detect trends within our survey and many of these have been commented upon as we have looked at the figures. The mechanism of using the same sample of students as their own controls by asking their activity before coming to university, is a useful tool to gain a degree of statistical validity, and certainly has helped us to answer the original question of the effects of a student lifestyle on health. To specifically answer that question, we can point to a number of areas where there appears to have been marked changes in behaviour patterns pre- and post-university. Smoking, drinking, diet and sexual behaviour have all changed dramatically and to a lesser extent, drug taking patterns and depression levels have also changed. To some extent, a cynic might observe that this equates with the worst aspects of the typical tabloid editor’s portrayal of the â€Å"typical student†. The reality is, of course, far more complex than that We have already alluded to the major sociological changes that occur when the typical student leaves school and arrives at university. The release from the comparatively structured and dependent world of home life and school into the comparatively independent and less structured world of the university allows a sudden explosion of freedom in many cases where new experiences and activities can be tried, exploited and (perhaps) enjoyed. Can we draw any conclusions as to whether the typical university student is more or less healthy than their pre-university counterpart? Clearly we have delineated some important pointers to this question. In terms of diet (perhaps one of the most important long-term factors in deciding the criteria of health) there is little doubt that our typical student has a worse diet at university than they did before coming to university. We can clearly see the reduction in fruit and vegetable intake although it is gratifying to see that the expected transition to fast-food existence is not a major factor in most cases. The amount of exercise appears to have increased, although we have to accept that a disproportionate number in our sample have a sporting interest, so clearly that will skew the figures to a degree. As we have discussed earlier, there is a basic amount of exercise that has been shown to reduce the incidence of cardiovascular disease, myocardial infarction and stroke, obesity and Type II diabetes. Our typical student just qualifies for the basic minimum target set by the Government, but the range is great. As we have seen, exercise varies from virtually minimal to enormous amounts on a regular basis. We can probably just about conclude that university has a positive effect on health as far as exercise levels are concerned. Drug taking is another area where the student lifestyle has a bearing on health. Less than a third of our respondents have used illicit drugs, so they clearly are not the majority, but this group nonetheless represents a significant group within the whole. It is a matter of intense current debate as to the effect that drugs have on the actual health of a person and therefore we cannot presume to take a firm view when there is still such controversy raging. We can say that there is probably a general consensus that there is evidence that some illicit drugs do appear to have long term implications for health and on that basis, we can point to a negative effect of the student lifestyle on health. An area that we can point to that has far more clear-cut implications for health is the explosion of sexual activity that appears to equate with the student lifestyle. We have already passed comment on the degree of promiscuity that our survey has revealed. Celibacy or monogamy is clearly the best way of avoiding the risks of sexually transmitted diseases. We have commented on the number of respondents who have already known that they have had a sexually transmitted disease, but perhaps our concern should be for those who have contracted asymptomatic disease and are therefore, unknowingly passing it on to other contacts. Again, this is an apparent negative effect of the student lifestyle on health. Recommendations It is difficult to know how to structure this section as, on the one hand, we have clearly identified areas where the student lifestyle could be changed to improve the overall health of the individual, but a much deeper and possibly more significant question remains – â€Å"should we seek to change it?† There are many significant arguments here. One is the basic freedom of choice argument. Some may say that it is appropriate to give people information on matters such as health but it is ultimately up to them as to whether they actually take or implement that advice. Equally there is the converse argument that points to the drain on the public purse of avoidable ill-health. Do people have a duty to society to keep themselves as healthy as they practically can? Should they avoid obvious factors that will cause ill-health in later life? If we follow this argument through to its logical conclusion then we would insist that everybody had a uniform healthy diet, did not smoke or drink to excess, took daily exercise and remained monogamous for their lifetime. A more balanced approach may be to conclude that, in general terms, people learn by their mistakes. Is has been said that the student lifestyle is not only about getting and education it is about getting an Education. Most students will utilise their time at university to explore and perhaps formulate their ideas and personal guidelines for their future life. Perhaps we should take a pragmatic view and observe that, although we have been able to point out some short term negative aspects of the student life style on health, perhaps it is a necessary phase of experimentation which is part of the evolution to a healthier lifestyle as an adult. PDG 25.3.05 Word count 5,572