"Constant Stress Has Become the New Normal": Stress and Anxiety Inequalities Among U.S. College Students in the Time of COVID-19

J Adolesc Health. 2021 Feb;68(2):270-276. doi: 10.1016/j.jadohealth.2020.10.030. Epub 2020 Dec 4.

Abstract

Purpose: The purpose of this study is to document young adults' perceived stress and anxiety in a diverse sample of college students across the U.S. during the COVID-19 pandemic.

Methods: We recruited, via Instagram, a sample of full-time college students aged 18-22 from across the U.S. We surveyed them in April (baseline; N = 707; mean age = 20.0, SD = 1.3) and July (follow-up) 2020. This study presents overall levels of perceived stress and general anxiety symptoms and inequalities across each of these outcomes by gender, sexual orientation, race/ethnicity, and household income. We also explore potential explanations for these health issues by analyzing baseline qualitative data.

Results: All students, on average, were suffering from perceived stress and anxiety, with especially high levels in April. We also identified inequalities in college student mental well-being, particularly by gender identity and sexual orientation. Women reported worse well-being compared with men; transgender and gender diverse and sexual minority youths reported worse outcomes than their cisgender, heterosexual peers at both time points. Qualitative data illustrate how the COVID-19 pandemic has generated educational, economic, and environmental stressors that are affecting college students' well-being.

Conclusions: As colleges and universities think about how to manage and mitigate the infectious disease dimensions of COVID-19 among their student populations, they must also consider who is most at risk for increased stress and anxiety during the pandemic.

Keywords: Adolescents; Anxiety; COVID-19; Health equity; Mental health; Stress.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Anxiety / psychology*
  • COVID-19 / psychology*
  • Depression / psychology*
  • Ethnicity / statistics & numerical data
  • Female
  • Heterosexuality / psychology
  • Heterosexuality / statistics & numerical data*
  • Humans
  • Income / statistics & numerical data
  • Male
  • Qualitative Research
  • Sex Factors
  • Sexual and Gender Minorities / psychology
  • Sexual and Gender Minorities / statistics & numerical data*
  • Surveys and Questionnaires
  • United States
  • Universities
  • Young Adult