group of students

93% of those surveyed by Dr. Emily Hotez and her team of undergrads said they were having trouble coping with pandemic stressors.

New research published by a UCLA Health professor and her team of 14 undergrads captures some of the intense challenges college students faced last summer during a particularly tumultuous time in the pandemic.

Emily Hotez, PhD, an assistant professor in the David Geffen School of Medicine at UCLA, led students in her health research class as they surveyed 242 of their peers. The diverse group of UCLA students answered questions anonymously about health, financial and interpersonal stresses brought on by COVID-19.

Dr. Emily Hotez and her team of UCLA undergrads conducted a survey to learn experiences and challenges of 18- to 30-year-old college students during the pandemic. Pictured, from left: Dr. Alice Kuo, Jennifer Lenghong, Ada Chung, Lizzet Lopez, Richard Tirado, Dr. Emily Hotez, Kevin Jimenez, Tayloneei Jackson and Dr. Candace Gragnani. (Photo by Joshua Sudock/UCLA Health)

The study was published Aug. 31 in the Cureus Journal of Medical Science.

Among the study’s key finds was the need to improve access to mental health care. “Almost all the students in our study struggled with the pandemic in some way,” said Dr. Hotez, a developmental psychologist-researcher.

Nearly all of the students surveyed — 93% — responded that they were having difficulty coping with COVID-19 stressors. Forty-four percent said they had had financial difficulties and 18% reported they received unfair treatment during the pandemic because of their race or ethnicity.

About the research

Students were surveyed online over a two-week period in June 2020, during which they were dealing with isolation from stay-at-home orders, racial-justice protests following the murder of George Floyd by a Minneapolis police officer and a surge of coronavirus cases in California.

“It wasn’t just the spread of the virus that was contributing to a lot of the challenges that we saw; it was also the corresponding discourse on racial and ethnic inequalities,” as well as other public events such as the presidential election campaign, Dr. Hotez said.

Among respondents, whose average age was 20, 41% were Asian, 28% white, 14% Latino, 9% multiracial, 1.24% Native American/Alaska Native and 0.83% Black.

Nearly half of respondents reported financial struggles. For example, 21% faced a drop in work hours or income, 14% lost jobs, 13% had difficulty paying for housing and 14% struggled to pay bills and afford groceries.

Changes in living circumstances also challenged the students. Prior to COVID-19, fewer than 2% of respondents lived at home; at the time of the survey, three-fourths were living at home, with 54% reporting interpersonal conflict with family and 62% reporting intrusive or interrupting noise.

In a narrative portion of the survey, students reflected on worries about themselves or a vulnerable family member falling ill, their loneliness from lack of social contact and concerns about their mental health.

“The qualitative data we got from the surveys was extremely illuminating,” Dr. Hotez said. “Students seemed to really open up.”

Some students wrote about an increase in anxiety and depression and their difficulty obtaining help. One respondent described experiencing “the collective trauma of being removed from support systems at school such as friends, clubs/organizations and therapy.”

Another student wrote about feeling “touch starvation” from not being able to see or hug friends for months. One described having arguments with family and friends over social distancing.

“One quote that stands out to me is, ‘My mental health is in shambles,’” Dr. Hotez said. “We had a respondent who was an EMT working with COVID patients and was particularly worried about contracting the virus. It really did seem as though they were taking the stay-at-home orders and quarantine very seriously, and, of course, experiencing challenges as a result.”

Students also described the challenges they faced involving social issues such as racism, ongoing protests and reports of gun violence.

Remote learning also presented difficulty for some students. One respondent described feeling unmotivated with schoolwork, and another felt constrained by the lack of study space at home and no access to a library.

Student researchers

The students who co-authored the study were enrolled in Dr. Hotez’s research seminar through the UCLA Pathways for Students into Health Professions, which works to broaden cultural diversity and representation in health care fields. 

“I think all research is more innovative, practical, relevant and robust when students play a key role in the scientific process,” she said. “(The students) played a role in all aspects of the research. They helped develop the survey and recruit participants, analyze and interpret the data and write up the results.”

“We now are more aware than ever that students have experienced a lot of challenges over the past year,” say Dr. Emily Hotez. (Photo by Joshua Suddock/UCLA Health)

The student researchers are: Apsara Chopra, Ada Chung, Julie Grassian, Sydney Huynh, Tayloneei Jackson, Kevin Jimenez, Eric Jue, Nancy Le, Jennifer Lenghong, Alejandrina Lopez, Lizzet Lopez, Pearl Omo-Sowho, Kennedy Pennington and Richard Tirado.

Application for doctors, colleges

The target audience for the study was a group of physicians who are trained in internal medicine and pediatrics. Known as Med-Peds, these doctors often care for so-called “emerging adults,” defined as 18-to-30-year-olds, who are navigating transitions such as college, first jobs and independently managing finances and student debt.

Dr. Hotez said people within that age group proved to be more susceptible to contracting COVID-19 than initially anticipated and were prone to delaying or avoiding health care services.

“We directed our recommendations specifically to health care providers who are serving emerging adult and college student populations,” Dr. Hotez said. “Providers should, to the fullest extent possible, facilitate patient access to mental health care services. We also recommended that providers focus on multidimensional health — not viewing physical and mental health as separate entities.”

With UCLA on-campus classes starting Sept. 23, Dr. Hotez said the findings also provide insight for university administrators and faculty as they encounter students who have faced struggles and may need greater support networks.

“I think it will be particularly important to connect with students in a way that goes beyond course material,” she said. “We now are more aware than ever that students have experienced a lot of challenges over the past year. We cannot expect that our academics are occurring in a vacuum.”

Courtney Perkes is the author of this article.