Lederer, A. M., Hoban, M. T., Lipson, S. K., Zhou, S., & Eisenberg, D. (2021). More Than Inconvenienced: The Unique Needs of U.S. College Students During the COVID-19 Pandemic. Health Education & Behavior, 48(1), 14–19. https://doi.org/10.1177/1090198120969372

More than inconvenienced: the unique needs of U.S. college students during the COVID-19 pandemic

- In March 2020, U.S. higher education institutions abruptly and nearly universally shut down college campuses and shifted to online education, in recognition that campuses were high-risk environments for COVID-19 transmission.
- This response was considered a temporary and precautionary measure, but when the late summer 2020 came around, institutions realized that they needed to make major changes for the fall semester, either remaining purely online, implementing a hybrid configuration of classes, or a full return to campus for in-person instruction.
- College students’ lives have been significantly disrupted by the COVID-19 pandemic, and the major health risks that this population already faces are even more severe now.

More than inconvenienced: Introduction

Approximately 20 million students are enrolled in higher education institutions annually, comprising 40% of the U.S. population aged 18-24.
- 40% of students are now over the age of 25.
- 44% of students are BIPOC.
- 34% of students are first-generation.

Historically, college students have been overlooked as a priority population for health initiatives due to misconceptions that they are a privileged, resourced, and healthy group. As a result, college students suffer from worryingly high and increasing rates of mental health conditions, particularly depression and anxiety:
- As of 2017, 36% of college students reported having a lifetime mental health diagnosis.
- As of 2019, almost ¼ of college students have been diagnosed or treated for anxiety or depression within the previous 12 months.
- The demand by students for mental health services exceeds the resources available on most campuses, which has led many to declare that there is a mental health crisis on college campuses.

The pandemic has continued to exacerbate college students’ known mental health risk factors and other health concerns, while simultaneously imperiling students’ academic outcomes.

More than inconvenienced: The Collegiate Population

Students’ college experience both in and outside of the classroom, including their engagement in university life and relationships with peers and faculty, is fundamental to their well-being and success.
- The pandemic has eliminated nearly all engagement opportunities for students with remote learning, in addition to the cancelation of study trips, extracurricular activities, internships, and graduation ceremonies.

Students are disproportionately at risk for housing insecurity, with some students fully dependent on their campus accommodations.
- For students whose institutions did not reopen, a lack of housing, as well as food insecurity (due to on-campus dining options also remaining closed) have become major and prolonged dilemmas.

For some students, being home, whether their own or their families’, meant a return to volatile circumstances.
- Reports show that family violence has risen as a result of COVID-19.
- LGBTQ+ students who may be “out” on campus may have returned to hostile or unsupportive families or communities.
- Although some institutions have granted exemptions which allow students with extenuating circumstances to continue to reside on campus, services have been vastly reduced, requiring these students to essentially live in isolation.

Substantial campus- and community-based job loss for students have their families have heightened students’ financial hardships, making it more challenging for them to meet their basic needs.
- This issue, in turn, then additionally contributes to housing and food insecurity.

In the academic realm, the change to remote learning was predicated on students having reliable internet access and technology, which is not the reality for all students, and with the shutdown of businesses or labs which offer this technology to the public, remote learning is made even harder.

Students of color are facing additional challenges:
- AAPI students have encountered mounting discrimination and xenophobia as a result of COVID-19.
- Students from China, who comprise the largest number of international students at American institutions are particularly vulnerable to these experiences due to the geographic origin of COVID-19.
- Disparities in underlying comorbidities, access to and quality of health care, and living and work conditions caused by structural racism have led BIPOC to be disproportionately affected by COVID-19.

More than inconvenienced: College students and COVID-19

- Using data to guide decisions making is a crucial way for institutions to determine their priorities moving forward, and assessment findings should serve as the foundation for public health and other interventions, which will ideally be instituted at multiple levels within the institution.
- A recent study found that college students have insufficient knowledge about COVID-19, with primary sources of information being the internet and social media, so higher education institutions should better utilize academic resources so they can become trusted sources of information on COVID-19 and support.
- Many institutions already have campus-based resources for students (health, counseling, etc.), and these entities should be prioritized as a critical investment in student success amid budget cuts due to COVID-19.
- Students support services must be established and implemented with an equity lens, recognizing that the most marginalized college populations are especially affected by COVID-19 amidst already existing health disparities and achievement gaps.

More than inconvenienced: Recommendations for Moving Forward

- Institutions are heeding national guidelines to minimize the risk of COVID-19 transmission, and while these efforts are critical, this guidance alone is insufficient given the many other concerns that students now face.
- Comprehensive plans should be devised, recognizing and responding to the toll that COVID-19 has taken and will continue to take on students.

More than inconvenienced: Conclusion

College students are a special population facing a myriad of challenges due to the COVID-19 pandemic. This study explains how pandemic conditions have exacerbated already challenging situations college students have faced, including mental health, academic pressure, food insecurity, housing insecurity, and a lack of social connectedness. This study also explains how the pandemic has exacerbated inequalities that students of color and low-income students already face. Researchers offer some recommendations for higher education institutions of how to solve these problems, including data-driven decision making, informative messaging, and expanding student support services.

Boston College

The COVID-19 pandemic affected higher education. Nodes for deeper study on the topic include:
- Higher Education Challenges during Pandemic: A Case Study
- The Balance of Roles: Graduate Student Perspectives during the COVID-19 Pandemic
- Challenges and Opportunities for Higher Education amid the COVID-19 Pandemic: The Philippine Context
- Covid-19 and Medical Students
- Longtitudinal Study on the  effects of COVID-19 on first year college students' mental health
- Reimagining higher education during and post-COVID-19: Challenges and opportunities

Effects of the COVID-19 pandemic on Higher Education

This article is a series of anecdotes from the viewpoints of six graduate students who talk about their struggles with their education during the outbreak of coronavirus. It provides a personal look at how higher education has been shaped by the pandemic.

- a parent/student with two children also attending school who organized her schedule into helping her kids during the day while doing her work in the afternoon
- an instructional designer who had to get used to the shift into online learning, which included learning how to use tools such as WebEx and Zoom
- an online lecturer who had to shift their curriculum to help their students with flexibility in classes while getting used to working at home
- an IT administrator whose work nearly stalled their doctoral dissertation, forcing them to focus on reflection regarding their research
- another instructional designer who had to help people figure out how to change their classes to work with online learning while neglecting their dissertation
- a teaching assistant who had to focus on helping the students get used to online learning while having to put their doctoral work on pause

It suggests that progress in higher education depends on the new work schedule caused by the pandemic and how each person responds to the transition in their own way.

The Balance of Roles: Graduate Student Perspectives during the COVID-19 Pandemic

For many college students, the transition to online learning due to the COVID-19 pandemic has not only led to academic difficulties, but also difficulties with their mental health. This study aims to determine the mental health outcomes for college students at a large university in Texas, US through an extensive interview survey. Findings suggest that most students are more stressed and anxious due to the pandemic, and multiple specific stressors were identified to exacerbate their stress level. 

Effects of COVID-19 on college students’ mental health in the United States: interview survey study

Higher education institutions in the Philippines faced challenges with instructional delivery due to the COVID-19 pandemic. This paper provides recommendations for higher education’s response to the pandemic. 

- Integrate Environment and Health Courses in the Curriculum

- Strengthen Environmental Policies and Hygiene Practices

- Incorporate Online Mental Health and Medical Services

- Migrate Courses, Align Curriculum Competencies, and Scale up Teachers’ Training for Online Learning Instruction

- Strengthen Research Efforts, Data Monitoring, and Evidence Based Practices


Challenges and Opportunities for Higher Education amid the COVID-19 Pandemic: The Philippine Context

Though many graduate students are experiencing increased difficulties with completing their education due to Covid-19, medical students are especially affected when it comes to the problems they are faced with during the pandemic. Educational areas that medical students expect to be negatively impacted due to Covid-19 include: 

- Clinical experience
- Research experience
- Finding faculty mentors
- Cancelation of sub-internships 
- Acquisition of surgical skills
- Performance on board examinations
- Conferences/networking opportunities
- Residency applications

With concern about all these educational aspects, it is therefore very important that academic institutions adopt new online educational programing to help medical students continue to make successful progress in their education.

Covid-19 and Medical Students 

The aim of this study was to compare higher education in Spain, Italy, and Ecuador during the COVID-19 pandemic, particularly with regards to the development of digital literacy. 


Digital Literacy and Higher Education during COVID-19 Lockdown: Spain, Italy, and Ecuador

This article looks at student productivity, engagement, and motiavtion through online forums in comparison to lectures.

- There was an increase of early homework submitters when students were in the online forum, in addition to fewer late submissions (reduced to less than 50% late submission rate compared to the regular online homework submission
- Majority of regular style homework was submitted on the 7th day, which was the final deadline. Amost none submitted it before day 5. The forum based submissions only had 30% of students wait until day 7 to submit
- Students who were asked to do in depth focus on a couple research articles and then give a presentation showed better understanding compared to those asked to write a research paper. They also reported lower stress
- Creating blocked work is better, both for final term papers and final presentations. Teachers that require students work on papers in small incriments over a span of time normally find better productivity with less repetition or plagiarism. 
- Around 80% of students agreed that information diversity could be increased on online discussion and more than 90% agreed that lecture was not enough for learning material
- However, the majority preferred to continue with normal lecture and regular homework (80%)

An experimental case study on forum-based
online teaching to improve student’s engagement
and motivation in higher education

The COVID-19 pandemic has affected higher education institutions on a global level, and has presented numerous different challenges according to this study, bringing into question higher education’s preparedness for crisis, quality concerns for remote learning, financial troubles, and issues with the online delivery of learning. The study also brings to light one silver lining among the the issues: the idea of digital resilience.

Higher education amidst COVID-19: challenges and silver lining


This study conducted in two waves (2019-2020) sought to estimate the effect of the COVID-19 pandemic on college students' mental health. Using data from 419 first year students, this study found significant results that the participants had higher moderate-severe anxiety as well as moderate-severe depression after the beginning of the pandemic.

The Covid-19 pandemic and mental health of first-year college students: Examining the effect of Covid-19 stressors using longitudinal data

The COVID-19 pandemic has brought about significant changes for undergraduate students, especially when it comes to the negative repercussions on their mental health. This study seeks to explore the experience of stress, anxiety, and depression among undergraduate students in a university in Kentucky during an early phase of the pandemic. Results concluded that 88% of students surveyed experienced moderate to severe stress, 44% experienced moderate to severe anxiety, and 36% experienced moderate to severe depression. This study also identified high-risk populations, as well as how often students utilized the mental health services provided by their university.

Stress, anxiety, and depression among undergraduate students during the COVID-19 pandemic and their use of mental health services.

This study was designed to assess the impact of the COVID-19 pandemic on the daily living, mental well-being, and experiences of racial discrimination among college students from communities of color. Findings suggested that students of color experienced elevated disruption on finances, living situations, academic performance, educational plans, and career goals. The findings also suggest that the primary mental health challenges on these students included stress, anxiety, and depression, especially due to the increased amount of racially-motivated violence against the Black and Asian American communities. The study indicates that higher education institutions would greatly benefit from financially and emotionally supporting students of color during the pandemic.

The impact of COVID-19 on college students from communities of color

Looking at gender, age, SES, use of camera for lecturer and students, belief of neessity of distanced education, belief about effectiveness, and belief of negtive impact of pandemic on motivation, they looked at the cyclical effect of distanced learning motivation and it's impact on frequency of class attendence, mediated by anxiety, stress, depression and Intolerence of Uncertainty (IU).

- Women showed higher attendence than men
- men's motivation was higher than women's
- use of computers showed more attendence than use of smartphones
- use of computers showed higher motivation compared to use of smartphones
- urban students attended class more often
- urban students had lower levels of motivation
- depression negatively impacted attendence, though stress positively predicted attendence
- stress is not significantly associated with distance learning motivation 
- inhibitory IU was positively associated with depression, anxiety and stress, but negatively with motivation.
- IU predicts increase in relationship between anxiety and stress
- Women show higher rates of anxiety, stress, depression and IU during the pandemic
- gender is not related to student satisfaction with learning.

Psycho-demographic variables effects on higher education students during COVID-19 in Turkey

Malisch, Jessica L., et al. “Opinion: In the Wake of COVID-19, Academia Needs New Solutions to Ensure Gender Equity.” PNAS, National Academy of Sciences, 7 July 2020, www.pnas.org/content/117/27/15378. 

In the wake of COVID-19, academia needs new solution to ensure gender equity

The pandemic has caused shifts in household labor or childcare that have increased faculty and students' mental health needs and reduced faculty and students' time for academic work. The pandemic exemplifies the privilege that some people possess(access to mental healthcare and financial security) and the inequalities in academia. Additionally, the pandemic has caused an increase in biased decision-making, which hinders the efforts for equity. Consequently, women in academia will be negatively impacted. Hence, there is a need for decisions to be made that will help women maintain their positions in academia.

Effects of COVID-19 on women in academia

The aim of this study was to evaluate the effect of coping behaviors, resilience, and social support on loneliness in college students during the COVID-19 pandemic and resulting lockdown. 

Social and emotional loneliness among college students during the COVID-19 pandemic: The predictive role of coping behaviors, social support, and personal resilience

Sexual and gender minority (SGM) youth experience compounding effects of COVID-19 due to unique social inequalities and existent mental health and substance use challenges. This study was designed to examine the associations between changes in alcohol use since the start of the pandemic, and the reported mental distress among SGM university students in the U.S.. Results suggested that nearly ⅓ of SGM students increased their alcohol use since the pandemic began, and that female students experience more psychological distress in association than male students do.

Changes in alcohol use since the onset of COVID-19 are associated with psychological distress among sexual and gender minority university students in the U.S.

The COVID-19 pandemic has led to significant, sustained, and continuing stresses on the socio-psychology of societies and has led to the development of depression, anxiety and PTSD, particularly on college-age populations. This study aimed to assess the psychosocial effects and coping strategies of university students during the COVID-19 pandemic. Results suggested that students reported increased degrees of depression, anxiety, and stress, and dysfunctional coping strategies were less utilized than problem-focused coping strategies.

University students under lockdown, the psychosocial effects and coping strategies during COVID-19 pandemic: a cross sectional study in Egypt

The emergence of the COVID-19 pandemic brought with it an abrupt shift from traditional, in-person schooling to remote learning. While faculty and professors in higher education focused mainly on how to maintain rigor and the deliverance of a quality education, they neglected to pay attention to how students may struggle to adjust to virtual learning. It is crucial that professors work with their students to decide how to best meet their needs while simultaneously moving the curriculum over to an online format. Researchers from The State University of New York College at Old Westbury (SUNY-OW) discuss the challenges faced by students, the expectations of faculty, and introduce a series of propositions regarding how to best develop online etiquette in a world of virtual learning.

Reimagining higher education during and post-COVID-19: Challenges and opportunities

This is a paper that goes into detail regarding not only the challenges that exist in higher education but the case study of a university in Romania that responded to the problems that came about out of trying to adapt the educational curriculum to the ongoing pandemic. The decision was made to switch from a focus in face-to-face learning to online learning. The survey that studied the response to this initiative was done with 152 female university students who gave their opinion as to the challenges and advantages that came about because of online learning. The overall results showed satisfaction with this shift in the educational approach and the use of conferencing and other apps, as well as the flexibility in online learning. There were some fears as to how adequate online learning was in providing an education and how the school year would be affected by this shift. It showed that online learning was a capable tool but one that needed some improvement to be truly effective.

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