Colleges Could Do More for Students With Chronic Ills, Study Finds
Only half of campus clinics felt they could handle diabetes care, and many don't identify students with needs
By Amy Norton
MONDAY, Oct. 27, 2014 (HealthDay News) -- Many college health centers may lack the resources to fully care for students with chronic health conditions, a new study suggests.
The research, published online Oct. 27 in the journal Pediatrics, surveyed health center directors at 153 U.S. colleges. It found that while most felt their center could care for students with asthma or depression, only half thought they could manage diabetes.
And despite the confidence in their asthma and depression care, most centers did not actively identify incoming students with chronic health problems. Only one-quarter contacted those students to encourage them to make an first-time appointment.
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Often, college health centers are limited in what they can do, due to tight budgets, experts said.
"Many have seen their funding cut significantly, and some colleges are now 'outsourcing' health services," said Dr. Terrill Bravender, a professor of pediatrics at the University of Michigan, in Ann Arbor.
And there are no official guidelines on the types of services colleges should offer, according to Bravender, who wrote an editorial published with the study. "Even before students arrive, there's a wide variation in colleges' health-screening requirements," he said.
Vaccination records are a must at most colleges, he noted -- but schools differ in whether they require students to have physical exams or give a full medical history, including medications.
And why are college health services important? "Some people would argue that students can go to a primary care provider in the community," Bravender said. "That sounds simple, but it's not."
Dr. Diana Lemly, the lead researcher on the study, agreed. "New students are often quite far from home -- about 90 miles, on average," said Lemly, a specialist in adolescent and young adult medicine at Massachusetts General Hospital, in Boston.
She said it's too much to expect an 18-year-old just adapting to college to also find a doctor in an unfamiliar city -- one who takes their parents' insurance, and can offer a prompt appointment. "That's almost impossible," Lemly said.
The findings are based on surveys of medical directors at 153 colleges across the U.S. -- public and private, large and small.
Overall, 83 percent said their center could care for students with persistent asthma, and 69 percent said they could help students with depression who were requesting therapy. Just over half said they could care for students with type 1 diabetes -- a form of diabetes that requires daily insulin therapy.
When they were asked how they reached out to students, 42 percent said their center had no system for identifying incoming students with chronic ills. And 24 percent said they contacted students to make a first-time appointment -- which was more common at small, private colleges, Lemly's team found.
Campus health centers can only do so much, Bravender noted. Besides budget constraints, they can't "coerce" students into seeking care. "They are young adults, after all," Bravender said.
But, he added, many colleges can do a better job of encouraging students to use the health services available.
As for parents of college-bound kids with chronic health conditions, Lemly said that planning is key. "Be aware that there's a broad variation in college health services, and make sure you investigate what's available at each school," she advised.
It's also wise, Lemly noted, to get a "care plan" from your child's current doctor before he or she heads off to school. From there, she said, "students should set up an appointment early on with campus health services."
Bravender agreed -- and said that when families visit potential schools, they can make a stop at the health center. "Parents can feel very reassured if they understand the health services that are available on campus," he said.
Research suggests that at least 15 percent of incoming freshman at U.S. colleges have a chronic medical condition or disability, according to Bravender. But that figure may actually be higher, he noted, because it's based on students' reports.
The National Alliance to Advance Adolescent Health has more on young adults' health care.
SOURCES: Diana Lemly, M.D., adolescent and young adult medicine, Massachusetts General Hospital, Boston; Terrill Bravender, M.D., M.P.H., professor, pediatrics, University of Michigan, Ann Arbor; November 2014 Pediatrics