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The Oregonian: From chronic disease to flu, sprains, and temptations, college health providers offer help
Author: By Andy Dworkin
Posted: August 25, 2010

http://www.oregonlive.com/health/index.ssf/2010/08/from_chronic_disease_to_flu_sp.html

Raiding a roommate's goodie drawer is a time-honored college tradition.

But if your roommate has diabetes, sneaking snacks she uses to boost low blood sugar could lead to disaster. That's just one message the Juvenile Diabetes Research Foundation includes in a sample "Letter to a College Roommate" published on the group's Web site.

"Low blood sugar can be life threatening to me," the letter reads, "so my food stash is like my 'medicine' and needs to be kept separate from the food we can share."

Most people think of college-age kids as enjoying the peak of health -- a picture that's not far from wrong. In a nationwide survey, 92.4 percent of college students told the American College Health Association that their health ranged from good to excellent. But even with the general health of youth, a substantial minority of kids carry an illness with them to campus, from asthma to HIV infections. Many more face a host of challenges from stress to strep throat while having to get health care on their own for the first time.

"Some of these issues become more prominent as people move out of the support systems they've been in for a long time," says Dr. Phillip Histand, director of Oregon State University's Student Health Services.

Services like Histand's are common on campuses and help many students find their way through the bumps, bruises, infections and stresses of college life. The Oregon State clinics see about 60 percent of the college's on-campus students each year, he estimates, and probably see 85 percent of students at some point in a four-year education. Histand has spent 30 years in student health and has seen lots of changes -- students with strep throat used to spend the night in a clinic bed, for instance, and now get sent home with antibiotics. But some things rarely change: Flu, accidents and birth control are common concerns.

"Our bread-and-butter stuff is still the viral infections, mono, flu, gastrointestinal stuff, sprained ankles," Histand says.

And it's still harder to persuade 19-year-olds to take care of themselves than it is to treat a specific illness, says Dr. Dana Tasson, clinical director of counseling and psychological services for Portland State University students. Persuading students to eat well, get enough sleep, avoid smoking and use alcohol responsibly are constant tasks for college health providers, he says.

At Portland State, Tasson says, providers take an "ecological view" of student health, asking, "What's getting in the way of success?" That means offering care for things like stress or relationship problems that people might not normally take to doctors. It's actually very common for students to see a counselor just once or twice to get advice on how to cope with problems and focus more on school, he says.

Counselors also see more students with diagnosed psychological conditions, such as attention deficit disorder, Tasson says. "There is better diagnosis and better awareness of mental health for kids." And "medication is more widely accepted for this generation."

In the college health association's national survey, one of nine students says depression hampered studies. One in 20 report having attention deficit disorder.

Other mental and social problems were common, too. Almost 60 percent of college students say they drank alcohol in the previous month, while one in eight smoked marijuana and slightly more smoked tobacco. Almost one in 10 students was in an abusive relationship, 8 percent got in fistfights and 6 percent were sexually assaulted.

College-age women reported more stress, sadness, loneliness, exhaustion, anxiety and anger, and were more likely to be physically assaulted by a partner or sexually assaulted. Male college students were more likely to report good health, even though they were more likely to be overweight, eat few fruits or vegetables, smoke tobacco, use drugs or binge on alcohol.

College health providers say students should not be shy about asking for help to understand or manage any of those concerns, as well as any physical ailments. They urge students to get a regular checkup or well-woman exam, make sure their vaccines are up to date, use birth control, eat well, exercise and get enough sleep.

And any students coming to campus with a chronic disease, such as diabetes, should be sure to let their student health center know and transfer their records to a provider on campus who can help them manage their illness.

"People think, well, you're 18 to 22, nothing bad ever happens to you," Histand says. "But it's surprising the number of students we see with serious illness."