Unhealthy behavior clustering and mental health status in United States college students

Nancy C. Jao, Laura D. Robinson, Peter J. Kelly, Christina C. Ciecierski, Brian Hitsman*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

51 Scopus citations


Objective: Examine the association of health risk behavior clusters with mental health status among US college students. Participants: 105,781 US college students who completed the Spring 2011 National College Health Assessment. Methods: We utilized the latent class analysis to determine clustering of health risk behaviors (alcohol binge drinking, cigarette/marijuana use, insufficient physical activity, and fruit/vegetable consumption), and chi-square and ANOVA analyses to examine associations between the class membership and mental health (mental health diagnoses, psychological symptoms, and self-injurious thoughts/behaviors). Results: Three classes were identified with differing rates of binge drinking, substance use, and insufficient physical activity but similar rates of insufficient fruit/vegetable consumption. Students classified with the highest rates of binge drinking and cigarette/marijuana use had the highest rates across all mental health variables compared to other classes. Conclusions: Students who reported engaging in multiple health risk behaviors, especially high alcohol and cigarette/marijuana use, were also more likely to report poorer mental health.

Original languageEnglish (US)
Pages (from-to)790-800
Number of pages11
JournalJournal of American College Health
Issue number8
StatePublished - Nov 17 2019


  • Mental health
  • clustering
  • health behavior
  • tobacco

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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