Research Objective: To examine the association between first-generation student status and health, across racial/ethnic groups

Study Design: We conducted a cross-sectional analysis of data from a single large university within the National College Health Assessment Survey (2023). Our outcomes were self-reported mental health (anxiety, depression, loneliness, stress (30-day and 1-year) and flourishing) and self-reported physical health (overweight/obese and general health). Our primary predictor was the interaction of two dichotomous variables (first-generation status (no parent graduated from a US college) and racial/ethnic minority status). Our statistical models were linear and logistic regression models, adjusted sequentially for demographics (sex, age, graduate vs. undergraduate status, full vs. part time and marital status), health behaviors (diet, exercise and sleep), and an index of microaggressions/trauma (MT) exposures. A two-sided alpha level of 0.05 was used for determining statistical significance.

Population Studied: 818 undergraduate and graduate students

Principal Findings: Minority first-generation students had higher levels of 30-day and 1-year stress, lower levels of flourishing, and worse general health, relative to their non-minority first-generation and non-first-generation minority counterparts, controlling for demographics and health behaviors. When we adjusted our models for our MT index, these differences were no longer statistically significant.

Conclusions: Minority first-generation students report worse mental and physical health outcomes, relative to their non-minority first-generation and non-first-generation minority counterparts. These findings may be partially driven by differences in exposure to microaggressions and trauma.

Implications: There is a critical need for interventions to create environments that support minority first-generation college students in achieving their academic aspirations while maintaining their health.