Lifestyle behaviors and mental health of health professional students during COVID-19, as measured by the CDC’s BRFSS, for the HOLISTIC cohort study

The World Health Organization estimates a 25% increase in anxiety and depression prevalence during the COVID-19 pandemic. 50% of surveyed US healthcare workers reported increased anxiety, and 27% of Chinese health professional students reported psychological distress. The mental health of US health professional students and their coping mechanisms, especially during an adverse time such as the pandemic, is less well understood. This study examined the US health professional students' lifestyle behaviors and their association with the prevalence of poor mental health days. 890 students across seven health sciences colleges in 2020 and/or 2021 were recruited using convenience sampling. Participants completed socio-demographic questions and items from the U.S. Centers for Disease Control and Prevention's (CDC) Behavioral Risk Factor and Surveillance System (BRFSS) 2019 survey. The participants reported a median of 7 days with poor mental health (IQR: 3-15 days) in the past 30 days. Female sex (OR 1.70, 95% CI [1.21, 2.38]), Asian race (OR 1.47, 95% CI [1.06, 2.06]), adverse childhood events (OR 2.01, 95% CI [1.45-2.78]), and frequent cannabis use (OR = 2.03, 95% CI [1.14-3.61]) were each associated with an increased risk of poor mental health during the COVID-19 pandemic. Exercise (OR 0.64, 95% CI [0.42-0.97]) was found to be a protective factor during COVID-19. These results indicate the need to design, implement, and evaluate mental health support services for health professional students, particularly among certain demographic groups. Students who are frequent cannabis users or have significant childhood trauma are more likely to have poor mental health and, as such, may benefit from additional support. A lifestyle psychiatry approach to overall wellness may offer students valuable and holistic coping mechanisms that incorporate lifestyle behaviors known to positively impact mental health.