healthcare utilization; undergraduates; health barriers; gender; college students; economic barriers
The transition to college can be a crucial period of one’s life as one gains new and increased responsibilities, including managing their own healthcare. Although campus health services are available, undergraduate students have been found to often underutilize these resources due to barriers such as financial instability, lack of insurance, and identity-based disparities. While examining the current literature on this topic,there is a gap in exploring how the role of gender identity interacts with these barriers. This study addresses this gap by analyzing secondary data from the American College Health Association’s National College Health Assessment (ACHA-NCHA). Results revealed that transgender and gender nonconforming (TGNC) students reported the highest rates of medical and mental health service use, yet also faced the greatest levels of food insecurity. Utilization of medical and dental services declined with increasing food insecurity across all gender groups, while mental health service use rose—particularly among TGNC students. Insurance coverage was associated with higher utilization across all service types, but disparities remained for uninsured students, especially in dental care. Mantel–Haenszel tests confirmed the persistent predictive value of insurance status, though Breslow–Day tests showed that this relationship did not significantly vary across gender identities. These results suggest that while TGNC students demonstrate high overall service utilization, they remain vulnerable to the compounding effects of financial hardship. The intersection of economic stressors and gender-based marginalization can exacerbate healthcare disparities. Targeted interventions—such as expanding financial assistance and ensuring culturally competent services—can help address these disparities and promote more equitable health outcomes for undergraduate students.
Thesis Completion Year
Thesis Completion Semester
College of Sciences
Length of Campus Access
Orlando (Main) Campus
Damarla, Akhila, "Barriers to Healthcare Utilization Among Undergraduate Students: A Gender Identity Perspective" (2025). Honors Undergraduate Theses. 309.