The Changing Landscape of Student Health and Wellness

Lawrence Bacow, President Emeritus, JD, MPP, PhD / September 9, 2016

In the five years since I left the presidency of Tufts University, much has changed relative to student health and wellness starting with the higher priority these issues now command among our overall imperatives. Whether it is higher expectations, increased government scrutiny, or a new way of thinking, colleges and universities are being asked to do more to ensure the well-being of their students. This increased attention raises all sorts of questions both philosophical and practical. Like everything worth examining, the answers are complicated.

As a former university president, I have given considerable thought as to how the volume and complexity of student health and wellness issues have affected colleges generally and the role of the president, specifically.

First, I think it is important to note that there is a widely-held myth that college and university presidents have more authority than we actually do. This is academia after all, where consensus rules the day and lateral power structures discourage autocratic leadership. I’ve often said that anyone on a college campus who tries to get something done by asserting their authority to do so has lost on day one.

However, institutions of higher learning need strong leaders, and college presidents have significant influence over many critical areas, including those that affect student health and wellness. And as overly presumptuous as it may be, presidents are the faces of their institutions in good times and in bad.

As most parents (and neuroscientists) understand, 18-year-old college freshmen are not quite fully formed adults. Their brains are still developing. They frequently lack judgment, perspective and maturity.

As a result, they often engage in unhealthy or even risky behavior whether it is eating poorly, not getting enough sleep, or experimenting with drugs or alcohol. And as we all know, temptations abound at most colleges and universities. In fact, you might argue that we try to educate students despite the lifestyles they tend to lead in the four years they are on our campuses.

The good news is that we now tend to take a more holistic view of student health. Issues that encompass student health and wellness have expanded to include physical health, mental health, substance abuse, suicide prevention, eating disorders and sexual assault.

How well college and universities address these issues affects every aspect of campus life, from academic performance and admissions to freedom of speech and inclusion to litigation and public relations.

Managing the growing array of student health issues is compounded by societal changes starting with increased public scrutiny. Society pays a lot more attention to higher education than it did in the past.

We’re in the news more and we are subject to more government intervention than ever before. Federal laws such as Title IX are important safeguards for women on campus who continue to be at-risk for sexual assault; campus cultures with high rates of binge drinking increase that risk, making these areas in which we must continuously improve.

But at the same time, we need to acknowledge the enormous and complicated set of requirements these laws impose on institutions that remain ill-equipped to adjudicate what are essentially allegations of criminal behavior.

The proliferation of technology also has had an enormous impact on the capacity of college administrators to address controversies that in prior years might have been resolved with a few meetings among students. Social media has opened up our campuses so that no issue or dispute is likely to remain local for very long, and every conversation is a public conversation.

Passions on campus are often inflamed by attention from outside groups with their own agendas. These groups often believe anything they read on the web, and are likely to have no tangible stake in the campus outcome. Their constant attention and scrutiny may keep the real stakeholders from having the hard conversations that are likely to produce mutual understanding. As anyone who has ever found themselves in the white heat of the media knows, generating consensus in such an environment is never easy.

The coarseness of today’s public dialogue also exacerbates the problem. In academic settings where we ought to be debating issues on merit, and learning from our differences, we have groups calling each other names and engaging in behavior that is far from civil.

I often say, “We need to model the behavior we hope to see in the rest of the world. If we can’t work these issues out on this beautiful campus with intelligent people who are neither starving nor scared, then there is no hope for the broader world.”

Another important generational change is the capacity of students to communicate 24/7 with their parents, again, fueled by technology. This constant communication encourages parental over-involvement that I believe is not in the long term interest of the student.

I used to say to parents, “What we all want for our kids is grow up to be independent, to be able to live without us, but when we send them off to college and our natural inclination is to cling to them.” Our children will never learn to navigate bureaucracies or advocate for themselves if they are not tested by doing so on their own.

Are students different? The science tells us yes in some ways. The drive for achievement is very high. There is far more focus on getting into the “right” school (thanks to US World and News Report) and not disappointing one’s parents. I also think the increase in the real cost of college has placed more pressure on students resulting in more stress-related illnesses. Part of it goes back to how prepared students are for independence.

I used to say to freshmen students upon matriculation, “You’re on your own now. We will do our part to take care of you but you must do yours as well. We expect you to be the type of person you described in your application. The Dean of Admissions assures me that none of you claimed to be loud, obnoxious, drunk or offensive to your neighbors.”

Some students seem very unprepared for the experiences they will encounter. Colleges and universities do not help by marketing themselves as utopian places where everyone succeeds. Nobody wants to say, “The truth is we have students here who struggle with identity, who feel isolated, who live with substance abuse or are hostile to others. Diversity works most of the time, but not always.”

As administrators, parents, and students deal with the changing landscape of student health, there are some assumptions that are universally accepted while others are subject to a wide array of differing opinion. We all want our students to be healthy and safe; we all view college as a place for growth on many levels.

Some institutions seek to cultivate life-long habits of fitness and health, both mental and physical. They are embracing a very broad view of their educational mission, one that some believe may be beyond their reach.

Still other institutions, particularly those with fewer resources, continue to approach student health as a safety net; a place where illness and substance abuse are more likely to be treated than affirmatively prevented. In these institutions, the curriculum is more narrowly constructed and traditional academic achievement remains the primary goal.

It seems to me that the critical question for college presidents today, at least for those at four year institutions with involved parents, is to determine the appropriate compact between parents, students and institution. What reasonable expectations do each of the parties hold for the other? What responsibilities are each expected to accept? Colleges and universities will need to examine these questions and college presidents will need to communicate the answers.


Lawrence Bacow is a former President of Tufts University and former Chancellor of MIT, and as of May 2011, serves as a member of the Harvard Corporation, the fiduciary body of Harvard University.