Enrollment in Higher Education

Higher education is any type of education after high school (12th grade), including 2-year college (community college), certificate programs, 4-year college (bachelor programs), graduate programs, and professional programs. In 2020, 66.2 percent of high school graduates ages 16 to 24 years were enrolled in universities or colleges.¹ This summary will focus on enrollment in and graduation from a 4-year college in relation to improved health and well-being. 

Graduation from college has a positive impact on employment options.^2,3 The risk of unemployment and underemployment is higher for those with less education.⁴ During the COVID-19 pandemic, the more education workers had, the more likely they were to keep their jobs and work remotely.⁵ Studies have shown that individuals with an associate’s degree are more likely to embark on a path of economic security and true economic success in comparison to those who only have taken certificate courses or have only completed high school.^3,6 The average graduate with a bachelor’s degree will earn double what the average individual without a degree will make in their lifetime.⁴ Higher education helps people secure better-paying jobs with fewer safety hazards.³ Income from these employment opportunities may improve health by increasing people’s ability to accrue material resources, such as higher-quality housing, as well as psychosocial resources, such as higher social status.^3,7

Overall, higher education can lead to improved health and well-being, as well as reduced risk for premature death.^3,7,8,9 College graduates have better self-reported health than high school graduates,⁹ and individuals with more education are less likely to report conditions such as heart disease, high blood pressure, diabetes, anxiety, and depression.⁷ Furthermore, individuals with more education are more likely to exercise, drink less alcohol, and seek preventive health care when needed.^2,3,7

Pursuing higher education later in life still offers health benefits. One study showed that people who received a bachelor’s degree at any point in life had better physical health than those who did not obtain any higher education degree.¹⁰ Regardless of how old someone is when returning to school, higher education can provide social interaction and intellectual stimulation.¹¹

One factor that influences students’ decisions to attend college is the college preparation that their primary and secondary education offers.¹² Additionally, the quality of this preparation influences students’ likelihood of graduating from college.¹³ High schools that lack financial resources rarely provide advanced or honors classes, making it difficult for students at those schools to be academically prepared for college-level work.¹² Some high schools lack counselor support to help students select a college, apply for admission,¹⁴ and identify financial aid options.¹⁵ This process may affect a person’s decision to enroll in higher education.¹⁶

Another factor that influences enrollment and completion in higher education is a student’s social context.^i,17 This shapes their beliefs about higher education as well as their ability to succeed in applying to and graduating from college.^18,19,20 For instance, students whose parents have attended college benefit from their parents’ knowledge, experiences, and network. This helps them navigate the college admissions process,¹⁴ conform to academic expectations,¹⁸ and make informed decisions about their education.²¹ Additionally, while first-generation college students may not have the advantage of parental knowledge and experiences,²¹ they still name family support as a main source of encouragement for college enrollment.²²

Institutional factors at colleges may impede enrollment and graduation. Public funding for colleges has been decreasing,²³ leading to steep increases in tuition and student debt.²⁴ Despite the availability of federal loans for many would-be students, the complexity of the financial aid process leads some students to forgo college.²⁵ College admissions policies may prevent students who need remedial education from enrolling,²⁶ and about a quarter of college students take remedial classes, potentially delaying graduation.^27,28 Many students need assistance adjusting to college (e.g., selecting courses, applying for ongoing financial aid), but funding for these services may be limited, particularly at community colleges.^29,30

Recent decades have seen a sharp increase in the racial/ethnic diversity of undergraduate enrollment at U.S. colleges and universities.³¹ However, certain racial/ethnic groups may face unique barriers to higher education. Undergraduate students from non-White racial/ethnic backgrounds, and particularly those who identify as Black, Hispanic, or American Indian/Alaska Native, generally show lower levels of academic persistenceⁱⁱ relative to White students.^{31, 32} African American and Hispanic individuals have lower college enrollment and graduation rates compared to White individuals,²⁸ and Latino individuals are most likely to attend college part time, which reduces their odds of graduating.³³ Several factors may contribute to these outcomes. 

Black, Hispanic, Asian/Pacific Islander, American Indian/Alaska Native students, and non-Hispanic multiracial students may experience other stressors, such as discrimination and debt accumulation, that can affect academic outcomes.³⁴ One study found that Black, Hispanic, Asian/Pacific Islander, and American Indian/Alaska Native students, as well as non-Hispanic multiracial students, experience discrimination at rates 2 to 4 times higher than White students. This study also determined that for 15 percent to 25 percent of students reporting discrimination, their academic performance was impacted.³⁴ However, students attending a minority-serving institution (MSI) reported fewer experiences of discrimination. MSIs include higher education institutions that are geared toward minority groups, such as Historically Black Colleges and Universities (HBCUs), Tribal Colleges and Universities (TCUs), Hispanic-Serving Institutions (HSIs), and  Asian American and Pacific Islander Serving Institutions (AAPISIs).³⁵ Some racial/ethnic minority students attending predominately White colleges and universities (PWCUs) experience social isolation, but colleges can provide programs that help students from different racial/ethnic groups build social and cultural capital.³⁰

Additionally, recent evidence has shown that African American college students accumulate more federal education debt than students of other ethnicities.^36,37 Despite this, grants and loans help increase the likelihood of enrollment and completion, making higher education more accessible to all students.³⁸ Grants and loans have made higher education more accessible to all students. One study documented that 80 percent of Hispanic students and 85 percent of American Indian/Alaska Native and Black students receive some type of grant. The same study found that 51 percent of Hispanic students, 62 percent of American Indian/Alaska Native students, and 72 percent of Black students receive some sort of loan.³⁹

Although barriers to higher education remain, there are a number of strategies to address them. Strengthening the curriculum in primary and secondary public schools may better prepare students for college.¹² Peer and faculty mentoring can help students apply to schools, secure financial aid, and feel a sense of community.^29,30 Expanding access to subsidies such as scholarships and financial aid may increase college enrollment and completion.³⁹

Further research is needed to identify how the association between higher education and health can be harnessed to improve health outcomes and reduce health disparities. Identifying, evaluating, and disseminating effective interventions to help students overcome barriers to college enrollment and graduation will be key. This additional evidence will facilitate public health efforts to address higher education as a social determinant of health.

Endnotes

ⁱ The American Psychological Association defines social context as the specific circumstance or general environment that serves as a social framework for individual or interpersonal behavior. This context frequently influences, at least to some degree, the actions and feelings that occur within it. 

ⁱⁱ The National Student Clearinghouse Research Center defines persistence as “continued enrollment (or degree completion) at any higher education institution.”