Author ORCID Identifier
0000-0002-0012-1561
Date of Award
Winter 1-10-2025
Degree Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
Department
Public Health
First Advisor
Amanda Gilmore, PhD
Second Advisor
Isha Metzger, PhD
Third Advisor
Karen Nielsen, PhD
Fourth Advisor
Natalie Watson-Singleton, PhD
Abstract
Introduction: Black college students face significant disparities in mental health and substance use, with racial and ethnic differences consistently observed in mental health care utilization, alcohol-related consequences, and posttraumatic stress symptoms (PTSS). Black students exhibit less help-seeking behaviors, experience more alcohol-related consequences and problems, and report higher PTSS severity compared to other racial and ethnic groups. While much research has explored experiences with racism as a primary explanation of these disparities, the multilevel and multidimensional nature of these experiences have received less attention. Furthermore, there is a need to uncover and understand differences within Black college student populations, rather than solely comparing them to other racial groups, as Black students are not a monolithic group and may experience varying outcomes influenced by distinct factors. Examining the influence of various campus environments (e.g., predominantly White institutions) may provide deeper insights into the drivers of these disproportionate outcomes.
Methods: To examine the associations of individual and environmental factors with alcohol use and mental health outcomes among Black college students, the following three studies were conducted: 1) a secondary data analysis on the associations between multiple dimensions of barriers and help-seeking intentions as well as the moderating role of racial discrimination 2) a hierarchical regression analysis to determine the associations of racial discrimination, racism-related stress, and potentially traumatic event (PTE) exposure with alcohol use and PTSS and examine the unique variance contributed by institution type over and beyond the foregoing factors, and 3) a multilevel analysis exploring the associations of individual (e.g., racial climate, sense of belonging) and institutional level factors (i.e., institution type, number of Black counselors) with alcohol use and PTSS.
Results: The secondary data analysis showed that negative perceptions of counseling and discomfort with emotions were significantly associated with lower intentions to seek mental health help among Black college students. Discrimination was not found to be associated with intentions or moderate the relationship between barriers and intentions. Hierarchical regression analyses showed that racial discrimination, trauma exposure, and sexual minority status were linked to higher PTSS severity, while PTE exposure and Greek membership were linked to greater alcohol use severity. Institution type was not significantly associated with alcohol use or PTSS, but differences in experiences with racism and alcohol behavior were observed among institution types. Results from the multilevel analysis showed significant individual level predictors of outcomes. Higher racism-related stress and PTE exposure were linked to greater PTSS severity, while positive racial climate perceptions were associated with lower severity. Greek membership and PTE exposure were associated with higher alcohol use severity, and students with positive university perceptions or peer belonging were more likely to report drinking.
Conclusions: Continued examination of within group differences among Black college students exposed to different institutional environments may offer a better understanding of the factors influencing mental health and alcohol use outcomes as these findings highlight a complex interplay of individual and institutional factors. Public health efforts by colleges and universities are needed and should prioritize addressing and preventing experiences of racism and related harms on campus. Intervention programming that integrates the management of posttraumatic stress symptoms and prevention of risky drinking behaviors may more adequately address the health needs of Black college students.
Recommended Citation
Fortson, Kennicia, "An Examination of the Effects of Individual and Environmental Factors on Mental Health and Alcohol Use Outcomes among Black College Students." Dissertation, Georgia State University, 2025.
https://scholarworks.gsu.edu/sph_diss/105
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