Evaluating Indigenous Identity and Stress as Potential Barriers to Accessing On-Campus Healthcare for Indigenous Students at a Large Southwestern University

William O. Carson (), Michelle Valenti, Kendrick Begay, Scott Carvajal, Stephanie Russo Carroll, Nicole P. Yuan and Felina M. Cordova-Marks
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William O. Carson: Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85721, USA
Michelle Valenti: Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85721, USA
Kendrick Begay: College of Engineering, University of Arizona, Tucson, AZ 85721, USA
Scott Carvajal: Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85721, USA
Stephanie Russo Carroll: Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85721, USA
Nicole P. Yuan: Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85721, USA
Felina M. Cordova-Marks: Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85721, USA

IJERPH, 2025, vol. 22, issue 9, 1-17

Abstract: Introduction: This study examined the relationship between Indigenous identity, perceived stress, and healthcare utilization for Indigenous students on-campus. Methods: Potential participants included undergraduate and graduate Indigenous students from Tribal Nations within the United States. Participants were recruited through community partnerships and in person communication. This survey included the Perceived Stress Scale (PSS-10), the Multiethnic Identity Measure (MEIM), and university Campus Health Service Health and Wellness Survey. Results: 153 Indigenous students from United States-based Tribal Nations participated in this survey. While there appears to be a relationship between Indigenous identity, perceived stress, and Campus Health utilization, the results were not significant for the second tertile (OR: 1.1 (0.4, 2.7)) or third tertile (1.4 (0.5, 3.3)). Students who reported “Yes” or “Unsure” to questions on if their insurance needed them to go outside of the university were far less likely to use Campus Health (Yes OR: 0.2 (0.08–0.5)); (Unsure OR: 0.09 (0.03–0.3)) and CAPS (Yes OR: 0.2 (0.09–0.6)); (Unsure OR: 0.2 (0.04–0.4)). Discussion: This study saw a complex relationship between Indigenous identity, perceived stress, and campus health utilization; however, the findings are not statistically significant. There are distinctions in on campus health care usage when adjusting for undergraduate or graduate student status and health insurance literacy. Conclusion: The research findings offer many promising avenues for future work around Indigenous identity, affordability of healthcare, and importance of health literacy.

Keywords: Indigenous identity; perceived stress; colleges and universities; healthcare access; healthcare utilization (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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