Clustering College Students by Lifestyle Behaviors: Insights into Mental Health Outcomes

Guided by the Social Determinants of Health (SDOH) framework, this study examined associations between lifestyle behavior patterns and mental health among U.S. undergraduate students. Data were drawn from 8,961 students across 13 universities participating in the 2021– 2022 Healthy Minds Study. Cluster analysis identified two distinct lifestyle behavior profiles, differentiated by substance use. Students of color, first-generation, international, younger students, and students with minority gender identities were more likely to be in the lower substance use cluster, whereas students with disabilities and minority sexual identities were overrepresented in the higher substance use cluster. Regression analyses revealed that students in the higher substance use cluster reported significantly greater anxiety and depressive symptoms. Overall, moderate to severe symptoms were observed in 40% of students for anxiety and 47% for depression. Consistent with the SDOH framework, these findings emphasize the need to consider both individual behaviors and contextual factors when designing mental health interventions.