Assessing university students' health needs: lessons learnt from Crete, Greece

Sir, During the past years a significant number of studies from different countries have reported the usefulness of school-based health centres and student health services.1–3 Documentation on this subject is still poor and there is certainly a need for both discussing the assessment instruments and testing the effectiveness of any interventions undertaken. There are also few studies available in Greece restricted to the identification of the risk factors of the students.4–6 The Clinic of Social and Family Medicine at the Medical School of the University of Crete undertook the initiative to commence a programme to assess the health needs of the enrolled first-year students. A General Practitioner (GP) with a nurse and two health visitors, who carried out the assessment of the students' health, staffed each of the two university health centers in two cities of Crete (Heraklion and Rethymnon). Five hundred and two (160 males and 342 females) first-year enrolled students (mean age 18.8 ± 3.5 years) participated in the study and were examined for somatometric measurements, health habits (dietary, alcohol consumption, smoking), and vaccination coverage. The subjective health of the students was assessed with a self-mediated, interactive health testing and promotion instrument called ‘Health-o-meter’, which was developed in Sweden and translated and tested in Greece.7,8 The 28-item Greek version of the General Health Questionnaire (GHQ-28) was also used in order to assess mental disorders.9 One hundred and one students (20.1%), out of the total number of students, were daily smokers and it was in concordance with another Greek study,5 while 43 (8.6%) reported occasional alcohol consumption. One hundred and twenty students (23.9%) were found to have a BMI over 25, a finding that is in agreement with another Greek study.10 The dose scheme of the MMR vaccine was found to be incomplete (101 students, 20.1%), while 199 students (39.6%) had been vaccinated against hepatitis B. One hundred and four students (20.7%) scored abnormally in the 28-question version of GHQ (GHQ ≥ 5), and we found that it was correlated with parts of the questionnaire that identify items related to somatic symptoms and anxiety-insomnia. Forty-nine out of the 117 students (41.8%) who completed the Health-o-meter questionnaire (Health-o-meter < 105) rated their health status as either fair or poor. This finding is in agreement with a recently published report where mental disorders accounted for the 5.6% of total morbidity of students.11 We also found a statistically significant correlation between the GHQ-28 and the Health-o-meter (part II of mental health) (r = 0.63, R2 = 0.40, P < 0.01). Our study revealed certain areas for potential intervention, including the important problem of obesity among university students, some vaccination insufficiencies and mental health. This study is also timely coming when a health reform in primary care is on debate in Greece, and the discussion on the potential role of GPs in carrying out health promotion activities among university students could receive some prompt attention.