Influence of the residential environment on undergraduate students' health

University campuses represent an opportunity to advance the understanding of how the built environment influences health. We used de-identified billing codes from a private university clinic serving undergraduate students for academic years 2008 through 2012 linked to students' residential history and demographic information. We used a two-stage, hierarchical regression model to study the differences in the reported prevalence of diagnostic groups by dorm and the association between building characteristics and disease incidence rates. We found significant differences in the prevalence of mental health (MH), upper respiratory infections (URI) and substance abuse between freshmen and upperclassmen. In addition, we found systematic differences in the relative rates of URI and MH diagnoses across dorms. Among upperclasmen dorms, the only mechanically ventilated building had a lower rate of allergy cases. An increase in available dorm space of 100 ft² per student was associated to a decrease in 10.8 URI cases per 100 students per academic year (p < 0.01). Construction age was also associated with lower incidence rate of MH (1.1 fewer diagnoses/100 students-academic year for every 25-year increment in building age, p = 0.04). These results suggest the potential for the use of electronic health records (EHR) to identify differential health issues faced by students depending on the housing characteristics and on the stages of their academic career.