Campus climate and intersectional inequities in eating disorders among U.S. college students: A multilevel analysis of individual heterogeneity and discriminatory accuracy

IF 3 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Annals of Epidemiology Pub Date : 2025-09-26 DOI:10.1016/j.annepidem.2025.09.014

Ariel L. Beccia , Vivienne M. Hazzard , Rachel F. Rodgers , Dougie Zubizarreta , Lauren M. Schaefer , Natasha L. Burke

{"title":"Campus climate and intersectional inequities in eating disorders among U.S. college students: A multilevel analysis of individual heterogeneity and discriminatory accuracy","authors":"Ariel L. Beccia , Vivienne M. Hazzard , Rachel F. Rodgers , Dougie Zubizarreta , Lauren M. Schaefer , Natasha L. Burke","doi":"10.1016/j.annepidem.2025.09.014","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>To advance understanding of how contextual factors explain eating disorder (ED) inequities among college students, we examined associations between campus climate – i.e., the extent to which a given school is hostile vs. friendly to students of diverse social/cultural backgrounds – and ED prevalence across intersections of gender, sexual, and racialized identity.</div></div><div><h3>Method</h3><div>Cross-sectional data came from 15,544 students at colleges/universities that participated in the 2018/2019 Healthy Minds Study. We conducted a Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) by grouping participants into 35 intersectional social strata defined by gender, sexual, and racialized identity and fitting multilevel models to obtain stratum-specific prevalence estimates of probable EDs across the range of campus climate ratings (1 = “very hostile” to 5 = “very friendly”).</div></div><div><h3>Results</h3><div>Campus climate was inversely associated with probable EDs; specifically, for every 1-unit increase in ratings (i.e., more friendly climates), odds decreased by 8 %. There were differences in the magnitude of this association across strata, such that multiply marginalized students experienced the largest benefits from attending “very friendly” campuses, and especially those who were cisgender women and/or LGBQ+.</div></div><div><h3>Conclusions</h3><div>Results reveal a complex social patterning of EDs among college students across campus climate ratings and provide preliminary evidence suggesting that hostile campus climates may function as a driver of intersectional inequities in this population.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"111 ","pages":"Pages 94-101"},"PeriodicalIF":3.0000,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Epidemiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1047279725002698","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

To advance understanding of how contextual factors explain eating disorder (ED) inequities among college students, we examined associations between campus climate – i.e., the extent to which a given school is hostile vs. friendly to students of diverse social/cultural backgrounds – and ED prevalence across intersections of gender, sexual, and racialized identity.

Method

Cross-sectional data came from 15,544 students at colleges/universities that participated in the 2018/2019 Healthy Minds Study. We conducted a Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) by grouping participants into 35 intersectional social strata defined by gender, sexual, and racialized identity and fitting multilevel models to obtain stratum-specific prevalence estimates of probable EDs across the range of campus climate ratings (1 = “very hostile” to 5 = “very friendly”).

Results

Campus climate was inversely associated with probable EDs; specifically, for every 1-unit increase in ratings (i.e., more friendly climates), odds decreased by 8 %. There were differences in the magnitude of this association across strata, such that multiply marginalized students experienced the largest benefits from attending “very friendly” campuses, and especially those who were cisgender women and/or LGBQ+.

Conclusions

Results reveal a complex social patterning of EDs among college students across campus climate ratings and provide preliminary evidence suggesting that hostile campus climates may function as a driver of intersectional inequities in this population.

查看原文本刊更多论文

校园气候和美国大学生饮食失调的交叉不平等：个体异质性和歧视准确性的多水平分析。

目的：为了进一步了解环境因素是如何解释大学生饮食失调（ED）不平等的，我们研究了校园气候（即一所特定学校对不同社会/文化背景的学生的敌意与友好程度）与ED在性别、性取向和种族认同交叉点的流行之间的关系。方法：横断面数据来自参加2018/2019年健康心理研究的15544名高校学生。我们进行了个体异质性和歧视性准确性的多层次分析（MAIHDA），通过将参与者分组到35个由性别、性取向和种族身份定义的交叉社会阶层，并拟合多层次模型，以获得在校园气候评级（1 =“非常敌对”到5 =“非常友好”）范围内可能的ed的分层特定患病率估计。结果：校园气候与ed的发生呈负相关；具体来说，每增加1个单位的评级（例如，更友好的气候），赔率下降8%。这种联系在不同阶层的程度上存在差异，因此，许多被边缘化的学生从“非常友好”的校园中获益最大，尤其是那些顺性女性和/或LGBQ+学生。结论：研究结果揭示了校园气候评分中大学生ed的复杂社会模式，并提供了初步证据表明，恶劣的校园气候可能是这一人群中交叉不平等的驱动因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Annals of Epidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.40

自引率

1.80%

发文量

207

审稿时长

59 days

期刊介绍： The journal emphasizes the application of epidemiologic methods to issues that affect the distribution and determinants of human illness in diverse contexts. Its primary focus is on chronic and acute conditions of diverse etiologies and of major importance to clinical medicine, public health, and health care delivery.