"Constant Stress Has Become the New Normal": Stress and Anxiety Inequalities Among U.S. College Students in the Time of COVID-19.

Purpose: The purpose of this study is to document young adults' perceived stress and anxiety in a diverse sample of college students across the U.S. during the COVID-19 pandemic.

Methods: We recruited, via Instagram, a sample of full-time college students aged 18-22 from across the U.S. We surveyed them in April (baseline; N = 707; mean age = 20.0, SD = 1.3) and July (follow-up) 2020. This study presents overall levels of perceived stress and general anxiety symptoms and inequalities across each of these outcomes by gender, sexual orientation, race/ethnicity, and household income. We also explore potential explanations for these health issues by analyzing baseline qualitative data.

Results: All students, on average, were suffering from perceived stress and anxiety, with especially high levels in April. We also identified inequalities in college student mental well-being, particularly by gender identity and sexual orientation. Women reported worse well-being compared with men; transgender and gender diverse and sexual minority youths reported worse outcomes than their cisgender, heterosexual peers at both time points. Qualitative data illustrate how the COVID-19 pandemic has generated educational, economic, and environmental stressors that are affecting college students' well-being.

Conclusions: As colleges and universities think about how to manage and mitigate the infectious disease dimensions of COVID-19 among their student populations, they must also consider who is most at risk for increased stress and anxiety during the pandemic.