Spotlight on Success


Dr. Shana Charles (April 5, 2021)

"For many college students, their home campus becomes their village of support, regardless of whether they live on-site."

Dr. Shana Charles, associate professor from the College of Health and Human Development, has spent the past 20 years researching health insurance gaps and healthcare access, both statewide and nationwide.

"During the COVID-19 pandemic, students experienced a huge disruption in their connection to campus and in their health care safety-net systems," Charles said.

Her research includes leading a series of reports published online every other year called The State of Health Insurance in California. The reports are sent to all state legislators and California's congressional delegation. Dr. Charles was about to launch the CSUHI study last spring, using methods of meeting in person and visiting classes, but the pandemic forced her and her team to make a quick adjustment.

"I had created this study to assess our student's insurance and access to health care needs and was about to submit to the Institutional Review Board when the pandemic hit," said Charles. "I had to then revise both the questions and the mode of administration to account for the impact of COVID-19."

Dr. Charles and her team, one graduate student and one undergraduate, then set out to conduct their study last summer and fall. Their goal was to determine the baseline of needs among CSUF students regarding their health insurance and access to health care to create programs that address identified problems.

"We found that students were doing surprisingly well in terms of their health insurance rates, but that delays in care were higher than expected and that lack of access to the Student Wellness Center affected vulnerable groups even among the insured."

All CSUF students have access to the Student Wellness Center, which offers Counseling and Psychological Services (CAPS), Health Services, and TitanWell Health Promotion Service. Associate Director Kerri Boyd Crooks says these services have remained available to students throughout the pandemic. They did, however, need to reduce the in-person hours in Spring 2020, and CAPS and TitanWell immediately adjusted to telehealth visits by phone or zoom. By June, the center expanded its hours, requiring students to be screened before visiting. (TitanWell information can be found on the center's websiteOpens in new window . The center's Instagram accounts are @csufhealth, @titanwell, and @csufcaps.)

Dr. Charles will go into more detail about her study's findings in her presentation, "Effects of COVID-19 on Health Insurance and Access to Care among College Students: The Good, the Bad, and the Ugly," when she speaks Tuesday, April 6, 2020, during Pollak Library's weekly, Faculty Noon Time Talks.

Spotlight asked Dr. Charles to share some of her key findings.

Good News
"The good news is that the insurance safety net, built up in California with expanding Medi-Cal and Covered CA, held throughout 2020 for our students. Just under 8% were uninsured, similar to the uninsured rate statewide in 2019."

Many Students Depend on Student Wellness Center
"Given that students were mainly studying virtually in 2020 is that over 20% of uninsured students, as well as students who had Covered CA insurance, depended on our Student Wellness Center as their usual source of care. More worrisome still was that 45% of international students and 40% of non-US citizen students reported using the Student Wellness Center as their usual care source. Without access to campus, access to their health care was jeopardized."

Vulnerable Students Hit Hardest
"Finally, half of the students with below-average health status and 55% of uninsured students reported delaying needed health care after March 2020, along with 40% of students with household incomes under $25,000 annually. Our most vulnerable students were hit hardest in delaying needed health care."

Ideally, Dr. Charles would like to create a survey that would be sent out every other year to college campuses, assessing students' well-being and their ability to access health care. "If we don't have data to identify and track disparities and problems, then we will be flying blind when working to improve our student populations' health," Charles said. "It would be incredible if we could make this kind of assessment work as part of what campuses do to serve their students."

If you'd like to attend Dr. Charles presentation virtually, you can register and receive the zoom information by emailing the Pollak Library Administration at