Prevalence and associated factors of anxiety among public health students in Hanoi, Vietnam: Cross-sectional study

In the quiet hours of a university library or the crowded aisles of a campus cafeteria, a specific kind of tension often hums beneath the surface of student life. This is not the simple nervousness of an upcoming exam, but a more persistent state of unease known as anxiety. It is a feeling of worry, panic, or fear that can settle in the mind and body, making it difficult to focus, sleep, or simply feel at ease. While everyone experiences stress now and then, for many young people navigating the transition to adulthood, this feeling can become a constant companion, interfering with their daily lives and their ability to learn. Understanding who is most likely to carry this burden and why is a crucial question for anyone concerned with the well-being of the next generation, particularly those training to protect the health of their communities.

Researchers in Hanoi, Vietnam, set out to explore this very question among a specific group: students studying public health. These are the future guardians of community well-being, yet they too are young adults facing the unique pressures of higher education. The team, led by scholars from Hanoi University of Public Health and other local institutions, conducted a careful survey to see how common anxiety was among these students and to identify the specific circumstances that made it more likely to appear. They did not rely on guesses or assumptions; instead, they asked 459 students, ranging from their first to fourth year of study, to fill out a standardized questionnaire designed to measure feelings of anxiety, panic, and fear. This tool, known as the DASS-21, asks simple questions about how often a person has felt nervous, worried, or unable to relax, allowing the researchers to categorize their emotional state from normal to severe.

The results of this survey revealed a significant reality: nearly half of the public health students studied were experiencing some level of anxiety. Specifically, 42.3 percent of the participants showed signs ranging from mild to very severe. This means that in a classroom of ten students, it is statistically likely that four of them are struggling with these symptoms. The researchers broke down these numbers further, finding that while a small portion suffered from mild symptoms, a larger group experienced moderate anxiety, and a notable number faced severe or very severe conditions. This prevalence suggests that anxiety is not a rare occurrence for these students but a widespread challenge that warrants attention.

To understand why so many students were feeling this way, the researchers looked closely at the lives these students led outside the classroom. They examined factors such as family income, parental occupation, and the pressure students felt from their studies. The data painted a clear picture of what drives this anxiety. The most powerful predictor was financial struggle. Students who reported that they could not afford their living expenses were five times more likely to experience anxiety than those who felt their finances were secure. Even those who could only just barely cover their costs were significantly more likely to feel anxious than their wealthier peers. Similarly, students coming from families with lower monthly incomes faced a much higher risk compared to those from families with higher incomes.

The study also highlighted the weight of academic expectations. Students who felt a high level of pressure from their coursework were nearly twice as likely to suffer from anxiety compared to those who felt their academic load was manageable. The researchers found that the type of work a student's father did also played a role; students whose fathers were workers or held other non-civil servant jobs were more likely to report anxiety than those whose fathers were farmers. Interestingly, the study did not find a strong link between a mother's education level and the student's anxiety, nor did it find that simply being unhappy with their chosen major was a primary driver, though there was a slight trend in that direction.

These findings suggest that the path to better mental health for these future public health experts involves more than just teaching them coping mechanisms for exams. The evidence points to the need for support systems that address the root causes of their distress, particularly financial instability and overwhelming academic pressure. The researchers conclude that universities in Vietnam, and perhaps elsewhere, should consider offering routine counseling services tailored to these vulnerable groups. By recognizing that anxiety is often tied to the real-world struggles of money and expectation, institutions can begin to build a safety net that allows students to focus on their studies and their future without the heavy burden of constant worry. The study does not claim to have solved the problem, but it has illuminated the path forward, showing clearly where the help is needed most.