TY - JOUR
AU - Strazdins,, Lyndall
AB - Abstract Australian undergraduate students are facing difficult economic circumstances and rates of psychological distress are well above the general population. Many are combining their study with paid work to manage financially. There is, however, little to no research on the relationship between economic pressures, academic demands and health (mental and physical) among these young adults. This study used a mixed-methods approach, combining semi-structured interviews with health measures to investigate the interactions and interconnections between work, study and health among 22 Australian undergraduate students. Thematic data analysis concentrated on the effect of time constraints on health, due to the financial and academic demands of contemporary undergraduate life. We found that students felt time-pressured, and commonly sacrificed sleep, nutrition, exercise and lecture attendance as a way of managing employment demands. These strategies contributed to poor health; we observed very high rates of psychological distress, poor sleep, diet and exercise, peaking during exams. Our in-depth study illustrates the challenges facing the current generation of undergraduate students in Australia, raising their study–work conflict as a genuine public health and social equity issue. Australia, undergraduate students, work, time, health practices INTRODUCTION In Australia, there is debate on the predicament of young people. On the one hand, they are seen as entitled, financially reckless and emotionally fragile ‘snowflakes’ (Bita, 2017; Haslam-Ormerod, 2017). On the other hand, they are viewed with real concern, as a ‘generation less’, experiencing declining health, rising financial pressures and a restricted and uncertain career future (Standing, 2011; Rayner, 2016). Like many Western countries, tertiary degrees cost money and growing numbers of students combine paid work with study to pay their tuition and living costs. We explore whether these pressures on young people, who need to earn income but find time for study, may be one of the reasons why their health status is suffering. Our aim is to examine the lived experience of Australian undergraduate students, with respect to paid work, study and their health habits and status. These domains have been studied to varying degrees among undergraduates, mostly in isolation, missing the potential interplay and trade-offs with health. Australia is considered the third most expensive country for higher education in the OECD, behind the USA and Japan (OECD, 2012). Thus, nearly 9 out of 10 undergraduate students undertake paid work while studying to pay for their degree and cost of living (Department of Education and Training, 2018). Although a loan system is available for those who cannot pay upfront, recent policy changes indicate study fees will increase and income thresholds will lower for loan repayment (Australian Government, 2017, 2018). While there is debate on how these financial pressures impact students in terms of career opportunities and long-term savings (Bradley et al., 2008), there is little comment on what the impact might be on their health. Adding to the financial pressure of studying is the often insecure, low-paid and unpredictably-scheduled jobs many students access. At the minimum casual wage of $23.70 per hour, it takes 24 hours of work each week to earn the poverty line wage of $523.88 (for a single adult, no children, after tax; Melbourne Institute: Applied Economics and Social Research, 2018), thus the time needed to earn while learning is considerable. Earlier Australian studies have argued that the time available for study has decreased as the need to work has risen (Hall, 2010). A full-time student is recommended to dedicate 40–45 h per week to study (Australian National University, 2018). To live above the poverty line and meet university commitments students may be allocating upwards of 64 h a week to both study and work, resulting in extreme time pressures and conflicts. Study–work conflict refers to the incompatibility of study and work due to their respective time demands (Owen et al., 2018). Preliminary findings from Australian and international studies have indicated that student health is vulnerable to pressures from financial responsibilities, work demands and academic achievement, and earning to learn combines all three (Carney et al., 2005; Miller et al., 2008; Hall, 2010). Time is important for health, especially for sleep, healthy eating and physical activity, while too many demands are consistently linked to poor mental health (Lingard, 2007, 2012; Strazdins et al., 2011). We argue that the current imperative for young adults to pursue tertiary education to secure their future now comes with another requirement, which is to concurrently earn income while they study. This imperative is most acute among the less resourced. Because this combination of pressures—both financial and academic—is sustained over the undergraduate years it could be generating new health risks and inequities among young adults. There is now a considerable body of evidence to indicate that health outcomes in this group have deteriorated. Given the increasing number of students globally who participate in both study and paid work, such pressures could constitute a significant public health issue. There is consistent evidence that Australian undergraduates are physically and psychologically stressed (Stallman, 2010; Bexley et al., 2012). The number of students seeking help from student counselling services has increased in recent years, as has the evidence that psychological distress is endemic among students (Twenge et al., 2018). The mental health of students, therefore, is an immediate and urgent concern, as are the long-term costs to chronic disease and workplace participation from disruptions to healthy behaviours. Although declining trends in student health is well documented, there is a deficit of papers on the processes that explain it (Roberts et al., 1999; Mahmoud et al., 2012). However, the evidence suggests an important mechanism may be central to this problem and it hinges on student trade-offs between time for health and time for study and earning income. For example, poor academic outcomes, high levels of anxiety and depression as well as adverse health behaviours such as binge drinking and irregular sleep patterns are well documented, especially amongst students working more than 20 h a week (Andrews and Wilding, 2004; Lingard, 2007; Miller et al., 2008; Rochford et al., 2009; Lund et al., 2010; Stallman, 2010; Shankar and Park, 2016). The association between debt, paid employment and physical and mental health has been debated in conflicting UK studies (Carney et al., 2005; Jessop et al., 2005). This evidence points to a fundamental dilemma for students, because their time is finite, and study, employment and keeping healthy all take time (Strazdins et al., 2011). Under both time and income scarcity, tertiary students choose between competing priorities, deferring or shifting time needed for self-care, health routines, sufficient sleep and exercise and allocating it to the immediate demands of study or employment. Current literature establishes that students' mental health and health behaviours are often poorer than in the general population. Given the general absence of research examining how study–work conflict is altering health among students, this study seeks to phenomenologically explore the conflict and its impacts on undergraduates' health. METHODS Design This project employed a mixed-methods study design, incorporating both qualitative and quantitative data collection. Semi-structured interviews aimed to explore the lived experiences of undergraduate students who combine work and study in Australia. Interviews probed the strategies used to manage the responsibilities of work and study, their health and their experiences of time scarcity. Upon completion, the interviews were transcribed, cross-coded and thematically analysed as per standards described by Braun and Clarke (Braun and Clarke, 2006). The standards outlined a six-phase process for thematic analysis: familiarization of the data; generating initial codes; searching for themes; reviewing themes; defining and naming themes and write up (see Supplementary Table S1). A self-reported survey was issued prior to interviews and contained questions regarding demographics, finances, employment, sleep habits, psychological distress, diet and lifestyle. Health items were taken from the Australian Bureau of Statistics, the National Sleep Survey and the Kessler measure of Psychological Distress scale, chosen to benchmark the sample against data from the general population. The Kessler 10 scale has been found to be a robust community measure and been included in national health surveys in Canada and the USA, and in the WHO World Mental Health Survey (Kessler et al., 2002). There were two waves of study. The first interviewed students during an exam period. The second conducted similar interviews during exams with a brief follow-up interview several weeks post-exams (one participant absented). Statistical analysis Prevalence of Kessler 10 categories was calculated by gender for both waves of the study. Participants The sample consisted of 12 domestic students in the first wave and 10 in the second. All studied at a relatively prestigious Australian University and were employed whilst undertaking study. Participants were recruited via flyers distributed around the campus. Interested students contacted the investigators via email. The students were then assessed for their eligibility (undertaking both paid work and study). No incentives were offered. Sample size was capped at 22 students, reflecting common considerations in interview-based research including saturation, whereby the same themes emerge consistently and pragmatic concerns, including time and resource availability (Vasileiou et al., 2018). RESULTS The total sample of 22 tertiary students had an even gender split and were aged between 19 and 30 years. More than one-third received no financial support from either their family or Government benefits. About one half were financially helped by families or received some form of Government income support, however, they reported that this was not enough to live on. Three received a self-described high level of financial support, mostly in the form of rent and grocery help, however, all still undertook paid work for personal expenses. Number of days worked per week ranged from 1 to 6. The number of study units undertaken and days dedicated to study ranged from 1 to 5 and 1 to 7, respectively. Work and study Due to the necessity of working to offset rising financial pressures within a finite time-frame, most participants experienced some degree of time scarcity. For example, Bec, a female 5th year full-time student working multiple casual jobs commented: I always feel time pressured. The majority of participants spoke of negative effects of work on study. Expectations from employers for a greater number of hours, late hours or very early starts were common. Many indicated that they arranged university commitments around work shifts: I went to all my tutorials, because they were in the afternoons, so I could go after work. I had to watch all my lectures when I got home from uni that day, or the next day… when I had time. (Joel, working full-time) Online study was a common method used to balance time demands. The flexibility created by the adoption of online delivery blurs work and study domains, as Bec indicated: … with uni it all just became a jumbled mess and I was never sure when was study time and when was not …. Immediate financial obligation underpinned these time conflicts, limiting capacity to prioritize the longer-term benefits of protecting time for study. This theme emerged repeatedly even when students said that their top priority was study. For example, If you don’t have financial stability it creates insane anxiety and stress right? So like, what's worse? The fear of not being able to pay your bills and getting credit card debt? Or getting a C average? What causes more stress? (Louise, studying full-time, working up to 38 h a week) Sally, who worked and studied full-time, similarly described the difficulty of prioritizing work over study: … I feel like—maybe—sometimes my priorities are what are wrong. My priorities are just to earn money to help my loan and not prioritise uni …. You know I don’t want to work in hospitality forever so why am I caring more about work? But then I need the money …. Immediate demands like rent and groceries were uncompromisable and therefore took precedent over long-term goals like improving academic grades to secure the employment returns from a degree. These young people were aware of the long-term costs of their compromise, but felt they lacked the freedom to invest more time in their study. Work, health and study Many students, particularly those who worked at night, in hospitality or for long hours, were aware that adding work onto study was potentially affecting their health. Meals! I've given up a lot of meals- I’ve been trading off meals for sleep or showering … I'm not in a great financial position at the moment so I'm trying not to buy food out. which means that I need to go home and cook but if I don’t have time then I just end up not eating and pushing through. Having, like, a Pepsi or coffee. Mary, working multiple jobs, up to 50 h per week and studying full-time Andrew echoed the health consequences of time pressure, explaining that: I didn’t have much time in the week that was down time- it was all, um, either uni or work. I didn’t have any time to just sort’ve sleep or de-stress or anything. Many explained that their time-scarcity meant health was relegated to the lowest priority. Man, I would really- in an ideal world it would [be] uni, health, work (laughs). Um, but what it actually is, is: work, uni, then health. I don’t have the time to make uni my priority. I don't have the financial ability to make uni my priority. And health just has to deal with it; you know? (Louise) Furthermore, many participants identified the financial burden of visiting health practitioners: [my mum] pays for things that like I probably wouldn’t … be able to afford … it’s a couple hundred dollars to go and see [doctors] for half an hour or something. (Scott, full-time student working 3 days a week) Despite health being their lowest priority, finances and study habits relied on good health. This precarious situation was a source of anxiety for many: Oh! I. Can’t. Afford to get sick! I can’t afford to break a bone! That would just put my whole timeline on hold and that would make me probably get sick again from stress. (Tara) Some participants attempted to mitigate negative health impacts of combining work and study. For example, Bec had elected to undertake only 3 units of study as: … keeping paid work the same, I found that 4 courses was more exhausting and challenging [than 3 units] and taking a toll on my sort of ah—mental health I guess. Decreasing university study was justified by work, or more accurately finances, being the highest, most immovable priority for majority of participants. Less courses reduced stress and helped lower incompatibility of study and work schedules, even while it extended the time taken to obtain their degree. Just as time pressure was a constant, distress and sleep deprivation seemed to be accepted by participants as the ‘norm’. Efforts to address or manage these health impacts were negligible, as it appeared that the students simply expected to be distressed and sleep deprived when combining work and study. Helen comments: Um still chugging along pretty solidly actually, which is surprising. Um I did have break down in the supermarket like a week ago because I was so tired and so drained but I feel like that’s probably to be expected …. (Helen, both full-time work and study) Mental health On the Kessler 10 Measure on Psychological Distress, 20 out of 22 participants recorded a moderate or higher level of distress during exams. 36% of male participants reported high or very high psychological distress compared with 72% of female participants (refer to Supplementary Tables S2 and S3). Crucially, only two participants recorded a low rating of psychological distress, reinforcing recent evidence that extreme levels of mental ill health are widespread among tertiary students. For some participants, their psychological distress scores were contradictory to their own assessment of their mental health. For example, Harry recorded a very high score of psychological distress but stated: Um, mental health, I've never, like been able to be aware of when I might be experiencing like some mental health problems, if that makes sense? Maybe because I haven’t experienced any depression or like anxiety, so I guess that means that I am, taking care of it, in a way, if I’m not, experiencing it … but I'm not sure. I’ve never seen anyone, or spoken to anyone about my mental health. Again, this suggests that distress and poor self-care for health has become commonplace enough that it is considered normative. Participants seemed to expect and accept the health costs, as did their peers, thus psychological distress was reframed as another, inevitable element to combining working with studying. Health habits We asked students to rank their work, study and health in priority order. Study was most commonly rated the highest priority, work most commonly second and good health most often placed last. They also indicated that their health habits and routines were fragile and easily disrupted. Their reports of their fruit and vegetable intake, exercise and sleep habits suggest that these health-protective activities were less frequent than the general population (NHMRC, 2013,; Adams et al., 2017). Many of the participants reflected on past attempts to re-instate healthier behaviours when study-associated pressure reduced, only to report that they were quickly eschewed when work or study commitments rose again. Feeling overwhelmed was common. The ideal balance-which I’m very happy with- happens for two weeks at a time, then falls off for a bit […] sometimes I just get over-worked […] it just gets a bit much […] I’ve always gotta have that force pulling there saying, “No I still have to study. I have to work”. (Josh) Students admitted that alcohol contributed to feelings of overwhelm, as either the cause or a respite. Students were within weekly average guidelines for alcohol consumption. Most participants, however, stated that they often engaged in risky binge-drinking behaviours (7+ drinks in one day), so the average likely under-estimates alcohol consumption (Australian Bureau of Statistics, 2012, 2018; NHMRC, 2013). Students acknowledged effects of excess consumption. For example: I often end up to the point where I black out but then I wake up and remember nothing and feel terrible about myself and so yeah, it has a really bad effect on my mental health. (Mary) Many students experienced sleep deficiency. Almost all said that sleepiness interfered with their daily activities, that they felt exhausted, fatigued, irritable or moody. Sleep was the health habit most commonly sacrificed for university or work obligations. For example, Helen reflected: I was falling asleep at my [work] desk in the middle of the day … because I was up until stupid o’clock in the morning trying to write grant proposals. Whilst most participants sacrificed their sleep due to time pressure, a few were accessing stimulant drugs, introducing additional health risks. Sally described: Um … on occasions I sort of use modafinil to like get me through if I need to smash out an assignment and I’m so tired that coffee doesn’t do it. Health practices during exams Time trade-offs became more extreme and health-damaging during exams. Many of the negative habits adopted were also expensive and feelings of guilt put additional strain on mental health. Male participants more commonly reported that they asked for time off work during exams, whereas female participants tended to maintain their hours. Female participants more often reported feeling that they could not take time off and not wanting to let workplaces down. For example: Um, exams were pretty hard time for me […] I felt like I couldn't say no to the amount of shifts that I was getting and I did silly things like work the night before an exam um, soooo I felt quite under-prepared for [the] majority of my exams. (Mary) These results suggest that, although exams are an academically stressful and time-pressured period for both genders, gendered processes and disempowerment contribute to a propensity for female students to put their own study and health interests after their workplace’s, especially during exam periods. Health practices post-exams We found little evidence from follow up interviews that those health practices abandoned during periods of acute academic stress (e.g. sleep, exercise and diet) were reinstated afterwards. There were no commonalities among participants regarding the uptake of healthy practices post-exams when study-time demands were reduced. For example, when asked if she’d reinstated healthy behaviours after an exam period, Helen responded: Ah less-I haven’t had time …. In comparison, James, a full-time 2nd year student working multiple casual jobs, found there was no change in the time he put towards health, saying: Um I would say I prioritise [other activities] over my health … it’s not like I have additional time now to like focus on health. Lastly, Bec stated that: I’ve been getting more sleep which means that I have more energy to exercise as well as feeling like I have more time. The K-10 measure used in baseline and demographic data collection indicated that only 9% of students reported low psychological distress during the exam period. This increased, however, to 44% post-exam period. Similarly, moderate psychological distress declined, 36% to 22% and high or very high levels decreased 53% to 33% from exam period to post-exam period. Whilst these findings suggest that psychological distress declines post-exams, the finding that 89% of students during exams, and more than 50% post-exams experienced moderate or higher levels of psychological distress remains concerning (refer to Supplementary Tables S2 and S3). During exams almost all participants reporting a moderate to high degree of daily sleepiness and exhaustion or fatigue. The majority of students still described feeling fatigued and sleepy several weeks post-exams. In contrast, mood deterioration over the exam period (e.g. irritability) only persisted for a minority post-exam. Intergenerational inequity A final emergent theme was that of intergenerational inequity and resentment. Most participants felt at a disadvantage to previous generations. Two key insights emerged. First, during their period of study, students felt they were being asked to do more with less: achieve better grades, have fuller resumes, undertake unpaid internships while receiving limited financial support and fee increases. Participants were frustrated with their current situation and disillusioned about their outcomes post-graduation, including job acquisition, salary and home ownership. I mean like we’re told we’re meant to go to uni, get a good job, save up, have a house, have a family and so much of this just seems sooo inaccessible to our generation. Like, I worked out that if I want to buy a house in Canberra, I’m going to be like 35–40 by the time I can even look at a deposit where I’ll be eating Vegemite toast for dinner again and that’s so, so unfair[…] so kinda incredibly, cripplingly, just paralysing-ly stressful. (Annie, works 20 h per week and studies full-time) Second, many felt that after they finished university, they would face more competition for securing employment in their chosen fields, while repaying the loans that paid for their tuition. Resentment about the value tertiary education now represented was compounded by awareness that previous generations of Australians had been able to obtain their tertiary education for free. These past generations were also more likely to afford housing (now a major problem in Australia) and this combination led to the feeling of intergenerational tension and inequity. Others argued that Centrelink supports, even in combination with casual work, were insufficient to support students while studying: [Youth Allowance] was preposterous. It was telling me that I had $500 a week to live on. When I said that to my dad initially he was like “how is that not more than enough?” [After weekly expenses] you’re left with 120 dollars and you haven’t done anything yet. So that's with no expenses, no surprising bills, no doctors appointments, no um- Oh! So the [student contribution] fee every semester- if you have to pay it that week, you're at zero dollars. (Louise) DISCUSSION This study yielded four main findings. First, undergraduate students who combine work with study are almost universally time-poor, due to the need to earn income while learning. Second, this limits students’ capacity to study and could also lead to worsening health outcomes, potentially also compromising academic performance. Third, there was no significant improvement to health habits following exams, suggesting that the loss of health routine and habits under acute time-related pressures may be persistent and long term. Finally, students believed that their study–work conflicts, and subsequent health concerns, were connected to and constituent of a growing intergenerational inequality. Our qualitative data reveals that in the effort to earn sufficient income while undertaking study, these young Australians were making multiple trade-offs with potential long-term academic and health consequences. We show how important time scarcity and the resultant time trade-offs are as pathways linking work–study conflicts to tertiary student health. As time demands from working rose, in terms of hours or inflexibility, so too did student reports of the negative impacts on their study and health, particularly mental health. In this and others studies, students who perceived more demands from their workplace reported feeling tired or overwhelmed, skipping classes and feeling too time-poor to study effectively or maintain healthy habits (Butler, 2007). The effect was most acute during periods of increased academic pressure and time scarcity; particularly for students who could not reduce their paid work hours. These participants described significant negative health outcomes, including higher distress levels, flu-like symptoms, skipping or unhealthy meals, reduced or no exercise and even hospitalization. Participants attributed their distress and ill health to cumulative factors such as pressure to work, debt, financial strain and academic performance anxiety. Consistent with current literature, the prevalence of mental disorders is associated with financial difficulty, work and academic demands and time scarcity (Cvetkovski et al., 2012; Farrer et al., 2016; Australian Bureau of Statistics, 2018). The immediate effects on physical health are concerning, as are the alarming rates of mental distress of our students. Both may contribute to long-term outcomes such as reduced productivity and chronic physical and mental health problems. The majority of these students experienced degrees of sleep deprivation. The negative effects of sleep deprivation include reduced social functioning, increased risk of accidents, poor physical and mental health and an overall reduction in quality of life (Lund et al., 2010). Within the work–study conflict literature, few studies explore sleep as a non-work domain, and therefore, the dynamics of the sleep–work–study conflict remain largely unknown. This study supports the findings of Barnes et al. (Barnes et al., 2012) that revealed how sleep was particularly vulnerable to being sacrificed when competing demands for other activities were high. The use of stimulants to overcome symptoms of sleep deprivation is concerning for long-term health outcomes, and use continues to rise in Australia, now overtaking the USA and Germany (Mazanov et al., 2013). For example, modafinil, used by one participant in this study was deemed inappropriate for any condition other than narcolepsy due to risks of serious skin reactions, negative cardiovascular events, depressive and suicidal tendencies (Ragan et al., 2013). Another finding is the perceived normalcy of sleep deprivation and distress. Our students appeared to exist in a state of denial of the impacts and the severity of distress and sleep deprivation. None made efforts to address, manage or ultimately improve their health. This perception that feeling unhealthy is expected and unavoidable, creates a culture of undervaluing health and a potential long-term chronic disease risk. Students commonly addressed conflicting time demands by adopting online course delivery, which enables greater flexibility as material can be accessed at any time. Online delivery has facilitated students’ ability to undertake full-time university and work long hours simultaneously, an opportunity uncommon in the past. This flexibility, however, may have significant health consequences such as greater risk of exhaustion and burnout (Lingard, 2007). The distortion of domain boundaries, a known contributing factor for overwork (Nam, 2014), has been facilitated by online course delivery and may lead to negative mental and physical health outcomes, with negative flow effects on other life-domains. The potential time, health and work–study conflicts have been a neglected aspect of online education policy and rollout. This study also explored the ability to reinstate healthy practices. We found that healthy practices rarely returned after the exam period ended. Some participants felt their well-being had improved, others felt it remained constant, and some thought well-being had declined. The importance of habit in the maintenance of healthy behaviour is well-established in current literature: it was visible in many participants’ responses (Verplanken and Melkevik, 2008; Riet et al., 2011). However, post-exam, time was difficult to redirect to academic or employment pressures, preventing the adoption and maintenance of healthy habits. Inadequate sleep, exercise and poor diet appear to become easily engrained and difficult to break, generating a longer-term risk. Confirming population statistics, we found that the state of our students’ health was poorer than in the general population (Australian Bureau of Statistics, 2018). The implications of this health gap are multi-layered, including: appropriate and adequately resourced response from government and universities to support self-care and healthy living; policy effort to address both the economic and health inequities associated with studying while working and; increased awareness among young adults who are studying and working on the value and need to protect and promote good health. In regard to the debate of the ‘entitled’ or ‘ungrateful’ younger generation (Rayner, 2016; Bita, 2017), students perceived they were being asked to achieve more with fewer resources, for a harsher and more uncertain future. The feelings of resentment and generational disparity were not a product of entitlement, rather an understandable response to inadequate and inequitable policies and circumstances, known social determinants of health (Marmot et al., 2008; Standing, 2011). These include welfare support, access to affordable housing, increasing casualization of the workplace, stagnant pay rates and loss of penalty rates for work on the weekends, evenings or nights, resulting in irregular earnings and rising underemployment among young Australians (Gilfillan, 2018; Stanford and Henderson, 2018). These changed policy, social and economic circumstances have most dramatically affected the hospitality and retail industries, which students are known to work in. Similarly, a recent study on housing in Australia found that not one of the approximately 69 000 rentals listed was affordable for a single on Youth Allowance (Anglicare Australia, 2019), thus high rents also drive students to work more. Time pressures then compound income demands and deficits, limiting students’ capacity to excel academically and leading to serious and long-term consequences for health. Limitations There are several limitations that should be acknowledged. First, this project has a small sample size. Although common in qualitative research, this limits the generalizability of the findings to the broader student population (Vasileiou et al., 2018). Second, the sample was recruited from one university known for a relatively high socioeconomic population (Hughes-Warrington, 2012) which may hinder the study’s external validity; our sample likely under-represented young adults who were less resourced or privileged. Finally, as the project was limited to examining only a few health outcomes, it was not possible to gain a comprehensive insight into the full range of health consequences from combining work and study. For example, mental health was examined using the Kessler 10 which measured psychological distress and omitted other aspects of mental health, we also did not include prodromal markers of chronic health problems such as diabetes or blood pressure. CONCLUSION Many students now experience time scarcity due to combining work and study. To lessen their time pressure, students are unsustainably trading off aspects of their health, such as sleep, exercise and mental well-being. We argue that the effects of trade-offs of time between work and study domains are multidirectional and may offer a causal explanation for the alarming and deteriorating health of young Australian students. It remains unclear if students can restore better health practices after periods of acute stress, an area that also warrants further investigation. Lastly, government and university systems were perceived as ineffective, unsympathetic and inequitable. Despite claims of over-entitlement and calls for gratitude, current students are experiencing worsening health outcomes, while facing uncertain economic outcomes post-graduation. 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TI - Earning to learn: the time-health trade-offs of employed Australian undergraduate students
JF - Health Promotion International
DO - 10.1093/heapro/daz133
DA - 2019-09-11
UR - https://www.deepdyve.com/lp/oxford-university-press/earning-to-learn-the-time-health-trade-offs-of-employed-australian-0qQEufUlvb
DP - DeepDyve
ER -