Chronic Disease Prevalence and Modifiable Risk Factors Among Undergraduate Students at Ha’il University: A Population-Level Cross-Sectional Study

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Collins Otieno Asweto,1,* Sehar-un-Nisa Hassan,2,* Mohamed Ali Alzain,2,3,* Bandar Alsaif,2 Mohammed Elshiekh Saeed,4,5 Ahmed Kassar,2 Kamal Elbssir Mohammed Ali,6 Mouna Ghorbel,7 Rafat Zrieq,8,9 Monzer Hamed,2 Wei Wang10,11 1Department of Community Health, School of Nursing, University of Embu, Embu, Kenya; 2Department of Public Health, College of Public Health and Health Informatics, University of Ha’il, Ha’il, Saudi Arabia; 3Department of Community Medicine, Faculty of Medicine and Health Sciences, University of Dongola, Dongola, Sudan; 4Department of Physiology, Faculty of Medicine, National University-Sudan, Khartoum, Sudan; 5Department of Physiology, Faculty of Medicine, University of Dongola, Dongola, Sudan; 6Department of Community Health, Occupation Health and Safety Program, Northern Border University, Arar, Saudi Arabia; 7Department of Biology, College of Sciences, University of Ha’il, Ha’il, Saudi Arabia; 8Medical-Surgical Nursing Department, College of Nursing, University of Ha’il, Ha’il, Saudi Arabia; 9Applied Science Research Centre, Applied Science Private University, Amman, Jordan; 10Clinical Research Centre, First Affiliated Hospital, Shantou University Medical College, Shantou, Guangdong, People’s Republic of China; 11Centre for Precision Health, Edith Cowan University, Joondalup, Western Australia, Australia*These authors contributed equally to this workCorrespondence: Sehar-un-Nisa Hassan, Department of Public Health, College of Public Health and Health Informatics, University of Ha’il, Ha’il, Saudi Arabia, Email s.nisa@uoh.edu.saBackground: Rising rates of chronic conditions among Saudi youth underscore the need for early prevention. Using a public‑health lens focused on demographic, academic, and lifestyle influences, this study investigates the risk and protective factors for chronic disease among students at the University of Ha’il to guide youth‑centered health policies and long‑term wellbeing initiatives.Methods: A cross-sectional survey was conducted among 10,775 undergraduate students studying in bachelor’s degree programs at Ha’il University, Saudi Arabia. Descriptive analyses were used to assess demographic characteristics, academic status, health status, and health-related lifestyles. Multiple logistic regression models were applied to determine which demographic, academic, and health-related lifestyle factors significantly predicted chronic disease among university students.Results: The overall prevalence of chronic diseases was 16.2% (n = 1748). Among chronic diseases, diabetes was the most prevalent 6.8% (n = 731), followed by migraines 5.4% (n = 583), heart disease 2.0% (n = 217), hypercholesterolemia 1.9% (n=201), and others 0.1% (n = 16). The results showed that younger, female, and married students had greater odds of developing chronic disease. Among the study-related variables, academic level, Grade Percentage Average (GPA), missed lectures, and intention to withdraw were significantly associated with chronic diseases. Among psychological variables, high stress levels significantly increased the odds of having chronic disease [AOR = 9.87 (95% CI: 8.01– 11.34), p < 0.001]. Students with unhealthy lifestyles were more likely to have chronic diseases than those with a healthy lifestyle [AOR = 2.60 (95% CI: 2.33– 2.90), p < 0.001].Conclusion: The 16.2% prevalence of chronic health conditions among university students is a notable public health concern within this typically healthy population. Demographic and academic vulnerabilities were further intensified by modifiable lifestyle behaviors which showed strong associations with chronic disease prevalence thus findings imply prioritizing student health through culturally grounded interventions.Keywords: health status, sleep, physical activity, academic stress, vulnerability

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