College Students Living with a Chronic Condition
The term "chronic conditions" may apply to a wide range of medical conditions. Traditionally, it refers to a disease that affected college students must continually mitigate against (typically with medication and/or physical therapy) for an indefinite period of time.Â The CDC listsÂ stroke, heart disease, cancer, diabetes, and arthritis as five of the most common chronic illnesses found among all U.S. citizens; in recent years, obesity has also been included on this list.Â Other illnessesÂ that occur less frequently but are still considered "chronic" include:
- Crohn's disease
- Multiple sclerosis
- Parkinson's disease
- Ulcerative colitis
Additionally, psychological conditions like bipolar mood disorder and schizophrenia also impact college students on a chronic basis. Chronic conditions that impact daily life like blindness, deafness, or partial paralysis are classified as disabilities, not chronic illnesses.
Chronic conditionsÂ may occur in individuals of any age, and there are special considerations for every age group. For college students, having a chronic illness generally requires strategies for finding the right balance between studying and managing a disease; important considerations concerning financial aid and health insurance; and disability services that are available to these students, both online and offline. In this guide to student resources for college students with chronic conditions, you will learn how to better manage your condition while attending college.
Balancing School and Disease Management
In a 2005-07 survey by the CDC, 12.9% of men between the age of 18-29 and 17.9% of women in the same age group professed to living with a chronic disease. The study found that the six most commonly occurring chronic conditions in this age group were (in order of frequency) asthma, arthritis, hypertension, diabetes, cancer, and heart disease. Today, WebMDÂ estimates that roughly 7% of college-aged people (18-23) live with a chronic illness in the United States.
Most college students struggle with college coursework to some degree, but men and women with chronic illnesses face the added burden of managing their disease while striving to earn good grades. Many of these individuals will struggle with their school's attendance policy and will be forced to miss days or weeks of school in order to receive treatment or therapy; in some cases, such as students with cancer who must undergo chemotherapy, this period of absence can last months or years. Managing the disease is of paramount concern to these individuals, but having to deal with an attendance policy can take a major emotionalÂ andÂ financial toll on them.
Lily Altavena, a blogger forÂ The New York TimesÂ who lives with Crohn's disease, underwent this struggle when she attended New York University. She urges other students with chronic illnesses to locate a specialist for their specific disease within reasonable proximity to their campus or college residence; they should schedule regular appointments (whether or not they are suffering from symptoms of the illness), and ensure that the doctor has an up-to-date copy of their medical files. These students should also inform all of their professors about the illness as soon as the course begins. "I have never encountered an instructor who was not understanding about my medical situation," Altavena writes. "I did not miss class excessively, but I did miss more than ordinarily acceptable, and I occasionally needed an extension on an essay."
WebMDÂ also encourages chronically ill students to visit their school's office of disability services, particularly if they are living on-campus and require a room with specific dimensions or an alternative meal plan. Other disability services available through this office include transportation to and from campus and stenographers who can attend class and take notes for individuals who are not able to meet the attendance policy. These student resources can be a life-saver for many students who would otherwise struggle to maintain their school's academic policy and attendance policy.
Students with chronic conditionsÂ who are forced to miss prolonged periods of class may consider an alternative course of study. Part-time enrollment is available at most two and four-year learning institutions. By selecting one or two courses (compared to full-time students, who typically enroll in three to five courses per quarter or semester), students with illnesses may be able to allot enough time for both studying and managing their disease. In recent years, online education has proven quite popular with all students; those with chronic illnesses may benefit from earning their degree from the comfort of their own home. Any student with an illness that stands to affect an attendance policy or coursework should visit their advisor once school begins to discuss either of these feasible disability services.
Virtually every major college and university has Â student resources such as a disability services office dedicated to students with disabilities and/or chronic illnesses. Additionally, some universities have launched programs specifically aimed at students. DePaul University's School for New Learning , for example,Â launched the Chronic Illness Initiative in 2003, and the program eventually served hundreds of DePaul students. However, programs of this scope are rare in the U.S.
Know Your Financial Aid Options
Cecilia Reyes, a DePaul student with multiple sclerosis who took part in the Chronic Illness Initiative during her undergraduate studies, toldÂ Inside Higher EdÂ that missing class to manage her illness ultimately cost her roughly $10,000 in tuition dollars (which were eventually refunded). This sort of financial toll is a sad but all-too-common consequence of chronic disease management.
Paying for college can be stressful. Financial aid is available to all students, regardless of whether they live with a chronic illness; however, some forms of financial aid are exclusively offered to full-time students. All three major federal loans — Direct Loans, Federal Family Education Loans (FEFLs), and Perkins Loans —Â require recipients to be enrolled as full-time students. Once the student drops to part-time status, he or she will be given a six-month grace period, after which the student must begin repaying the loans. However, all three federal loans will beÂ completely forgivenÂ if the student's chronic illness forces him or her to drop courses; this is known as a âTotal and Permanent Disability Discharge.' If a student dies (either due to a chronic illness or under other circumstances), then the loan will be canceled.
If a student's chronic conditions are severe enough to cause school absences, but do not qualify for a Total and Permanent Disability Discharge, he or she may be able toÂ apply for forbearance. This will not forgive the loan, but paying for college becomes easier with a repayment process that will temporarily delayed the loan.
However, the same rules do not apply to loans acquired from private lenders such as banks or credit unions.Â An article in USA Today notedÂ that these lenders will frequently demand repayment from recipients who reduce their schedule to part-time, even if chronic illness is the primary reason. Financial adviser Mark Kantrowitz toldÂ USA TodayÂ that, for students with chronic diseases, federal loans are "always" a better option for paying for college, rather than obtaining financial aid from private lenders.
The policies of all scholarships and grants will vary on a case-by-case basis; some will demand repayment from students who do not finish their degree program while others will not, and typically the amount of money awarded to recipients is the compelling factor. Students who are chronically ill that apply for this type of financial aid should research these repayment policies for any scholarships or grants they wish to apply for.
It's important for college students with chronic conditions to note that they are entitled to certain rights as college students. In the event that a disease significantly impacts their ability to study, attend class, and complete coursework,Â colleges and universities are legally requiredÂ offer certain amenities such as extended testing time or course load reduction. These accommodations are also known as an "academic adjustment." However, according to the U.S. Department of Education, a "postsecondary school does not have to make adjustments that would fundamentally alter the nature of a service, program, or activity, or that would result in an undue financial or administrative burden."
Below, we have listed 10 scholarships geared specifically toward college students who live with chronic illnesses. Each scholarship will help to reduce or eliminate the burden of paying for college:
- Cancer for College: Established in 1994, this scholarship award is available to both current and former cancer patients. Amounts will vary from hundreds to thousands of dollars per recipient.
- Cancer Survivors' Fund: This scholarship is available to former and current cancer patients who are U.S. residents. The annual deadline is June 1.
- Crohn's and Me: This one-time $5,000 scholarship is awarded each year to eight college students living with Crohn's disease.
- Diabetes Scholar Foundation: This foundation awards 21 scholarships ($3,000 to $5,000 per recipient) to diabetic students who attend four-year universities, community colleges, or technical/trade schools.
- National Collegiate Cancer Foundation: This organization offers a non-renewable, $1,000 scholarship to college students who are undergoing cancer treatment.
- National M.S. Society Scholarship: This award (ranging from $1,000 to $3,000 per recipient) is given to college students living with multiple sclerosis.
- Patient Advocate Association: This organization annually awards eight $5,000 scholarships to individuals who have been forced to leave college in order to undergo treatment of a life-threatening disease.
Going Back to School After Treatment
Returning after a long disease-related absence and re-adjusting to campus life can be a trying, emotionally charged experience. An article from Cancer.net titled "Returning to School After Cancer" notes three ways college students can ease their return to school after completing chemotherapy treatment; these strategies can be applied to those with other chronic illnesses that must leave college in order to manage their disease.
- Discuss the circumstances with faculty members: Prior to their return after a long absence, chronically ill students should notify their academic advisor. Additionally, the student may want to meet with someone at his or her college's office of student affairs. These faculty members can assist students in the days and weeks to follow. They can provide information about the possibility of a reduced course load, explain any accommodations or services that are available to the student and, if necessary, help the student make a contingency plan in relation to an existing attendance policy. Faculty members can also point students toward internships, part-time employment, professor assistantships, and other work opportunities that will enable them to professionally advance while still re-adjusting to college life.
- Contact the school's student health center: When the student is ready to return to campus, he or she should schedule time to meet with a doctor, nurse, or other medical professional. During this meeting, the student should provide up-to-date medical information — including current medications, prognosis, and contact numbers for the doctor(s) who provided treatment — that will allow staff at the health center to provide the highest level of care. Most college student health centers have systems in place to specifically address these individuals and offer guidance and assistance for the remainder of their studies.
- Seek out necessary accommodations and other student resources: Certain medical treatments can affect motor skills and physical coordination, while others can dull the patient's senses and hinder their ability to think and process information clearly. Under the Americans with Disabilities Act and other federal laws, colleges and universities must provide amenities to assist students who have these sorts of limitations. These matters can be discussed with professors, but students who would rather not share this information can speak to a school counselor in order to receive the amenities they require to study, attend class, and complete their coursework.
TheÂ Cancer.net articleÂ also urges chronically ill students who are returning to college to build a support network of friends, relatives, faculty members, and other individuals with whom they have a personal relationship. Additionally, they might benefit from joining a support group comprised of individuals who share their chronic illness; discussing the disease with those who know and understand it best can be very therapeutic for students who are still reeling from extensive medical treatment.
Maximize Your Health Coverage
The vast majority of accredited colleges and universities in the United States provide health insurance to students who enroll and choose to receive coverage; the specific conditions (deductibles, procedures that are covered, etc.) will vary from school to school. However, the health coverage of chronically ill students may be affected (or even cancelled) in the event of a prolonged absence that reduces their full-time status. For this reason, WebMD urges chronically ill students to discuss this matter with their parents prior to leaving school; if a health plan covers one or both parents, then itÂ must also cover each childÂ in that family until they reach the age of 26.
If the student so chooses, he or she may also opt to apply for heath insurance or health coverage under the Affordable Care Act. Additionally, Young Invincibles Deputy Director, Jennifer Mishory, noted in aÂ recent USA Today articleÂ that students can enroll in ACA plans "without the threat of being denied coverage because of a pre-existing condition." However, in aÂ 2013 publication from the National Center for Public Policy Research, Dr. David Hogberg reported that more than 3.7 million young people in the country, for reasons related to income and family size, stand to save $500 per year by simply opting out of ACA health insurance and paying the $95 penalty fee.
Mishory also explained that students who either earn less than $36,000 or come from families whose annual household income falls below $94,000 may also apply for Medicaid or health insurance that is subject to tax credits — although the terms and conditions of this arrangement will vary by state. Finally, theÂ American College Student AssociationÂ can provide low-cost health coverage for chronically ill individuals; in some cases, the ACSA will insure students for a pre-determined duration (i.e., one semester) to accommodate special circumstances.
Chronically ill college students who attend brick-and-mortar schools should meet with staff at their college's health center to discuss the conditions of their health coverage. Online students facing the same circumstances should research their school's health insurance policy. Many web-based institutions offer health coverage plans through affiliated, brick-and-mortar partner schools. Other options for eLearners,Â according to StraighterLine, include low-cost coverage providers like Horizon and StudentHealthInsuranceRates.com
Finally, it's important for chronically ill students to recognize, regardless of the disease they're living with, that they are not alone. Each of the student resources was created by a student living with a chronic illness:
- Chronically Katie: This blog chronicles the daily life of Katie, a college student living with three chronic diseases: fibromyalgia, Chronic Fatigue Syndrome, and depression.
- College Student with Celiac: Celiac disease is a chronic autoimmune disease that affects the small intestine; individuals with Celiac are required to maintain a gluten-free diet. In this blog, Chynna discusses her experiences living with the illness as a student at Rice University.
- Elise Rachelle: Subtitled, "I am the luckiest unlucky person I know," this blog details Ms. Rachelle's cancer diagnosis during her sophomore year of college, the treatment she underwent, and the often painful recovery period that followed. She alsoÂ maintains a blogwith The Huffington Post.
- Insight: Boston's Dana-Farber Cancer Institute maintains this blog that primarily covers news about all types of cancer. Many of the posts are written by cancer survivors or current patients.
- Overcoming Schizophrenia: Ashley started this blog in 2008, following her schizophrenia diagnosis, and has since detailed her return to college.
- Rheumatoid Arthritis Guy: The anonymous author of this blog discusses living with rheumatoid arthritis. Many posts address concerns he faced during his collegiate years.
Next, we've listed a handful of support groups for students with certain chronic illnesses.
- CCFA Campus Connection: This is a support group for college students who live with Crohn's disease and/or colitis.
- National Collegiate Cancer Foundation:Â Founded by college student Dan WaegnerÂ (who passed away from cancer in 2009), this organization seeks to connect cancer patients and survivors across the country, and to provide access to information about treatments, medications, and other important concerns these individuals face.