Health Insurance Literacy and Financial Strain Among College Students: Comparing First-Generation and Non-First-Generation Student Experiences

Publication Date

2026

Presentation Length

Poster/Gallery presentation

College

College of Pharmacy & Health Sciences

Department

Public Health, Department of

Student Level

Undergraduate

Faculty Mentor

Christian L. Williams, DrPH, MPH

Presentation Type

Poster

Summary

The purpose of this study was to determine the relationship between health insurance literacy and financial strain for first-generation students, compared to non-first-generation student peers. Poor health insurance literacy in college may establish patterns of healthcare avoidance or financial mismanagement that persist in post graduation (Vong et al. 2025, p12).  A cross-sectional survey was conducted during the fall 2025 semester. The sample included undergraduate students over the age of 18 who are currently enrolled at Belmont University in the college of Pharmacy and Health Sciences in the majors of Social Work, Public Health, Exercise Science, and associated minors. Participants completed an online survey including 27 Likert scale questions and one open ended question assessing health insurance knowledge and literacy. Financial strain was measured through the Financial Strain and Economic Support Measure, using the Chronic Financial strain subscale. Health literacy levels were assessed using the Health Literacy Self-Assessment tool. Responses from first-generation students were compared with non-first-generation students to assess differences in health insurance literacy and financial strain. Results indicated that all students regardless of first-gen status, or non-first gen status struggled with health insurance illiteracy with 57% of students reporting they did not know enough to feel confident about their own health insurance and only 5% feeling totally confident about their health insurance literacy. The results of this study could inform future programs aimed at increasing health insurance literacy among undergraduate students, particularly those who are studying to become future health care professionals.

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