ORIGINAL RESEARCH
Health Promotion & Student Health

Health Risk Factors and Health Promoting Behaviour Among Medical and Non-Medical Students

Background and Context

University students represent a critical demographic for public health intervention. The transition from secondary school to higher education is frequently accompanied by significant changes in lifestyle, dietary habits, physical activity patterns, sleep behaviours, and psychological wellbeing. For many young adults, this period represents the first time they bear primary responsibility for their own health choices, often in an environment characterised by academic pressure, irregular schedules, and limited financial resources.

In Malaysia, where university enrolment has expanded substantially over the past two decades, the health behaviours established during this formative period have long-term implications for the national burden of non-communicable diseases (NCDs). The National Health and Morbidity Survey has consistently documented rising prevalence of obesity, diabetes, hypertension, and mental health disorders among young Malaysian adults, suggesting that preventive strategies targeting university-age populations deserve greater attention.

A particularly relevant question in health promotion research is whether students enrolled in health-related disciplines — who presumably receive extensive education about disease prevention and healthy lifestyles — actually practise what they learn. International research has produced mixed findings on this question, with some studies showing that medical students adopt healthier behaviours than their peers while others document comparable or even higher rates of stress, burnout, and unhealthy coping mechanisms among health science students.

Study Design and Methodology

This cross-sectional study was conducted among undergraduate students at a Malaysian university, comparing health risk factors and health-promoting behaviours between students enrolled in medical or health science programmes and those in non-medical disciplines. Participants completed a structured, self-administered questionnaire assessing multiple dimensions of health behaviour, including physical activity, dietary habits, smoking and alcohol use, stress management, sleep patterns, and health responsibility (defined as proactive engagement with personal health monitoring and preventive care).

The Health-Promoting Lifestyle Profile (HPLP) framework, adapted for the Malaysian context, provided the theoretical basis for the study instrument. This widely validated tool assesses six dimensions of health-promoting behaviour: health responsibility, physical activity, nutrition, spiritual growth, interpersonal relations, and stress management. Sociodemographic data including age, sex, ethnicity, year of study, and body mass index (BMI) were also collected.

Key Results and Discussion

The study found that while medical students scored higher on measures of health knowledge and health responsibility, the differences in actual health behaviours between the two groups were less pronounced than might be expected. Physical inactivity emerged as a concern across both groups, with a substantial proportion of students failing to meet the World Health Organisation’s recommendation of at least 150 minutes of moderate-intensity physical activity per week. Female students in both groups reported particularly low rates of regular exercise, consistent with broader patterns observed in Malaysian health surveys.

Dietary patterns were similarly suboptimal across both groups. Irregular meal timing, frequent consumption of processed and fast foods, low intake of fruits and vegetables, and habitual consumption of sugar-sweetened beverages were common. These findings are consistent with the broader literature on university student nutrition in Southeast Asia, where the food environment around campuses typically favours inexpensive, calorie-dense options with limited nutritional value.

Stress and mental health indicators revealed that both medical and non-medical students experienced significant academic-related stress. However, medical students reported higher levels of perceived stress, attributed to the demands of clinical training, examination pressure, and the emotional burden of patient contact. Despite this, medical students were not significantly more likely to seek professional psychological support, suggesting that knowledge of mental health services does not overcome the barriers to utilisation, including stigma, time constraints, and perceived self-sufficiency.

Implications for University Health Promotion

The findings reinforce the argument that health education alone is insufficient to produce behavioural change. Malaysian universities, particularly those with medical and health science faculties, have an opportunity to model healthy institutional environments through policies that support physical activity (accessible sports facilities, active transport infrastructure), improve campus food environments (healthier cafeteria options, nutrition labelling), and normalise mental health help-seeking through embedded counselling services and peer support programmes.

For medical education specifically, the study raises questions about the hidden curriculum — the implicit messages about health and self-care that students absorb from the culture of medical training. If medical students observe that their professors and clinical supervisors routinely sacrifice sleep, exercise, and personal wellbeing in service of professional obligations, the formal curriculum’s health promotion messages may be undermined by the lived experience of medical culture.

Limitations

As a cross-sectional study conducted at a single institution, the findings cannot establish causal relationships and may not be generalisable to all Malaysian universities. Self-reported health behaviours are subject to social desirability bias, and the specific response rate and sample characteristics were limited to the study setting. Additionally, the study did not assess clinical biomarkers (blood glucose, lipid profiles, blood pressure) that could provide objective validation of self-reported health behaviours.

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