How healthy were students in US colleges in 2021? Especially during the COVID-19 pandemic? Survey from Fall 2021 shows top 4 health problems that affected academic performance were Stress, Anxiety, Depression and Sleep Difficulties. These were the same top 4 from 2019 and 2020. More than one in five reported using some form of non-medical Cannabis in the last 3 months. This was higher than those who used a tobacco product. Psychological distress loneliness scores were moderate to high for at least half of students. Nutrition and Physical Activity were also studied. Detailed study of 41 colleges and universities by the American College Health Association, National College Health Assessment. (ACHA-NCHA data). Updated February 2022.