The purpose of this article is to provide identified stressors, physical and psychological health issues that affect first year campus college students as they transition from high school to college. The Health Behaviors, Self-Rated Health and Quality of Life (QOL) questionnaire was administered to 514 university college students. Results from this study determined that there were significant differences among student life stressors and physical and psychological health status between first-year on-campus and first-year off-campus college students. Most importantly this study documented compelling information regarding selection of roommate, poor housing, chronic and temporary diseases, injury and prescription medicine among college students attending a university in North Carolina. Implications for university health administrators, student affairs personnel, counselors and faculty are discussed.