U.S. border colonias, otherwise known as Disadvantaged Unincorporated Communities, are rural settlements along the U.S. Mexico border with substandard housing conditions. Colonia residents often face inadequate access to necessities such as appropriate shelter, septic and sewer systems, and potable water. Water insecurity in colonias poses a particularly difficult challenge for residents who require clean water not only for consumption, but also household use in sanitation and hygienic practices. As of 2015, an estimated 30% of over five million US colonia residents lack access to clean drinking water, resulting in health complications and unsanitary living conditions. Preliminary health data collected indicates that due to water insecurity, colonia residents are more likely to contract gastrointestinal disease, be exposed to carcinogenic compounds from contaminated water, and experience psychosocial distress. Yet more comprehensive research needs to be conducted to understand the full breadth of the public health issue. A scoping review on water insecurity in colonias has not been completed before and could be beneficial in informing policymakers and other stakeholders on the severity of the situation while advising possible solutions.

Diabetes affects millions of people globally and can lead to other severe health complications when undiagnosed or not properly managed. The incidence of diabetes has rapidly increased over the past several years, however, not all individuals have access to affordable or convenient healthcare. We hypothesize that wastewater-based epidemiology (WBE) has the potential to assess community health status by analyzing biomarkers indicative of human health and disease, including diabetes. Used in tandem with current methods, monitoring indicators of diabetes in community wastewater could provide a comprehensive assessment tool for disease prevalence in large and small populations. Specifically, the proposed targeted biomarker evaluated in this study to indicate population-wide diabetes prevalence was 8-hydroxy-2’- deoxyguanosine (8-OHdG). This work combines a rigorous literature review and initial laboratory studies to explore the possibility of diabetes monitoring at the community level using WBE. Here, 24-hour composite wastewater samples were collected from within two wastewater sub-catchments of Greater Tempe, AZ. Overall goals of this study were to: i) Determine the feasibility to detect endogenous markers of diabetes in community wastewater; ii) Assess the potential impact of confounding factors, such as smoking, cancer, and atherosclerosis, through a literature analysis; and iii) Evaluate the socioeconomic status and demographics of the study population. Preliminary results of the experiments suggest this methodology to be feasible, as indicated by the observation of detectable signals of 8-OHdG in community wastewater collected from the sewer infrastructure; however, future work and continued experimentation will be required to address low signal intensity and assay precision and accuracy. Thus, the work presented here provides valuable proof-of-concept data, with detailed information on the method employed and identified opportunities to further determine the relationship between 8-OHdG concentrations in municipal wastewater and diabetes prevalence at the community level.