National Public Health Institutes (NPHIs) around the world vary in composition. Consolidated organizational models can bring together critical functions such as disease surveillance, emergency preparedness and response, public health research, workforce development and laboratory diagnosis within a single focal point. This can lead to enhanced coordination and management of resources and enable more efficient and effective public health operations. We explored stakeholders’ perceptions about the benefits and challenges of consolidating public health functions in an NPHI in seven countries where the US Centers for Disease Control and Prevention has supported NPHI establishment and strengthening. From August 2019 through January 2020, we interviewed a total of 96 stakeholders, including NPHI staff (N = 43), non-NPHI government staff (N = 29) and non-governmental and international organization staff (N = 24) in Cambodia, Colombia, Liberia, Mozambique, Nigeria, Rwanda and Zambia. We conducted a policy analysis using Tea Collins’s health policy analysis framework to assess various possible options for coordinating public health functions and their likely effectiveness. The findings can be used by policymakers as they consider public health infrastructure. We found that consolidating functions in an NPHI, to the extent politically and organizationally feasible, promotes efficiency, flexibility and coordination, as well as supports data-driven health recommendations to government decision makers. Countries pursuing NPHI establishment can weigh the potential challenges and benefits of consolidating functions when determining which public health functions will comprise the NPHI, including clarity of role, access to resources, influence over decisions and political viability.

Thyroid hormone abnormalities are among the most common endocrine disorders comorbidly suffered alongside metabolic syndrome and type 2 diabetes mellitus (T2DM), and within the euthyroid range they may also impact other outcomes, such as mood disorders. This study aimed to observationally examine the relationship between TSH and social determinants of health and clinical measures in a euthyroid Hispanic/Latinx patient sample with a diagnosis of anxiety and/or depression disorders from a community health clinic. A needs assessment was completed using a random sample of 100 de-identified medical records of individuals who received free medical care, including mental health, at a community-based clinic. Those with low normal TSH (<2 mIU/L) compared with high normal TSH (≥2 mIU/L) had a greater odds of food insecurity (p = 0.016) and being at 100% of the federal poverty level (p = 0.015). The low normal TSH group had significantly higher fasting glucose (p = 0.046), hemoglobin A1c (p = 0.018), and total cholesterol (p = 0.034) compared with the high normal TSH group. In those with T2DM, individuals with low normal TSH had six-times greater odds of having high fasting glucose (p = 0.022) and high hemoglobin A1c (p = 0.029). These relationships warrant further study, to inform future public health policies and follow-up care for underserved and vulnerable communities.

Objectives Mental and physical health conditions are intrinsically linked. Depression and anxiety may co-exist with an array of chronic diseases and conditions. Social Determinants of Health (SDOH) may have a powerful impact on health and may contribute to chronic disease disparities in underrepresented and underserved communities. The objective of this study was to examine the comorbidities found in patients seeking mental health care and their relationships to SDOH. Methods A needs assessments was completed using a random sample of 100 de-identified medical records of individuals seeking mental health care at Caridad Center in Boynton Beach, Fl. Demographics, diagnoses, laboratory tests results and the Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences (PRAPARE) questionnaire data were abstracted. Statistical analyses included descriptive statistics, Spearman's correlations, Mann-Whitney U, and chi-square. Results The patients’ mean age was 51.9 ± 11.9 years and 79.4% were female. About 64% were below 100% of the federal poverty level and 52% were unemployed. About 43% were diagnosed with depression, 38% with anxiety and 17% with both depression and anxiety. In addition, 33% had 2 or more other diagnosed comorbidities and 11% had 3 or more comorbidities. Annual income was negatively correlated with the number of CVD risk factors (r = −0.283, P = 0.008). Median annual income was lower for those with hypertension compared to those without hypertension ($14,472 (IQR = $7200-$19,260) vs. $19,200 (IQR = 14,400–28,800), P &lt; 0.001). Higher rates of unemployment in those diagnosed with diabetes were found compared to those without diabetes (67.6% vs. 56.6%, P = 0.035). Three or more social contacts per week was associated with lower median hemoglobin A1C levels (5.9 mmol/mol (IQR = 5.6–7.7) vs. 6.9 mmol/mol (IQR = 6–10.4) P = 0.05) compared to less contacts. Conclusions SDOH were associated with comorbid conditions in this Latinx sample who are sought mental health care at a community clinic in South Florida. Minority populations such as Latinx may suffer a greater burden of disease and health complications. Assessing SDH may be an important marker for identifying and intervening within the most vulnerable members of the population afflicted by multiple comorbidities. Funding Sources FIU RCMI/NIMHD.

Objectives Cardiovascular disease (CVD) is one of the leading causes of mortality among the Latinx population in the U.S. In recent years, an increased risk of CVD among young adults has been observed. During emerging adulthood, health behaviors are adapted that can affect cardiometabolic risk factors (CMRF) providing an opportunity for targeted prevention strategies. Research has highlighted an association between gut dysbiosis and elevated risk for CMRF such as obesity and type 2 diabetes. Miami-Dade county's population is predominantly Latinx, with the largest heritage groups being of Cuban and Colombian descent. We hypothesize that gut dysbiosis and reduced microbial diversity will be associated with elevated CMRF. Methods The participants will be community-living young adults recruited from the Florida International University student body and the larger community of Miami-Dade County. This study follows a cross-sectional design to examine the relationship between cardiometabolic risk factors (obesity, body composition, blood pressure, fasting glucose, diet, physical activity, smoking, sleep, and alcohol) and gut microbiome profiles. Individuals are eligible if they are 18–22 years old, self-identify as being of Cuban or Colombian background, are willing to provide a stool sample, have not been on antibiotic treatment in the past 6 months, and do not have autoimmune conditions. Participants will complete two visits; an assessment visit to gather demographic and anthropometric data, and a collection visit where fecal samples are returned and blood pressure, fasting blood glucose and other exposures are assessed. Fecal samples will be collected using the OMNIgene-GUT kit and participants will complete two 24-hour recalls using the Automated Self-Administered Recall System (ASA24). To characterize intestinal bacteria, 16S ribosomal RNA (16S rRNA) sequencing will be performed. Results N/A Conclusions The findings of this study will expand the current knowledge on the relationship between CMRF and the gut microbiome in emerging adulthood. This knowledge is necessary for the development of targeted prevention strategies for Latinx young adults who are at high risk for metabolic syndrome and other CMRF. Funding Sources NHLBI/SUNY Downstate Health Sciences University.