Water is a limiting resource, and the pressure exerted on surface and groundwater resources should be reduced or at best maintained, rather than increased, as the human population and industrial development increase. Water recycling and reuse is thus of increasing importance, not only in arid regions but also in cities and contaminated environments. This paper provides an international understanding to inform optimization of treatment under local conditions, operating efficiencies associated with chemical and energy inputs or recovery, and optimization of traditional wastewater treatment to complement water recycling. Large quantities of freshwater can be saved by industrial water reuse and recycling, lowering costs, reducing environmental pollution and improving carbon footprint. Reuse is a sustainable and cost-effective alternative water supply.As the demand for potable quality water increases, driven by increasing human populations and economic development, the drivers for indirect and direct potable reuse of water also increase in their intensity. In this paper we inspect the national situations in developed countries in the northern and southern hemispheres (the USA and Australia), and in a middle-income country (South Africa). Examples of full scale potable reuse schemes in each country are described, followed by summaries of current research focal areas and priority challenges. Finally the international research trends and commonalities are highlighted, along with the key regional differences in research objectives and application, concluding with an outline of perceived opportunities for mutual benefit by enhanced international cooperation.

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OBJECTIVE We examined whether relative availability of fast-food restaurants and supermarkets mediates the association between worse neighborhood socioeconomic conditions and risk of developing type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS As part of the Diabetes Location, Environmental Attributes, and Disparities Network, three academic institutions used harmonized environmental data sources and analytic methods in three distinct study samples: (1) the Veterans Administration Diabetes Risk (VADR) cohort, a national administrative cohort of 4.1 million diabetes-free veterans developed using electronic health records (EHRs); (2) Reasons for Geographic and Racial Differences in Stroke (REGARDS), a longitudinal, epidemiologic cohort with Stroke Belt region oversampling (N = 11,208); and (3) Geisinger/Johns Hopkins University (G/JHU), an EHR-based, nested case-control study of 15,888 patients with new-onset T2D and of matched control participants in Pennsylvania. A census tract–level measure of neighborhood socioeconomic environment (NSEE) was developed as a community type-specific z-score sum. Baseline food-environment mediators included percentages of (1) fast-food restaurants and (2) food retail establishments that are supermarkets. Natural direct and indirect mediating effects were modeled; results were stratified across four community types: higher-density urban, lower-density urban, suburban/small town, and rural. RESULTS Across studies, worse NSEE was associated with higher T2D risk. In VADR, relative availability of fast-food restaurants and supermarkets was positively and negatively associated with T2D, respectively, whereas associations in REGARDS and G/JHU geographies were mixed. Mediation results suggested that little to none of the NSEE–diabetes associations were mediated through food-environment pathways. CONCLUSIONS Worse neighborhood socioeconomic conditions were associated with higher T2D risk, yet associations are likely not mediated through food-environment pathways.

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