Preparing the university community to respond to 21st century global public health needs.

Previous investments in public health research and education played major roles in improving population health and increasing life expectancy [1,2]. In the early 1900s, amidst efforts to eliminate hookworm from the southern United States (US), Welch and Flexner recognized the need to train public health leaders. They proposed a freestanding public health school affiliated with, but independent from, the university and medical school, charged with training a public health workforce to improve the lifespan and ‘‘health span’’ of populations [3,4]. We now stand at a similar junction as in 1900, confronted with a vastly different set of growing health burdens: chronic non-communicable diseases (NCDs) [5]. These diseases cause significant mortality and morbidity on their own, but also exacerbate existing population health issues. For example, diabetes can increase the risk for tuberculosis [25]; anti-retrovirals given to HIV/ AIDs patients can increase cardio metabolic risk [26,27]; under-nutrition in utero or during early childhood increases risks of NCDs later in life [28]. Here, we argue that the university community (UC), with its key constituents (institution leaders plus faculty and students derived from all disciplines), can be leveraged to improve 21st century public health. Driven by a common set of behavioral risk factors (diet, physical inactivity, tobacco and alcohol use) and underlying environmental exposures (e.g., rapid urbanization and globalization of societies), NCDs – heart disease, stroke, diabetes, chronic respiratory illness, and cancers, as well as mental health disorders and injuries – now con-