Delaware
VIEWPOINT: This is a critical moment: Delaware must not go backward in health equity
Dr. LeRoi Hicks | PHOTO COURTESY OF CHRISTIANACARE
The proposed Delaware House Bill 350 is well-intended but would have terrible consequences for Delaware’s most vulnerable populations. There is a better way.
As a Black physician who has dedicated his 25-year career to understanding and addressing health equity, I am deeply concerned about Delaware’s proposed House Bill 350, which aims to address rising health care costs by establishing a body of political appointees that would oversee the budgets of Delaware’s nonprofit hospitals.
While the goal of bending the cost curve in health care may be well-intentioned, this bill will have horrific consequences for Delaware’s most vulnerable populations, including Black people, Hispanic people and other groups that have been traditionally underserved in health care. We can and must work together to solve this problem and provide the right care, in the right place, at the right time.
A tale of two cities
To borrow a phrase from Charles Dickens, Delaware, like much of America, is a tale of two cities. The experience of life—including a healthy, safe environment and access to good-quality health care—is vastly different depending on where you live and your demographic background. In the city of Wilmington, for example, ZIP codes that are just a few miles apart represent more than 20 years difference in life expectancy. This is not OK—it’s a sign that we have serious structural problems in our communities that are causing harm to people and making their lives shorter.
Importantly, chopping $360 million out of Delaware’s hospital budgets, as House Bill 350 would do in year one, is not going to help this problem—it’s going to make it worse. And in doing so, it would ultimately make health care in Delaware more expensive—not less expensive.
The key to lowering health care costs is to improve quality, access and equity
Data show that about 5% of patients in the United States account for more than 50% of all health care costs. These are primarily patients who have complex and poorly managed chronic conditions that cause them to end up in the most expensive care settings—hospitals, operating rooms, emergency departments.
The key to driving down health care costs is to improve quality and equity so that everyone is supported in achieving their best health, and these high users of the most expensive kinds of care are better supported in managing their health conditions such as diabetes or heart failure in the appropriate way. In doing so, they prevent the need for costly emergency or “rescue” care.
Let’s do more—not less—of what we already know works
Health care is not a one-size-fits-all industry. The delivery of care for patients across a diverse population requires multiple interventions at the same time. These interventions are designed not only to improve the quality of care but also to close the gap in terms of health care disparities. That’s important, because when we improve care and outcomes for the most vulnerable populations, we tend to get things right for everyone.
One type of intervention is about doing exactly the right things for a patient based on the evidence of what will help—and doing nothing extra that will cause harm or generate additional costs without providing additional benefit. An example of this might be ensuring that every patient who has a heart attack gets a certain drug called a beta blocker right after their heart attack, and they receive clear guidance and support on the actions they must take to reduce their risk of a second heart attack, such as regular exercise and good nutrition.
The second type of intervention is for the highest-risk populations. These are patients who live in poor communities where there are no gyms and no grocery stores, and people commonly have challenges with transportation and lack of access to resources that makes it difficult—sometimes impossible—to follow their plan for follow-up care. They lack access to high-nutrient food that reduces their risk of a second heart attack. They also live in areas where there are fewer health care providers compared to more affluent areas.
These interventions tend to be very intensive and do not generate income for health systems; in fact, they require significant non-reimbursed investment, but they are necessary to keep our most vulnerable patients healthy.
The medical community has developed interventions for these populations that are proven to work. A local example is the Delaware Food Pharmacy program, which connects at-risk patients with healthy food and supports their ability to prepare it. The program helps patients improve their overall health and effectively manage their chronic conditions so they can prevent an adverse event that would put them back in the hospital or emergency department.
When we work together, we succeed
We’ve seen incredible examples of how this work can be successful right here in Delaware. Delaware was the first state in the country to eliminate a racial disparity in colorectal cancer, and we did this by expanding cancer services, including making it easy for vulnerable people to get preventive cancer care and screenings. This is an incredible success story that continues to this day, and it was the result of thoughtful, detail-oriented partnerships among the state and the health care community. The work continues as we collaborate to reduce the impact and mortality of breast cancer in our state.
Unfortunately, these kinds of interventions are the first thing to go when health care budgets get slashed, because they don’t generate revenue and are not self-sustaining. These kinds of activities need to be funded—either through grants or an external funder, or by the hospitals and health care systems.
By narrowly focusing on cost, we risk losing the progress we have made
Delaware House Bill 350, as it’s proposed, would cause harm in two ways:
- First, it would compromise our ability to invest in these kinds of interventions that work.
- Second, it increases the risk that higher-cost health services and programs that are disproportionately needed by people in vulnerable communities could become no longer available in Delaware.
In states where the government has intervened in the name of cutting costs, like Vermont and Massachusetts, we see the consequences–less quality and reduced equitable access to much-needed services. House Bill 350 will widen the gap between those who have means and those who are more vulnerable.
These changes will lead to increased disease burden on these populations. They will end up in the emergency room more and hospitalized more, which is by far the most expensive kind of care. That’s not what anyone wants—and it’s the opposite of what this bill was intended to accomplish.
At this moment, in Delaware, we have an opportunity to put our state on a sustainable path to better health for all Delawareans. House Bill 350 is not that path. However, the discussion that House Bill 350 has started is something that we can build on by bringing together the stakeholders we need to collaborate with to solve these complicated problems. That includes Delaware’s government and legislators, the hospitals and health centers, the insurance, pharmacy and medical device industries, and most importantly, patients and the doctors who care for them.
LeRoi Hicks, M.D., MPH, FACP is the campus executive director for ChristianaCare, Wilmington Campus.
Note: This commentary was originally published on news.christianacare.org.
About ChristianaCare
Headquartered in Wilmington, Delaware, ChristianaCare is one of the country’s most dynamic health care organizations, centered on improving health outcomes, making high-quality care more accessible and lowering health care costs. ChristianaCare includes an extensive network of primary care and outpatient services, home health care, urgent care centers, three hospitals (1,430 beds), a freestanding emergency department, a Level I trauma center and a Level III neonatal intensive care unit, a comprehensive stroke center and regional centers of excellence in heart and vascular care, cancer care and women’s health. It also includes the pioneering Gene Editing Institute.
ChristianaCare is nationally recognized as a great place to work, rated by Forbes as the 2nd best health system for diversity and inclusion, and the 29th best health system to work for in the United States, and by IDG Computerworld as one of the nation’s Best Places to Work in IT. ChristianaCare is rated by Healthgrades as one of America’s 50 Best Hospitals and continually ranked among the nation’s best by U.S. News & World Report, Newsweek and other national quality ratings. ChristianaCare is a nonprofit teaching health system with more than 260 residents and fellows. With its groundbreaking Center for Virtual Health and a focus on population health and value-based care, ChristianaCare is shaping the future of health care.
Ever seen a spring peeper peep?
A spring peeper singing in the Millsboro area.
Meteorological winter has ended and we’ve entered spring.
However, there’s still a last winter blast hitting Delaware early this week before a spring warm up hits at the end of the week.
Here’s a look at the Delaware forecast.
Will Delaware see more snow?
After a brisk Monday, March 2 with sunny skies and highs only reaching 35 degrees, there’s a chance of snow after 1 a.m. Tuesday, March 3 with freezing rain after 4 a.m. in New Castle County. Snow and freezing rain are expected before noon Tuesday, March 3. The county may receive less than a half inch of accumulation.
In Kent County and Sussex County, there’s a chance of snow and freezing rain after 1 a.m. Tuesday, March 3.
When will it warm up in Delaware?
It will start feeling like spring as warmer air moves into the First State on Tuesday evening, March 3, but wet weather is coming as well.
Rain is predicted from Tuesday, March 3 through Friday, March 5, but spring-like temperatures will make it bearable. In New Castle County temperatures will range from the mid-50s on Wednesday, March 3 to the 60s on Thursday, March 4 and Friday, March 5. Kent County should see temperatures in the 60s and Sussex County will see 70s during the mid- to later part of the week
What’s the weekend forecast?
Remember when you were daydreaming about warm weather during the polar vortex or blizzard? Well, it is coming next weekend.
The forecast is calling for sunny to partly sunny skies throughout Delaware on Saturday, March 7 and Sunday, March 8. Highs will reach the upper 60s in the north to the low 70s in the south.
PHILADELPHIA – Law enforcement agencies across the Delaware Valley are boosting security at religious and cultural sites following U.S.-Israeli strikes against Iran, even as officials say there is no credible threat to the area.
The Department of Homeland Security also issued an alert after Operation Epic Fury, warning agencies to remain vigilant for suspicious activity despite assessing that a large-scale attack on U.S. soil is unlikely.
Hours after the strikes, protesters gathered in cities nationwide. In Phoenixville, dozens rallied Saturday afternoon, calling the military action “senseless.”
“Stop the war. People are suffering in this country with food prices, rent, healthcare, money for the people’s needs here,” said Curry Malott, a West Chester University associate professor of educational foundations and policy studies.
President Donald Trump has said the joint operation would eliminate Iran’s nuclear and military programs and change the regime. Some demonstrators criticized the president’s decision.
“Trump has broken his campaign promises with no new wars, and here he is going into another,” said Kyle Horstmann of Phoenixville.
Republican Congressman Brian Fitzpatrick said in a statement that Iran poses a grave threat, adding, “Iran and its proxies are responsible for countless deaths of Americans and our partners. That record is long, deliberate, and undeniable-and it cannot be ignored.” He adds sustained military engagement should be done with consent of Congress.
Democratic leaders, including Senator Andy Kim, argued the president failed to seek congressional approval for the strikes.
“I have zero confidence in this president who has so flagrantly violated our constitution,” Kim said. He called for Congress to immediately reconvene to vote on a war powers resolution.
“I hope there can be unanimity that when it comes to strikes of this magnitude, when American service members lives are at risk, what greater responsibility do we have in Congress than to look out for our service members and the national security of our country?” he said.
The Homeland Security alert also warned of potential low-level cyberattacks targeting U.S. networks, adding another layer of concern for authorities monitoring threats at home.
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As the Delaware County Health Department recognized success over a year period, county officials also voiced work needed to be done particularly in light of infant and maternal outcomes.
“Unfortunately, in Delaware County, we do still have some issues with maternal and child health,” county Executive Director Barbara O’Malley said. “Between 2019 and 2023, 1.3% of our births were classified as ‘very low birthweight.’
“That’s actually higher than our neighboring suburban counties, which are all under 1%,” she explained. “And Philadelphia is at 1.6. So, we know we have work to do and that’s what our health department is here to do.”
O’Malley added that 15.6% of Delaware County residents received inadequate prenatal care, which is determined by when someone begins their prenatal care.
In addition, County Deputy Health Director Stephanie Reese said the disparity among communities of color has grown.
“While Pennsylvania’s Black and white infant mortality gap has narrowed in recent years, Delaware County’s gap has widened. Black infant mortality in Delco increased from 2.9 to 3.9 times that of whites,” she said.
That’s a factor driven by low birthweights linked to premature birth and preventable social and environmental factors.
Last week, Delaware County Council approved to advertise a request for proposals for an awareness and education campaign for the county health department’s Centralized Intake System and the Delco Doula Collaborative. This is funded through a U.S. Department of Labor grant.
This action will allow the DelcoDoula.org to go live once completed. This site for the Delco Doula Collaborative is a web-based registry of perinatal doulas offering doula information and matching services in Delaware County.
“We have so many resources available to people but they may just not be aware of how much we can do for people that are around maternal and child health issues,” O’Malley said.
She said the intake system would be a single point of entry for maternal and child health resources, including eligibility-based matching.
“Once we maybe learn about you, we can give you customized services and resources that you would qualify for,” O’Malley added.
The executive director explained why it’s critical to focus on these outcomes.
“We do know that maternal and child health is very important for so many reasons,” O’Malley said. “A healthy infant, a healthy pregnancy obviously gives people a healthy life, a great start in life, has better health outcomes, educational outcomes and better outcomes for the families.”
Doula programs can help, she explained.
“Research shows that doula programs such as the one that is supported by grant funding through the health department (and) through The Foundation for Delaware County … that there are lower rates of pre-term births, lower rates of low birthweight, lower rates of Caesarian section and higher rates of breastfeeding,” O’Malley said.
One way to support this is through increased awareness of these programs and initiatives, something O’Malley said is hoped to improve birth outcomes and advance health equity in Delaware County.
While the awareness campaign is coming, many of these programs already exist.
“People can avail themselves of them right away,” O’Malley said, directing the community to the health department website.
There, moms and moms-to-be can get support through virtual pre- and postnatal partum doula groups, where moms can learn how to care for their baby, free supplies including diapers and baby essentials, immunizations for infants as well as mental health support for new moms.
“It is critical that we get our Delaware County infants and youth off to the right start and taking care of their moms and families is the way to do it and we do have a lot of resources and we want to make sure that people take advantage of them,” O’Malley said.
Other health programs
Among some of the efforts the Delaware County Health Department have done include meeting with residents during February to offer free blood pressure screenings across the county, including Yeadon, Lansdowne, Chester and Springfield.
Through its Delco Revive! program, it also continues to offer free CPR classes with another one being held at the Yeadon Wellness Center at 125 S. Chester Road from 9 a.m. to 1 p.m. on Thursday, March 26.
“According to the American Heart Association, about 70% of cardiac arrests that happen outside the hospital occur in homes,” county Council Chair Richard Womack said. “Please take the opportunity to learn how to save a life by participating in one of these classes.”
The health department also released its 2025 Annual Report that focused on strengthening public health infrastructure, expanding equitable access to services, and deepening community partnerships across the county.
Some of the accomplishments included expanded doula services, maternal wellness programming, and youth health initiatives to support healthy families and improve early-life outcomes; comprehensive Back-to-School events and community-based education efforts, including the Lead Free in 1-2-3 campaign connecting residents to screenings, supplies and preventive services.
Over the last year, the department has also offered continued implementation of Delco Revive! by increasing community training, lifesaving supply distribution, and overdose response capacity while also strengthening data-driven monitoring and outbreak response to guide prevention strategies and protect residents from communicable diseases; and also expanded the public health kiosks.
The department is also responsible for conducting inspections, investigations and regulatory enforcement to safeguard food safety, monitor environmental hazards, respond to complaints, and prevent vector-borne disease.
The annual report stated that 83% of the department’s $11.4 million budget came from federal and state funding and that the remainder for that time period was funded through American Rescue Plan Act revenues.
“As we reflect on 2025, this report represents the dedication of our staff and partners who work every day to protect and promote the health of Delaware County residents,” county Health Director Lora Siegmann Werner said. “We remain committed to building a resilient, equitable public health system for the future.”
The full Delaware County Health Department annual report can be viewed at https://delcopa.gov/sites/default/files/2026-02/DCHD-2025-Annual-Report-Revised.pdf.
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