Bridging The Gap: Delaware’s Approach to Health Disparities

In 2001, Delaware formed the Delaware Advisory Council on Cancer Incidence and Morality. The goal: advise the governor on the causes of cancer incidence and mortality in Delaware and create plans on how to address them. The council has since been renamed the Delaware Cancer Consortium (DCC) and is supported by Delaware’s Division of Public Health.

The DCC:

• Is managed by a neutral party reporting directly to the governor to oversee implementation of the recommendations and comprehensive cancer control planning. 
• Serves as a public resource providing Information through reports and the Healthy Delaware website about cancer prevention, early detection, and treatment to residents of the state.
• Create a new four-year plan to both reflect on the success of the last plan, and map out new goals. The most recent plan covers 2022-2026.
• Has implemented more than 30 of its recommendations in the past four years.

The consortium has improved health outcomes for the citizens of Delaware. In the late 1990s, Delaware had one of the highest cancer death rates in the country, but the state has closed this gap in recent years and even improved at a faster rate for some cancer disparities compared to the nation as a whole. This improvement can be attributed to the work of the DCC and three key initiatives-- the “Screening for Life” program, the Delaware Cancer Treatment Program and patient navigation.

Screening for Life fully covers cancer screenings for eligible Delaware residents. This includes underserved groups like those with minimal or no insurance and those who are ineligible for Medicaid. If cancer is found, then Delaware’s Cancer Treatment Program will cover treatment for up to two years. Finally, patient navigators have been crucial in connecting with the community. Every five years, the state places navigators at community gathering places—e.g., grocery stores, churches, laundromats-- in zip codes that see the lowest screening rates. These three initiatives have produced results, including:

• A 30 percent decrease in colorectal cancer incidence, which is 8 percent higher than the national average.
• State cancer deaths have declined in line with the national rate.
• Twelfth highest rate of colorectal cancer screening in the U.S.
• A lower colorectal cancer incidence rate for African Americans (43.0 per 100,000) compared to the U.S. (48.7 per 100,000)

Delaware’s coverage of cancer care for up to two years is a landmark initiative for reducing the barrier to care for underserved communities. This is further bolstered by other DCC work that improves access to screenings and investing in patient navigation. From their wake-up call in the 1990s, Delaware has, and continues to exert, consistent and ample effort in improving cancer-related health outcomes through prevention, improved access to early detection, and lower barriers to care.