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Population/Community Health Promotion Project

Mariah Little

Delaware Technical Community College

NUR 330: Population & Community Health

Mrs. Dawnyel Furlong

December 5, 2021
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Children in Sussex County Delaware account for approximately 18.9% of the county’s

population. In 2019, 9.4% of Sussex county’s population were Hispanic, 1.3% were Asian, 12%

were African American, 1.1% were American Indian and Alaskan native, and 75% were non-

Hispanic white (County Health Rankings, 2019). There were 21% of children living in poverty in

Sussex County in 2019. There were 36% of children living in single-parent households. In

Sussex County, 9% of the population was listed as uninsured (County Health Rankings, 2019).

In ages ranging from 5-17 years old for 2019, 89% speak English, 2.3% speak Spanish, 0.1%

speak Asian and pacific languages, and 0.3% speak Indo-European languages (United States

Census Bureau, 2019). There is 39.83% of the population that were born in Sussex County.

When conducting a windshield survey of Sussex County there are many areas to cover

with a lot to see. The green space is abundant in Sussex County but seems to be dwindling over

the years as you drive closer to the beach area. Sussex County is home to 14,265 acres of state

parks, nature reserves, and other recreational land. In just about each town there is a town

playground for kids to play. There are several trails throughout the county that citizens can walk,

run, or ride bikes. One of the most popular trails is the Georgetown-Lewes trail that is 8.7 miles

long. There are other trails in Georgetown and Laurel that are about 4 miles long. Throughout the

county there are various community centers available, the Gumboro community center, Camp

Rehoboth, Dagsboro Boys and Girls Club, The Cheer Center in Georgetown, YMCA in

Rehoboth, Children and Families First in Georgetown, Cape Henlopen Senior Center, The

Nanticoke Senior Center in Seaford, and many others. The main transportation around Sussex

County is cars. The Dart bus is one of the popular forms of public transportation when it comes

to bus and trolleys in the county. Regarding the size of the county and public transportation, that

is an area that could use improvement. There is minimal access to healthcare due to lack of
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public transportation. There are trains that run throughout the county but not for the use to

transport citizens. In each school system there are school buses that travel throughout Sussex

County to transport kids to and from school. The healthcare system is expanding rapidly along

with the population. Beebe Healthcare, Tidal Health, and Bay health are the common hospital

systems in Sussex. Sussex County has a liquor store density of 31 liquor stores per 100,000

population members. The fast-food density is 0.79 per 100,000 population members (Beebe

Healthcare, 2019). Sussex County has an abundance of farmland making farmer markets quite

popular and the best option for farmers to sell their products locally. There are various

pediatrician offices throughout the county. Regarding our pediatric population one thing, we are

missing in the county is a children’s hospital. They are beginning to expand and incorporate

more services for the pediatric population in the county. In Milford, they have built a new

building through AI Dupont that offers various outpatient specialties for children. In the Lewes

and Rehoboth Beach area there is many shopping opportunities. There is the Tanger Outlets that

is broken into 3 areas along with several other store fronts like Marshalls, Home Goods, Home

Depot, staples, and many more. As you ride into downtown Rehoboth there are many locally

owned businesses and restaurants. The movie theater at Midway is a very popular entertainment

option. Popular waterpark attractions are Jungles Jim’s and Midway waterpark in Rehoboth

Beach. The air pollution in Sussex County is still reported to be in the green zone with 104,883

pounds of carcinogens recorded of being released into the air in 2017 (Beebe Healthcare, 2019).

In Delaware students enrolled in the school systems must provide proof of vaccinations in

accordance with the CDC policy. Amongst the vaccinations required are DTaP, IPV or OPV,

hepatitis B, MMR, varicella, and when entering 9th grade 1 dose of Tdap and 1 dose of

meningococcal (Delaware Department of Education, 2020). Children in poverty is a significant

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issue in Sussex County as 23% fall into this category. We also face the issue of the 8.1% of

children in Delaware being listed as uninsured in 2020 (County Health Rankings, 2019). The

predominate health insurance for children in Delaware is through an employer with 50.5% of

children falling in this category (Kids Healthcare Report, 2019). Through the affordable care act

more Delawareans in Sussex County can possibly be covered by Medicaid to be able to receive

healthcare. For our pediatric population that their parents are unable to have Medicaid coverage

because they make too much money but still are unable to afford healthcare, the children may be

eligible for the Children’s Health Insurance Program (CHIP). CHIP covers immunizations,

routine checkups, doctor visits, prescriptions, dental care, vision care, inpatient and outpatient

hospital care, laboratory and X-rays services, and emergency services (Delaware.gov, n.d.).

Delaware also offers the Delaware Healthy Children Program, a low-cost health insurance

program for Delaware’s uninsured children. Caregivers pay anywhere from $15 to $25 a month

for the child or children (Delaware.gov, n.d.). In our hospital systems, a nurse or a case manager

can be the crucial connecting person to help children obtain some type of health coverage

through the state when kids are in need. The ability to enroll and be insured for children can be

the key factor to ensuring children’s health and an opportunity for a healthy childhood. When

these children present whether it be to a first pediatrician appointment, an emergency care visit,

or right after birth, the nurse can ensure an equal opportunity for all kids.

When assessing the pediatric population, substance exposed infants remains an issue in

Sussex County. In 2017, the rate of babies born withdrawing from substances their mothers

abused while pregnant was 24.3 cases per 1,000 hospital births (NIDA, 2020). You may not look

around and see children who are homeless on the streets but the 8.1% of children living in

poverty is a concern. Each child should grow up with an equal opportunity in Sussex County. It
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should not be on the mind of a growing, helpless child of where their next meal will come from

or how they will get clothes tomorrow. In 2017, 12% of the youth reported making a suicide plan

in Delaware. That is a 21% increase from 2013 to 2017 (Delaware Health and Social Services,

2017). Addressing children’s mental health is valuable and important.

When looking at what creates health disparities between individuals in the pediatric and

adolescent population racial category provides a starting point. 37% of children in poverty in

Sussex County are Hispanic followed by African Americans with 32%, Caucasian children with

11%, and lastly Asian/pacific islander with 4% (County Health Ranking, 2019). Ongoing racism

and discrimination are at the source of disparities. Children living in poverty are at increased risk

to experience lasting effects into adulthood effecting health, academic achievement, and

financial income. Communities need to come together and work together to remove barriers for

our children. A recommendation to decrease these disparities are creating community events to

establish a relationship between children living in poverty and children who are not to encourage

children that they are no different than other kids in their community. The ability to facilitate

more community members to recognize the reality of the inequalities children in the community

face due to discriminatory policies. Also educate community members of individuals that start

behind and stay behind because of money and housing. Every child in the community should

have a fair and just opportunity to receive what they need to prosper. Unfortunately, one person

themselves cannot change the world. Therefore, if we were able to inform others about the

importance of the development of our youth with equity and the ability to feel enabled, we can

lower the disparities present.

To decrease the infants born to substance abuse mothers, addressing the substance use

disorder population is important. The goal would be to reduce, decrease, and eliminate tobacco
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and illicit drug use. Surveying the number of women abusing drugs before and after

interventions is a tool for measurement. Creating statewide media campaigns from Facebook ads,

television commercials, billboards, brochures, and posters in public areas to end substance abuse.

Partnering with clinics and community-based organizations to increase compliance with

cessation of illicit drugs and support during withdrawal periods. Creating a strategic and

universal plan for patients with substance abuse disorders so they are treated equally across the

board. If interventions are upheld and treated the same across the board, results should be seen

and improved within three years. Substance abuse cessation is timely and for safety is not a goal

that can be seen achieved tomorrow. With the goal aimed of the cessation of substance abuse

with women we can decrease and eliminate the infants born with a difficult and challenging start

of withdrawal. If only a goal to eliminate all illegal drugs could be made but unfortunately that

will most likely never be achieved, for now all we can do is educate, assist, and support this

group of individuals to help our children and infants have a better start.

For the children living in poverty, decreasing the disparities and image on children can

increase the equity. Ensuring that each child has access to food, housing, and clothing is

important. While educating the public on racial disparities can help decrease the number of

children in poverty as it increases the population on assisting those in need. There is a website

and initiative started on health equity for children in Delaware through DE thrives. The website

is aiming at allowing community members take the pledge to help close the gap while giving

informative information on where to start. It allows citizens to help by hosting a visit by

community ambassadors or creating a community lead action plan (DE Thrives, n.d.). This is an

initiative that needs community assistance to aid in ending the disparity. Presently they are

taking special aim at reducing the high rate of death amongst African American babies. The
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website offers a pledge that individuals can take to practice safe sleep recommendations.

Interventions to help decrease children in poverty and that all children get access to healthcare

each family and child should be aware of the Delaware Healthy Children Program where their

children can be insured for only $15 a month. Guaranteeing kids can seek healthcare can ensure

their transition to adulthood will be improved. Enabling kids can set them up for success with

higher education outcomes.

For improvement of children with suicidal thoughts and depression completing a baseline

survey on all children at their pediatrician appointments or in a daycare or school facility will

allow the results to be measurable. For realistic interventions each school should employ a

trained mental health care provider for kids to be able to utilize. If within the school’s budget and

depending on number of students enrolled, employing 3 mental health care providers to be able

to meet with each student weekly to create a relationship and talk with children that may not

otherwise establish a relationship with a mental health care provider out of fear. To employ more

mental health care providers as needed, increasing their pay to be competitive to other job

markets can be a starting point.

Regarding the children in poverty and unable to receive their next meal or see the doctor,

Sussex County has resources available. Through La Red Health Center children can receive

dental care, well visits and sick visits with a pediatrician, access to transportation, assistance with

enrollment in Medicaid, and referrals for WIC. The health center also specializes in 2 languages,

Spanish and English, to better serve the community (La Red Health Center, n.d). This allows

more community outreach to other population of individuals. La Red Health Center has 3 centers

currently operating. The Georgetown office offers several services. Members can locate the

building at 21444 Carmean Way, Georgetown, DE 19947 and contact them at 302-855-1233.
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The La Red health center can connect homeless individuals with a case worker to help fulfill

their needs with community programs.

For children experiencing depression, stress, suicidal ideations and more, there are

community programs to assist them. Public schools in Sussex County provide services through a

wellness center. There, kids can go to talk to a counselor and receive the care they need. Parents

sign a parental consent form and from there the student can use the services while they remain in

school (Vishnubhakta, n.d.). The La Red Health Center also provides mental health counseling

services starting at age 3 and older. To reach a behavioral health service provider individuals can

call 302-855-1233 and press start, one, and then extension 1124 (La Red Health Center, n.d.).

Ensuring each student and youth member has knowledge of crisis numbers available so when

they are in need in a mental emergency situation, they are knowledgeable of the resources. By

posting an ad on billboards, commercials, posters and even handing brochures out in school,

each child can be equipped with the resources when needed. They can dial 1-800-969-

HELP(4357) to reach Delaware’s 24-hour Mobile Response Stabilization Services Hotline and

can text DE to 741741. Also always reminding the youth to dial 911 in an emergency, it could be

the last life saving measure for a child in distress (Department of Services for Children Youth &

Their Families, n.d.)

Women abusing drugs need assistance and guidance on quitting and making safe

decisions. By advertising and communicating with this group of individuals we can assist our

youth on a healthier life. Mothers who abuse drugs have an increased risk for their babies to be

born with birth defects and they are at an increased risk of miscarriage or pre-term delivery.

Delaware has many helplines and resources for these women who need help with substance

abuse. Individuals can call the Delaware Hope Line at any time at 800-345-6785. Women can
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also connect with an advisor through DE thrives and the help me grow initiative by dialing 211

(Delaware Health and Social Services, n.d.). By decreasing and eliminating substance abuse

especially amongst childbearing women we can increase our youth’s ability to live a happy and

healthy life. By also making an initiative to expand contraception use among women with

substance abuse disorders, we can decrease the number of babies born withdrawing from

substances.

Through many interventions of educating our youth on resources available, educating

community members on disparities and how to narrow the gap, assisting children with the

resources needed through La Red Health Center and wellness centers at school, crisis hotlines,

and programs through DE thrives. With all the interventions in place we can decrease poverty,

increase the amount of newborn born with a just and fair start by decreasing substance abuse,

and decrease the depression and suicidal ideations of our children today. By surveying kids at

schools on depression and homelessness we can measure and observe the outcomes of

interventions completed.
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References

Beebe Healthcare. (2019). Community health assessment needs.

https://www.beebehealthcare.org/sites/default/files/Official%20Beebe%20CHNA

%20June%202019_FINAL.pdf

County Health Rankings. (2019). Delaware.

https://www.countyhealthrankings.org/app/delaware/2019/rankings/sussex/county/outco

mes/overall/snapshot

DE Thrives. (n.d.). Health equity. https://healthequityde.com/

Delaware Department of Education. (2020, December 5). Delaware immunization regulation.

https://www.doe.k12.de.us/Page/2871

Delaware Health and Social Services. (2017). Suicide.

https://myhealthycommunity.dhss.delaware.gov/locations/state/mental-health-substance-

use/suicide?comparison_slug=county-sussex

Delaware Health and Social Services. (n.d.). Pregnant? Alcohol and illegal drugs: Not safe.

https://dethrives.com/wp-content/uploads/2017/06/5-DE-FASD-Brochure-05-26-17.pdf

Delaware.gov. (n.d.). Delaware healthy children program.

https://dhss.delaware.gov/dhss/dmma/dhcp.html

Department of Services for Children Youth & Their Families. (n.d.). Youth Suicide Prevention &

Response Support. https://kids.delaware.gov/prevention-and-behavioral-health-

services/suicide-prevention/
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Kids Healthcare Report. (2019). Children’s health coverage in delaware.

https://kidshealthcarereport.ccf.georgetown.edu/states/delaware/

La Red Health Center (n.d.). http://www.laredhealthcenter.org/index.cfm?ref=20200&ref2=32

NIDA. (2020, April 3). Delaware: Opioid-involved deaths and related harms.

https://www.drugabuse.gov/drug-topics/opioids/opioid-summaries-by-state/delaware-

opioid-involved-deaths-related-harms

United States Census Bureau. (2019). Language spoken at home.

https://data.census.gov/cedsci/table?tid=ACSST5Y2019.S1601&g=0500000US10005

Vishnubhakta, V. (n.d.). School based health center evaluation.

https://bidcondocs.delaware.gov/HSS/HSS_11013HealthCenters-Add2A-Data.pdf
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