Health Policy

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Recent Submissions

Now showing 1 - 20 of 31
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    Understanding Opioid Related Health Issues Among Older Adults
    (Institute for Public Administration, 2023-11) O'Hanlon, Julia; Rouff, Sarah
    The financial and healthcare struggles older adults face from opioid misuse have many consequences. Unemployment and employment instability can damage an older adult’s financial and healthcare savings. Providing more opioid prevention and recovery opportunities for older adults could have long-term health implications. This population’s unique needs are important considerations among healthcare providers, community-based organizations, and policymakers. The stigma of opioid misuse can prevent older adults from seeking out services and resources. Mental health problems can lead to opioid misuse as a coping mechanism. The limited availability of mental health professionals creates challenges in developing other coping mechanisms besides opioid misuse and healing from addiction. The Covid-19 pandemic has underscored the need to address this issue. Recent settlement funds can be used to support policies and programs that address the specific needs of older adults who may be at risk for or already struggling with opioid addiction.
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    The Role of Congregate Meals at Senior Centers—History, Trends, and Future Considerations
    (Institute for Public Administration, 2023-05-23) O'Hanlon, Julia; Prickett, Lindsay
    Between 2016 and 2060, the number of Americans aged 65 and older (65+) is projected to double. In Delaware, this population is projected to increase from about 164,000 in 2016 (17 percent of the total population) to over 268,000 (25 percent of the total population). While many older adults rely upon existing social networks and are capable of managing their own nutrition, many might benefit from congregate meal programs hosted by their community senior centers.
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    Trends and Challenges Related to Food Insecurity Among Rural Households with School-aged Children–Before, During, and Beyond the Pandemic
    (2022-06-17) O'Hanlon, Julia; Minni, Nicole; Crowell, Emma; Pragg, Sarah
    This policy brief is part of a suite of tools developed by the University of Delaware’s Institute for Public Administration and the Delaware Council on Farm and Food Policy. It presents Delaware-specific issues related to school-aged children from rural, low-income, and/or minority households, including a case study of food-security vulnerabilities in western Sussex County. Examples of how continual data and mapping resources can be used to better understand the communities in this region are featured. National food insecurity issues and efforts are discussed to provide broader context. This brief presents long-term considerations and opportunities to address barriers to accessing community food resources at the state and local levels.
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    A Landscape of School-Based Health Centers in Delaware
    (Institute for Public Administration, 2019-12) Chesser, Margaret Culpepper
    A school-based health center (SBHC), also referred to as a student wellness center, is a method of healthcare delivery that provides school-aged youth with comprehensive physical, mental, and preventive health services delivered by qualified medical and behavioral providers in a school setting. These health centers are designed to mitigate the barriers to health-care services that students may face, such as lack of transportation, health-care providers, and insurance coverage. It has been well documented that school-based health centers can effectively address such barriers and reduce emergency room visits in school-aged children and adolescents. These wellness centers are cost-beneficial and have the potential to close health disparity gaps between racial groups.3 In Delaware, every public high school has opened a school-based health center and key stakeholders are advocating for the expansion of schoolbased wellness programs to provide care in elementary schools. The following brief will examine the history and role of school-based health centers on a national and a statewide level, the differences between high school health centers and elementary school health centers, the existing model of high school-based health centers in Delaware, and the pilot public elementary school-based health centers, the first of which opened in April 2018.
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    Planning for Age-Friendly Communities: An Assessment of Two Sussex County Communities
    (Institute for Public Administration, 2019-10) O'Hanlon, Julia
    Between October 2017 and June 2018, a literature review was conducted and meetings with community leaders and stakeholders of two Sussex County communities were hosted to help identify the communities’ capacity to promote aging in place through aging-friendly criteria and domains endorsed by the American Association of Retired Persons (AARP), American Planning Association, Village to Village Network, and other nationally recognized organizations with interests in supporting and planning for communities’ increasing older adult populations.
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    Access to Healthy Food: A Guide for Delaware Local Governments
    (Institute for Public Administration, 2019-07) Michalowski, Allison; Scott, Marcia
    Why are some individuals healthier than others? Social determinants of health—conditions where people live, work, and play—affect a wide range of quality of life outcomes. Poorly designed physical environments, sedentary lifestyles, and inadequate nutrition can all impact a person’s health. Our communities need basic elements to support health equity for all people. These elements include access to nutritious food, a quality education, good jobs, affordable housing, equitable health care, parks and recreation, and dependable transportation. Local governments (i.e., towns, cities, and counties) are recognizing the need to plan for, design, and implement policies to foster healthy and complete communities. Attention has focused on improving the built environment to foster walkable-, bikeable-, and transit-friendly communities; planning to address sprawling land use patterns; and advancing Complete Streets for people of all ages and abilities. Traditionally, food insecurity has been regarded as a public health issue. Recently, local governments have become more attentive to address and incorporate healthy food access as part of local public policy agendas. This guide recognizes the important role that Delaware local governments can play in improving access to healthy food. Comprehensive plans and community design, policies and regulatory tools, and local partnerships are key strategies that can be utilized by Delaware local governments.
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    The Role of Senior Centers in Mitigating Alzheimer's and Other Forms of Dementia
    (Institute for Public Administration, 2019-01) O'Hanlon, Julia; Jacobson, Eric D.; Perillo, Kelly
    Dementia, a common term associated with memory loss, causes problems with an individual’s memory, thinking, and behavior to the point where it affects day-to-day life and social functioning. Alzheimer’s, the most common and familiar form of dementia, is becoming more prevalent among the older adult population. Of all individuals diagnosed with dementia in the United States, Alzheimer’s accounts for sixty to eighty percent of the cases. Understanding the severity and impact of Alzheimer’s and other forms of dementia on older adults and their family members is crucial for policy makers, stakeholders, supportive services, and medical professionals due to the implications on national, state, and local governments, health and social services, nonprofits, and communities. To address national demographic trends, it is important to understand the appropriate programs and services necessary to prevent, treat, and evaluate Alzheimer’s, as well as the large impact the disease has on U.S. healthcare costs. With definitive ways to address prevention and a cure, it is vital that this disease become better known.
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    Leading Tomorrow’s Senior Centers
    (Institute for Public Administration, 2009-07) Jacobson, Eric D.; O'Hanlon, Julia; Scott, Jacquelyn
    American society has traditionally desired “quick fixes” such as prescription drugs to treat physical and mental health conditions, which may contribute to the one-third of older adults over the age of 65 who lead sedentary lifestyles. However, a growing body of research suggests that disease-prevention approaches and healthier behaviors can offer longer-term societal and economic benefits. Senior centers can enhance individuals’ health-behavior change through preventive approaches and high-quality programs. Given today’s fiscal environment, senior centers may be interested in learning more about economically savvy approaches to promoting healthy lifestyles through community-based programs and services known to prevent the onset of chronic conditions and risk of injury. The participation in health-promoting and disease-preventing programs will further assist older adults in overcoming barriers to mobility and transportation, maintaining independence, and achieving better overall health and well-being.
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    Senior Centers and Aging-Related Challenges
    (Institute for Public Administration, 2009-07) Jacobson, Eric D.; O'Hanlon, Julia; Scott, Jacquelyn
    The United States’ older adult population is growing at a rapid rate due to the aging of the baby boomers and medical advancements that are increasing the population’s overall longevity. According to the Institute of Medicine, the U.S. is not prepared for the impact that this population increase will likely have on healthcare services, including the need for appropriately trained geriatric professionals. As the varying needs and interests of older adults become more apparent (e.g., opportunities for active community involvement for baby boomers versus health supportive services for elderly seniors), leaders of community-based programs may become interested in learning new ways of addressing the increasing diversity of the population. For example, senior center directors and their staff may pursue new or expanded program ideas to address the changing needs of the aging population. This is issue brief one in a two-part collection.
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    Understanding Demographics, Profiles, and Quality of Life Determinants Related to Delaware’s Senior Population
    (2014-06) O'Hanlon, Julia; Jacobson, Eric; Watson, Verity
    As Delaware’s senior population grows, state and local policymakers and social service professionals will likely undertake new and varied demands for senior services and programs. These demands hail from challenges and opportunities facing seniors in the midst of current economic circumstances and forthcoming systematic changes in national and state policies. In particular, senior citizens are experiencing lifestyle shifts related to the current national economy, changes in the healthcare system, and the need for greater, more accessible mobility and transportation options.
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    Aging in Community Opportunities for Delaware’s Senior Population: The Significance of Accessible Community Transportation Options
    (2014-11) O'Hanlon, Julia
    Access to affordable and reliable transportation for the elderly is a concern for many communities, especially in rural areas where service is practically nonexistent. As defined by the National Aging in Place Council (NAPC), aging in place (i.e., aging in community), is “the ability to continue to live in one’s home safely, independently, and comfortably, regardless of age, income, or ability level. It means living in a familiar environment, and being able to participate in family and other community activities (2014).” The World Health Organization (2007) notes that aging in place/community aims to reverse or lesson the decrease in functional capacity that occurs with age. As a comprehensive approach to staying in one’s community/home, aging in place involves a variety of issues facing senior citizens, including housing, finance, health, education, recreation, and transportation.
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    Quality of Life Indicators Related to Sussex County’s Growing Senior Population: Preliminary Needs Assessment and Environment Scan
    (2016-07) O'Hanlon, Julia; Kline, Angela
    Statewide senior population trends, particularly the projected growth in the percentage of older adults in more rural areas of Delaware, are becoming increasingly important for local officials, social service organizations, and community stakeholder groups to consider. As the area’s senior population increases over the next decade, demands for social services, affordable housing, and accessible transportation are also likely to increase. Based on previous transportation-related projects and work with senior centers in Sussex County, Delaware, the Institute for Public Administration (IPA) conducted a preliminary needs assessment and environmental scan that will help inform future statewide research and educational activities and provide considerations for local officials, nonprofits, and community groups regarding the need for greater senior-friendly environments within their communities— considerations that could shape longer-term, county-wide planning and support the needs of the area’s older adult population and their opportunity to age in community. To obtain additional information about the needs and interests of Sussex Countians and their opportunities for aging in community, IPA project manager Julia O’Hanlon, working with doctoral student Angela Kline, developed a literature review and research outline, conducted semi-structured interviews with community stakeholders, and coordinated with the Sussex County Advisory Committee on Aging & Adults with Physical Disabilities on polling participants at the LIVE Conference in October. This project was conducted in cooperation with and support from the University of Delaware’s Sustainable Coastal Communities Initiative (SCCI). SCCI Program Coordinator Edward Lewandowski and IPA Policy Scientist Martin Wollaston served as senior advisors for this work. This project builds on IPA’s statewide work related to mobility, aging, transportation, land use, and complete communities. Additionally, it extends work conducted with SCCI in 2014 on the Sussex County Transportation Cooperative, now referred to as ITNSouthernDelaware, and helps inform other IPA project work with state agencies such as the Delaware Department of Transportation (DelDOT), Department of Health and Social Services (DHSS), and the Department of Natural Resources and Environmental Control (DNREC). In response to SCCI’s request for proposals, IPA developed a project proposal in the spring of 2015 to conduct a preliminary needs assessment and environmental scan to identify preliminary strengths, weaknesses, and gaps in resources for senior citizens in Sussex County. This assessment should be considered one small piece of a larger and increasingly complex policy issue related to the state’s overall influx of seniors to its coastal and rural areas. Additionally, this document serves as the baseline for future research and work in this area. IPA’s objective for this project was to identify preliminary strengths, weaknesses, and gaps in resources for senior citizens in Sussex County. This preliminary needs assessment and environmental scan is the first step in identifying future research activities and informing appropriate strategies to prepare for the changes that Sussex County is currently experiencing. Information obtained for this assessment summary derived from a literature review of key quality of life indicators, as well as through informal interviews with community stakeholders, informal polling, and LIVE Conference (October 2015) participation evaluations. This assessment summary document is categorized into five primary content areas including quality of life indicators: 1. Demographics 2. Community Models 3. Transportation and Mobility 4. Sussex County Community-Based Resources 5. Strategies for Future Opportunities
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    Sussex County’s Growing Senior Population: Community Voices
    (2017) O'Hanlon, Julia; Kline, Angela
    The University of Delaware’s (UD) Institute for Public Administration (IPA), working with UD’s Sustainable Coastal Communities Initiative (SCCI), sought to conduct research regarding seniors living in Sussex County, Delaware. Research conducted in 2015 included in-depth interviews with senior-service providers and Sussex County officials. To read the full report summarizing the 2015 work, please visit: This work was expanded in 2016 to include direct feedback from seniors. As the county’s 65+ population continues to grow over the next decade, it is critical to hear about quality of life issues directly from seniors.
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    The Role of Senior Centers in Promoting Intergenerational Play
    (2017-04) O'Hanlon, Julia; Thomas, Emily
    Intergenerational play occurs when senior citizens and youth connect with one another through fun, interactive activities. These mutually beneficial activities can be structured as games with rules or a planned play program. They also can occur through free play— putting two generations in a room together with crafts, books, and toys, and allowing them to choose activities. Both formal and informal play offers mutual benefits for both populations, including learning opportunities and fun. This brief discusses the benefits of intergenerational play for senior citizens and youth and highlights model programs being employed across the United States. It also presents opportunities for integrating intergenerational play into programs and activities offered in senior centers. In conclusion, this brief provides guidance to senior center staff and boards on best practices for implementing a successful intergenerational play program.
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    Health Policy Issue Brief 4 - Access to Healthy Foods in the Built Environment
    (2015-07) Jacobson, Eric; Homsey, Andrew; Pragg, Sarah; Floros, Emily; Stump, Jessica; Clark, Amy; Miller, Patti
    While the United States boasts one of the most abundant food supplies in the world, disparities in access, affordability, and quality of healthy foods have continued to plague communities across the country. Millions of Americans are living without access to healthy foods, and the alarming rates of obesity and dietrelated diseases continue to increase. Nevertheless, many promising practices and policies implemented within diverse communities demonstrate that the challenges to increasing access to healthy foods in underserved communities can be resolved. Continued research on the issue will encourage local, state, and national attention and allow policymakers, community leaders, and advocates to explore solutions that address the role that access to healthy foods plays in promoting healthy economies, healthy communities, and healthy people.
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    Health Policy Issue Brief 3 - Access to Healthy Foods in the Built Environment
    (2011-10) Jacobson, Eric; O'Hanlon, Julia; Clark, Amy
    While the United States boasts one of the most abundant food supplies in the world, disparities in access, affordability, and quality have continued to plague communities and neighborhoods throughout the country. With millions of Americans without access to healthy foods, the alarming rates of obesity and diet-related diseases will continue to increase. However, it has recently been demonstrated through promising programs and policies that the challenges to increasing access to healthy foods in underserved communities can be resolved. Delaware continues to be involved in the discussion surrounding this important issue and by utilizing the resources available in the online Toolkit (, those involved are provided the necessary tools to do so. It is hoped that continuing research on the issue will encourage local, state, and national attention and allow policymakers, community leaders, and advocates to explore solutions that address the role that access to healthy foods plays in promoting healthy economies, healthy communities, and healthy people.
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    The Health-Impact Assessment (HIA): A Useful Tool
    (2011-02) Jacobson, Eric; DeCoursey, William J.; Rosenberg, Natalie
    The purpose of this quick guide is to introduce health-impact assessment—an exciting and relatively new analytic approach to planning healthier communities. “How are existing or planned land use, community design, and transportation policies, projects, or programs affecting or likely to affect public’s health?” (NACCHO). Recently endorsed by the nationwide health promotion plan Healthy People 2020, health-impact assessment is one method local communities can use to begin to address this question. In today’s society, media coverage of health topics such as smoking and obesity has become the norm. Issues that used to be thought of as individual problems have grown into public health concerns and are forcing society to rethink how choices made in various sectors affect health. Health-impact assessments (HIAs) are rapidly growing practices within the United States that can help decision-makers outside of the health sector evaluate the potential health effects of proposed projects and policies. An HIA can be defined as “a combination of procedures, methods and tools by which a policy, program or project may be judged as to its potential effects on the health of a population, and the distribution of those effects within the population” (1999 Gothenburg consensus statement). It is becoming increasingly clear that many of the things that determine health, disease, or injury lie outside of the traditional health sector. Uncovering these determinants is imperative in restoring the nation’s health. Both revolutionary and surprisingly intuitive, the HIA methodology simply seeks to evaluate public-policy decisions on their likely human outcomes. With the central and sole assumption that peoples’ health, vitality, and longevity ought to guide significant policy decisions, HIAs can be used as a planning tool to confront the social determinants of health amid the growing consensus that there are many social, environmental, and economic factors that affect health. There are vast opportunities for the use of HIAs. They can be used to assess the health impacts of seemingly small plans to those of complex land-development efforts. For example, deciding where to place a playground may seem irrelevant, but the realization that children must cross a busy highway to get there could lead to plan revisions that make access more practical and lead to greater use and physical activity. Decisions made regarding community design, development and policy implementation have the potential to impact the health of surrounding populations. safely than when they have the perception of a “neighborhood expressway.”
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    Healthy Communities: The Comprehensive Plan Assessment Tool
    (2010-12-22) Beck, Claire
    The Healthy Communities Comprehensive Plan Assessment Tool is a checklist‐based document designed to aid Delaware municipalities in the process of writing comprehensive plans that emphasize planning for and building healthier communities. This tool is intended for use by local government officials, planning commissions, or other individuals involved in writing or updating their community’s comprehensive plan. By focusing on policy initiatives and urban design guidelines that can increase physical activity and encourage healthier lifestyles, the Comprehensive Plan Assessment Tool will ultimately result in comprehensive plans that set the stage for a new era of health‐focused community planning. One goal of this Assessment Tool is to stress that planning for healthy communities is about more than just walkability. There are several elements of community planning and design that contribute to whether or not a particular community fosters healthy lifestyles. Many of these elements are included in the focal item of this document, the Comprehensive Plan Healthy‐ Community Checklist. This checklist provides a user‐friendly format for guidance and review during the comprehensive‐planning process.
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    Healthy Communities: The Walkability Assessment Tool
    (2010-12-22) O'Hanlon, Julia; Scott, Jacquelyn
    As indicated in a number of recent research studies and articles, an increase in moderate physical activity among Americans could substantially improve the nation’s public health. Given Delaware’s current obesity trends, it is important to keep the state’s residents active and engaged. Walking is one of the easiest and cheapest ways to stay physically fit. In addition to keeping residents physically active and healthy, community spaces that promote walking can draw people together safely and provide more opportunities for people of all ages and abilities to stay socially connected and engaged. Local areas with good pedestrian networks can also have substantial economic and environmental benefits to a local area.
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    Healthy Communities: A Resource Guide for Delaware Municipalities
    (2008-08-28T20:07:37Z) Scott, Marcia; Boyle, Michelle; Eckley, Jason; Lehman, Megan Dively; Wolfert, Kaitlin
    Walkable communities result from careful planning and community design that provides active living opportunities. The resource guide shows how improving the walkability of a community can lead to environmental, health, and economic benefits. The guide stresses that community leaders can catalyze changes by communicating a compelling vision, identifying and mobilizing stakeholders, nurturing strategic partnerships, and building consensus. With broad-based participation and support, public policies and plans can be developed and implemented for a pedestrian-friendly community. The guide offers strategic tools to develop these policies and plans, provides tips for writing a funding proposal, and lists technical assistance and funding resources. Finally, the resource guide provides examples of recreation programming to promote awareness and use of pedestrian-friendly infrastructure, showcases examples of walkable municipalities in Delaware, and highlights outcomes of the University of Delaware’s Healthy/Walkable Communities Initiative.