Community and Internal Hospital Meetings

• Fragmentation of Health and Social Services. Fragmentation and a low level of coordination of care were named as major issues in provision of care, especially with COVID-19 testing and vaccination roll-out. Interviewees identified a gap in coordination between state services and healthcare services. Also noted, was a need to help patients navigate the very complex medical and social services that exist.

Interviewees identified several types of programs and initiatives that would help fill gaps and improve community health. These include a need to integrate mental health services into neighborhoods with a key priority of making services culturally appropriate and accessible. Interviewees identified a need for more mobile services for opioid and other substance use disorders. There is a particular need for substance use treatment for pregnant women, especially hospital level care for pregnant women who need detox services.

Community and Internal Hospital Meetings

Six community meetings were conducted in March 2022 to obtain community input. Four community stakeholder meetings were held. Thirty-five (35) individuals participated. These individuals represented organizations including Delaware Health and Social Services, non-profit organizations, local businesses, healthcare providers, local policymakers, and school systems. Forty-five (45) individuals participated in meetings with Christiana Hospital and Wilmington Hospital staff. Individuals from administration, nursing, case management, social services, project management, and health equity participated. A meeting was also held with one hundred ten (110) students from William Penn High School, health classes. That meeting focused on needs pertaining to New Castle County youth. Each meeting began with a presentation that discussed the CHNA process and the purpose of the meetings. Secondary data were presented including a summary of unfavorable community health indicators. Meeting participants then were asked for feedback on the secondary data analysis and to identify community health issues that may not have been found based on the data. Participants then were asked to complete an online survey and to identify “three to five” community health issues they consider to be most significant. Through this process, meeting participants identified the following community health needs as most significant in New Castle County:

• Access to care • Chronic conditions • Dental health • Mental health • Obesity, poor nutrition, and physical inactivity • Sexually transmitted infections (youth)

• Smoking, tobacco, and vape product use (youth) • Social determinants of health • Substance use disorders • Violent crime • Preventive services and screenings