Delaware’s overall population has increased by nearly 21% since 2006, and much of that growth occurred downstate – Sussex (increased 57%) and Kent (increased 30%) Counties have grown much more quickly than New Castle (12%) over the same period of time. Delaware now has the eighth-oldest population in the nation; many seniors immigrate to Sussex County for our beaches and weather.
This rapid population growth amongst older Delawareans, coupled with a large number of people retiring from healthcare and exiting the workforce will lead to a loss of experience and access to care, as well as an increased need for healthcare expertise in the medical needs of seniors (e.g., geriatrics, polypharmacy, complex medical decision making).
We are deeply grateful to this issue’s Guest Editors, Elizabeth Orsega-Smith, PhD and Julia O’Hanlon, for their work curating this issue.
Table of Contents
3 | In This Issue: Aging and Public Health
Omar A. Khan, M.D., M.H.S. & Katherine Smith, M.D., M.P.H.
4 | From the Guest Editors
Elizabeth Orsega-Smith, Ph.D., F.S.B.M. & Julia O’Hanlon, M.P.A.
5 | We Are All Aging: Is Delaware Ready?
Rita M. Landgraf
9 | The Infrastructure of Aging Well: How Delaware Is Preparing for Its Future
Christen Linke Young, J.D.; Dava Newnam; Shekeila Hines, P.T., D.P.T
12 | Population Aging and Public Health Infrastructure in Delaware: A Comparative Analysis of Delaware and Four Comparison States
Athena A. Bruess, B.S.; Grace Hrustich, M.P.H.; Lauren C. Camphausen, M.S.; Yendelela L. Cuffee, Ph.D., M.P.H.; Jennifer A. Horney, Ph.D., M.P.H., C.P.H.; Katlyn Culhane-Suluai, M.P.S.; Daniel A. Harris, Ph.D., M.P.H.
18 | Role of Higher Education Institutions in Advancing Healthy Aging: Education, Engagement, and Experiential Learning Collaborations
Cynthia Newton, Ph.D., M.P.A.; Julia O’Hanlon, M.P.A.; Elizabeth Orsega-Smith, Ph.D., F.S.B.M.
24 | Identifying Barriers to Fall Prevention for Community-Dwelling Older Adults in Delaware: A Qualitiative Study
Margaret Gulledge, O.T.D., O.T.R./L.; Jolaolu Jimoh, P.T., D.P.T., M.Sc.; Gianna Clemente, O.T.R./L.; Tina Lopez, O.T.R./L.
31 | Highlights from the Nation’s Health
32 | Exploring Cognitive Load and Relative Neural Efficiency in Aging: Preliminary Insights from fNIRS and the SLUMS Assessment
Nancy Getchell, Ph.D.; Elizabeth Orsega-Smith, Ph.D.; Serena Schade, M.S.; Elham Bakhshipour, O.T., Ph.D.; Barry Bodt, Ph.D.; & Gregory Dominick, Ph.D.
40 | Reducing Dementia Risk with the BrainSpan Program: A Public Health Practice Vignette
Matthew L. Cohen, Ph.D.; Kimberly Van Buren, M.S., C.C.C.-S.L.P.; Mindy J. Myers, M.A., C.C.C.-S.L.P.; Christopher R. Martens, Ph.D.; & Steven Huege, M.D., M.S.Ed.
44 | Factors Predicting Loneliness in Older Adults Attending Delaware Senior Center Programs
Serena A. Schade, M.S.; Julia O’Hanlon, M.P.A.; Adam Davey, Ph.D.; Elizabeth Orsega-Smith, Ph.D.
50 | Successful Aging: Taking A Ride With Weston
Vicki K. Sheraton
52 | Loneliness Moderates the Association between Neighborhood Disadvantage and Cognitive Function Among Older Adults
Regina S. Wright, Ph.D.; Desiree C. Bygrave, Ph.D.; Alexa C. Allan, M.A.; & Alyssa A. Gamaldo, Ph.D.
60 | Fogarty International Center – Global Health Matters
84 | Impact of an Intergenerational Service Learning Program on Goal Attainment Among Homebound Older Adults: A Multi-Site Community Study
Yeonjae A. Lee, B.S.; Meti Negassa, M.D., M.P.H.; Maggie Ratnayake, L.P.C.M.H.; Maddi Riemenschneider, L.M.S.W.; Keith Chan, Ph.D., L.M.S.W
90 | Lessons Learned from the February 2026 Blizzard: An Interview with Two Village Networks
Danielle R. Swallow, C.C.-P. & Nicole M. Minni, G.I.S.P.
93 | Milford Wellness Village – Foundation of Value-Based Care in Rural Delaware: Adaptive Reuse, Social Determinants of Health, and an Integrated Continuum of Care
Jeanne De Sa, M.P.P. & Andrew Spicer, M.P.P
98 | Let’s Rethink Aging
Susan Getman, B.A., M.A.
101 | Fecal Incontinence as a Marker of Multisystem Cardiopulmonary-Kidney Disease and Mortality in US Adults: A Nationally Representative Cohort Study
Chukwuemeka Ogbu, M.D.; Ifeanyi Momodu, M.D., M.P.H., F.A.C.P.; Chinazor Umerah, M.D., M.B.A., F.A.C.P.; & Prashant Raj Bhatt, M.D.
110 | Impact of Neonatal Intensive Care Unit (NICU) Environment on Maternal Breast Milk Utilization: A Retrospective Study
Leia Heckman, M.S., C.C.C.-S.L.P., C.L.C., O.M.T.; Kelsey Flynn, M.S., C.C.C.-S.L.P., C.L.C., C.N.T.; Amy Mackley, R.N.; & Kelley Kovatis, M.D.
114 | Closing the Training Gap on Addiction Can Save Lives
Eliza Zimmerer, L.C.S.W., M.P.H., C.A.S.A.C.
116 | Resources
117 | Index of Advertisers