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DHSS Press Release

Dr. Kara Odom Walker, Secretary
Jill Fredel, Director of Communications
302-255-9047, Cell 302-357-7498

DPH Media Contact:
Jennifer Brestel
302-744-4907, Cell 302-612-6223

Date: February 4, 2020


DOVER (Feb. 4, 2020) - The Delaware Division of Public Health (DPH), along with the University of Delaware, has released the second edition of the Health Equity Guide for Public Health Practitioners and Partners. The latest edition, which follows the 2015 release of the original guide, further supports the state's efforts to advance health equity in Delaware.

The Health Equity Guide highlights the best available evidence and data to explain the connections between the social determinants of health and good overall health. Social determinants of health are the 90 percent of what affects a patient's health that have nothing to do with clinical care, such as housing, transportation, employment, public safety, income, or how close they live to a grocery store, park or health care provider. The second edition of the guide also focuses on structural racism as a fundamental cause of health inequities.

"Everyone - regardless of race, religion, political belief, ability, sexual orientation and economic or social condition - has the right to a standard of living adequate for optimal health," said DPH Director Dr. Karyl Rattay. "By advancing health equity, we provide every Delawarean with equal opportunities to achieve their full health potential."

For example, there is strong evidence tying the stability, quality, safety, and affordability of housing to health outcomes. Throughout Delaware, there is a shortage of affordable rental homes that are available to extremely low-income households, whose incomes are at or below the poverty guideline or 30 percent of their area median income (AMI).

"Many of these households are severely cost burdened because they must spend more than half of their income on housing," said DHSS Secretary Dr. Kara Odom Walker, a practicing family physician. "Severely cost-burdened households are more likely than other renters to sacrifice such necessities as health care and healthy food to pay the rent. Plus, they're more likely to experience unstable housing situations like evictions."

To improve environmental and social conditions, all sectors - public health, health care systems, businesses, schools, religious organizations, lawmakers, community leaders, non-profit organizations, and other stakeholders - must join together to address inequities tied to social determinants, and in doing so will help to advance overall health.

"As our understanding of what is needed for optimal health changes, so should our approach," said Rita Landgraf, director of the UD Partnership for Healthy Communities. "Addressing equity is key, and this guide should be required reading for anyone working to improve the health of Delawareans."

DPH believes that all practitioners working in any field of study can find value in reading the second edition of the Health Equity Guide. The latest edition includes the most current data regarding health status and inequities that currently exist in Delaware, and shares new strategies and tools to support practitioners and partners in the implementation of evidenced-based strategies, interventions and policy considerations.

Both versions of the guide highlight place-based, system, environmental, and policy-oriented strategies, as well as research, evaluation, and leadership.

"Unless we are purposeful in addressing our persistent health inequities, it will be difficult for us to collectively achieve our goals to create a healthier Delaware." said DPH Associate Deputy Director Cassandra Codes-Johnson, who co-authored the first and second editions with Erin K. Knight, associate director of the UD Partnership for Healthy Communities and associate director of the Biden School's Center for Community Research & Service. In November 2019, the pair presented the publication at the American Public Health Association's Annual Meeting and Expo held in Philadelphia.

"The Division of Public Health should be commended for continuing to promote and invest in strategies that advance health equity," said Erin K. Knight. "Addressing racism and other social inequities that lead to poor health requires courage and persistence, and I'm grateful that we have such committed leaders in our state."

To read the Health Equity Guide for Public Health Practitioners and Partners, Second Edition, visit

A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person's spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit

DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware's citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations.