Population Aging and Public Health Infrastructure in Delaware: : A Comparative Analysis of Delaware and Four Comparison States.

Consistent growth in the number of older adults in the United States has led many health systems to evaluate their capacity for supporting an aging population. Delaware needs to identify priorities and action areas to support the state's increasingly older population. Using publicly available data from national surveillance systems and state reports, this analytic essay compared demographic aging trends, age-related chronic disease prevalence, and public health infrastructure across Delaware, Maryland, Pennsylvania, Rhode Island, and Vermont. These states were chosen given their similar geographical location or population size. Between 2015 and 2024, the proportion of Delaware residents aged 60 years and older grew from 23.7 percent to 29.3 percent, placing Delaware as second among comparison states in the proportion of older adults. Relative to the comparison states, Delaware had the highest proportion of older adults moving into the state, with 18.8 percent of adults aged 60 years and older relocating from another state in 2024. In 2024, Delaware had the highest prevalence of several age-related health conditions, including diabetes (13.3%), stroke (3.5%), arthritis (26.2%), and neurological difficulties (15.8%). Delaware had the highest disparities relative to the comparison states on measures of economic hardship, food instability, and uninsured populations. Despite these demographic, economic, and disease trends, Delaware had the second-lowest geriatric healthcare workforce capacity, reporting 39.3 geriatricians and nurse practitioners per 100,000 adults aged 65 years and older in 2025, compared with 74.1 in Rhode Island. These findings suggest that Delaware's aging population is growing rapidly, and that the state may be facing substantial preparedness gaps related to meeting the needs of older Delawareans. Strategic investments in workforce development, economic supports, community-based services, healthcare access, and dementia preparedness will be critical to ensuring Delaware is prepared to meet the evolving needs of its growing older adult population.