📊 Small State, Dense Population

Delaware is unique among U.S. states as the 45th most populous but 5th most densely populated state, with 1.067 million residents packed into just 2,044 square miles. The state’s population continues to grow steadily at 1.49% annually, with significant concentration in New Castle County near Wilmington.

Delaware’s median age of 41.4 years makes it the 6th oldest state, which significantly impacts health service needs and mortality patterns. The state serves as a corporate hub with strong financial and chemical sectors, providing generally good economic conditions that support healthcare access.

💊 Drug Overdoses – Remarkable Turnaround

Delaware achieved one of the most dramatic public health victories in the nation, with drug overdose deaths plummeting by 36% in 2024 to 338 deaths, down from 527 in 2023. This represents the first significant decline after a decade of increases that had made Delaware the 2nd highest state for overdose deaths nationally.

The transformation is remarkable considering Delaware’s recent history:

• 2024: 338 deaths (36% decrease)
• 2023: 527 deaths (first decrease in decade)
• 2022: 537 deaths (near peak levels)
• Historical peak: Previously ranked 2nd highest nationally

This improvement places Delaware among the top performers nationally for overdose reduction, with the second-highest percentage decrease according to CDC preliminary data.

🎯 Comprehensive Intervention Strategy

Delaware’s success resulted from a coordinated, evidence-based approach involving multiple state agencies and community organizations:

• Widespread, targeted naloxone distribution in high-risk areas
• Enhanced addiction treatment access and navigation services
• Changes in drug use patterns (less injection, more smoking)
• Prescription Opioid Settlement Distribution Commission with $13 million in new grants
• Behavioral Health Consortium coordination
• Street outreach programs and peer support specialists

⚠️ Persistently High Accident Rates

Delaware continues to struggle with the 3rd highest accidental death rate in the nation at 72 per 100,000. Over half of these deaths result from poisoning (largely drug-related), though this category has improved significantly with the overdose reduction.

Vehicle-related deaths remain a particular concern, with Delaware being the most dangerous state for drivers in the Northeast at 13.7 vehicle-related deaths per 100,000 population. The state’s high population density and heavy traffic contribute to this elevated risk.

🧠 Stroke – Persistent High Risk

Delaware maintains the 3rd highest stroke mortality rate nationally at 47 per 100,000, significantly above the national average. This elevated rate may be related to the state’s aging population and underlying cardiovascular risk factors in the population.

🎗️ Cancer – Moderate but Improving

Delaware currently ranks 16th nationally for cancer mortality, representing significant improvement from the 1990s when the state ranked 2nd highest. Cancer remains the leading cause of death in Delaware, ahead of heart disease, reflecting both an aging population and historical environmental factors.

👶 Excellent Maternal Health

Delaware is among just six states with maternal mortality rates below 25 per 100,000 births, alongside California, Colorado, Massachusetts, Minnesota, and Utah. This places Delaware among the safest states for childbirth, reflecting quality healthcare infrastructure and prenatal care access.

🔫 Low Violence Rates

Delaware maintains relatively low rates of violent death, with suicide rates ranking 43rd lowest nationally (11 per 100,000) and moderate homicide rates. The state has the 12th lowest firearm mortality rate overall, contributing to generally safer communities.

💰 Economic Advantages

Delaware’s strong economy, with a median household income of $82,855 and just 10.7% poverty rate, supports better healthcare access. The state’s role as a corporate hub provides stable employment and health insurance coverage for many residents.

⚠️ Life Insurance Considerations

Delaware residents present unique considerations for life insurance underwriting. While the dramatic improvement in drug overdose deaths is encouraging, the persistently high accident rates (3rd nationally) and elevated stroke risk require careful evaluation.

We typically help Delaware applicants first qualify for no medical exam term life insurance when possible. For those requiring additional coverage, fully underwritten life insurance policies and guaranteed issue policies remain viable options.

Given the elevated accident risks, we strongly recommend considering additional accidental death policies to supplement traditional life insurance coverage.

🏙️ Geographic Health Disparities

Delaware’s three counties show distinct health patterns:

• New Castle County (585,000 residents): Highest population density, best healthcare access, corporate employment benefits
• Sussex County (278,000 residents): Aging beach communities, seasonal population fluctuations, rural healthcare challenges
• Kent County (194,000 residents): State capital region, moderate density, mixed urban-rural characteristics

Population density varies dramatically from New Castle’s 1,374 people per square mile to Sussex’s 297, creating different healthcare delivery challenges and health outcomes across the state.

🏥 COVID-19 Management

Delaware demonstrated effective COVID-19 management throughout the pandemic, consistently ranking among states with lower death rates. In the 2024-2025 season, Delaware recorded just 103 COVID-19 deaths, with a total pandemic toll of 3,855 deaths – relatively modest given the state’s high population density.

Continuing Success and Challenges

Delaware’s dramatic success in reducing drug overdose deaths provides a model for other states while highlighting what’s possible with coordinated public health intervention. Key priorities moving forward include:

• Sustaining overdose prevention gains through continued naloxone access and treatment programs
• Addressing traffic safety to reduce the state’s high vehicle accident rates
• Cardiovascular health initiatives to reduce stroke risk
• Preparing healthcare infrastructure for the state’s aging population
• Maintaining healthcare access as population continues to grow

Delaware represents a state in transition, having achieved remarkable success in addressing what was once a devastating drug overdose crisis while confronting ongoing challenges with accidents and stroke. The state’s small size, high density, and strong economy provide both advantages and unique health challenges.

With excellent maternal health outcomes, effective COVID-19 management, and now dramatically reduced overdose deaths, Delaware demonstrates the potential for targeted public health interventions to achieve meaningful results. However, persistent high rates of accidents and stroke require continued attention and resources.

For insurance considerations, Delaware’s health profile suggests careful individual assessment, with particular attention to accident risks and age-related factors, while recognizing the positive trajectory in substance abuse mortality reduction.

Data Sources

Delaware Department of Health and Social Services, My Healthy Community Platform, 2024-2025

Delaware Division of Forensic Science, Drug Overdose Mortality Reports, 2024

Centers for Disease Control and Prevention, National Center for Health Statistics, 2023-2024

U.S. Census Bureau, Population Estimates Program, 2024-2025

Delaware Division of Substance Abuse and Mental Health, 2024 Reports

March of Dimes 2024 Report Card for Delaware

Commonwealth Fund Maternal Mortality Report, 2025

Delaware Population Consortium, Annual Projections, 2024

Delaware Department of Health and Social Services Cancer Registry, 2024

World Population Review, Delaware Demographics, 2024-2025