Over the past 9 years, the DE-CTR ACCEL Program has established an exceedingly strong network and infrastructure for clinical and translational (C&T) research within the state of Delaware. While we will continue with the activities that have made us successful, we have a sharper focus on building sustainable infrastructure across the state that can continue to thrive and mature for years to come. Our focus is on creating a scientific culture focused on improving the health of Delawareans but doing so through a lens of health equity. In our mission to establish a cadre of successful C&T scientists in DE, we will use various approaches to promote full consideration of how their work impacts the needs of all members of society, from design to study implementation to dissemination of findings. And, we will have a much greater focus on building a bi-directional relationship between our scientists and the community so we can have a greater impact on Delawareans. Delaware is an ideal state for a CTR grant as it represents the whole of the USA in a compact form. The population of Delaware (~970,000) mirrors the US population in urban-to-rural citizen ratio and ethnic/racial diversity, with 23% African American, 62% Caucasian, 10% Hispanic, 4% Asian and 1% Native American. Thus, studies involving a cross-section of Delaware can be generalizable to populations nationally. The dominance of adult (CCHS) and pediatric (Nemours) hospital systems, which serve at least 85% of the residents of the state, provides a unique opportunity to treat the state of Delaware as a model for examining how healthcare changes can impact population health. The overarching goal of the ACCEL CTR Program is to create a unified Delaware Clinical and Translational Research Community (inclusive of investigators and community members) that breaks down existing barriers, capitalizes on the unique strengths of its partners to establish infrastructure and accelerates the creation of equitable solutions that improve the health of all Delawareans and all Americans.