In Tennessee, there is a wide disparity between the health of individuals living in the wealthiest counties, and those living in the poorest. In the wealthiest counties, people lived 2.5 to 4 years longer than those in less wealthy counties on average, and there were lower rates of smoking, obesity, and lack of physical activity in those wealthy counties. In Tennessee, having a lower income is associated with significantly worse health outcomes, and the state's poorest counties have some of the worst health outcomes in the United States (Beatty et al., 2020).
According to the CDC, in 2021 11.9% of Tennesseans did not have health insurance (CDC, 2022). Understanding patients' insurance, or lack thereof, is a critical aspect of understanding their ability to access care. For most uninsured Americans, a bill for lifesaving healthcare is beyond what they could ever pay. Even routine healthcare costs are increasingly expensive for the uninsured, making individuals less likely to access preventative care and overall worsening their health. This also puts them at a higher risk of needing more intensive, and expensive, medical care later on for issues that are not treated early on (Beatty et al., 2020). Tennessee has consistently ranked in the bottom ten states for health (US Department of Health & Human Services, 2021).
2022 Tennessee Health Outcomes Map from the County Health Rankings & Roadmaps.
Financial, employment, and food support
Families First is Tennessee's Temporary Assistance for Needy Families (TANF) plan. It provides temporary cash assistance, transportation, child care assistance, educational supports, job training, employment activities, and other support services with an ultimate goal of self-sufficiency via employment. Families First can also provide assistance in paying for childcare. It provides assistance to families with children who are experiencing financial difficulty. Families may apply using this link and can call 1-866-311-4287 (toll free) for assistance.
The Supplemental Nutrition Assistance Program (SNAP) is managed by the Tennessee Department of Human Services (TDHS). SNAP provides grocery assistance for a set period of time, which is known as a certification period. This article is a starting point for individuals looking to sign up for SNAP benefits. Patients may also visit the library to print a SNAP application from this link, if they would like to mail it.
Tennessee also offers vocational rehabilitation for individuals with disabilities hoping to reenter the workforce. People can apply directly with an office. Here is a list of all of the offices in the state. Knox County is served by the region two office.
There is a wide array of community service programs available in Tennessee. Here is a full list of programs Tennessee Association of Human Resource Agencies provides, including help for those experiencing homelessness, pharmaceutical assistance, and emergency food and shelter.
The summer food service program provides food to children while school is not in session. Those interested can learn more using the website here, or to find locations nearby they can “Summer Meals” to 914-342-7744 or call 1-866-348-6479.
Mental health care
The Behavioral Health Safety Net offers services including assessment, evaluation, diagnostic, therapeutic intervention, case management, transportation, peer support services, psychosocial rehabilitation services, psychiatric medication management, labs related to medication management and pharmacy assistance, and coordination for individuals at least three years old who have a mental health diagnosis and who do not have behavioral health insurance. Here is a link where people can learn more and register themselves or their children.
NAMI has a list of resources available in Middle Tennessee, including councils, support groups, and counseling.
How to access low-cost healthcare in TN
Tennessee has options for low-cost healthcare, especially for those in or around urban areas. The US Department of Housing and Urban Development has a list of options on their website here.
The state of Tennessee uses the health insurance exchange run by the federal government. This means that people who want to enroll use Healthcare.gov to sign up for their exchange plans. In 2023, six insurers offer healthcare via the exchange in TN, but no provider covers the entire state. This means that available coverage may depend on what county an individual lives in.
Understanding insurance is an important part of health literacy. When working with patients who are uninsured, or not aware of how to sign up for insurance, there are resources that can help. Tennessee State Health Insurance Assistance Program (TN SHIP) helps eligible patients sign up for Medicare. For all other questions, the Tennessee Department of Commerce & Insurance can provide information and assistance with issues, and also has links to other organizations within the state that can help.
Uninsured rates in 2020 from the Rural Health Information Hub
