The latest analysis of the 2024 Tennessee Child Health Survey found that the share of uninsured children in Tennessee remained stable from the 2023 survey, and rates of mental health diagnoses and related concerns among Tennessee parents remain high.
The annual survey by the Vanderbilt Center for Child Health Policy found that 4.5 percent of Tennessee children lack health insurance, a steady decline from a peak of 9 percent in 2020.
About 41 percent of parents said their child was insured through TennCare, the Tennessee Medicaid program, when the survey was conducted in late 2023, down from 46 percent in 2022. Children insured through employer-based or private insurance coverage, increased from 51% to 54% of surveys from 2023 to 2024.
“Tennessee has made great progress in returning to the relatively low rate of uninsured children the state had before the pandemic. Although the state is restarting the process of evaluating who is eligible for TennCare, it appears that most of the decrease in TennCare for children in 2023 is due to the shift to private insurance,” said Joe Zikafus, MD, MPH, pediatrician and researcher at Monroe Carell Jr. Children’s Hospital at Vanderbilt and a member of the center.
In 2022, Congress ended a federal requirement put in place during the pandemic that required states to keep Medicaid participants continuously enrolled during the public health emergency. In the spring of 2023, states began redefining eligibility after the continuous enrollment requirement ended.
“The study was about halfway through the first year of the TennCare redefinition process, and it remains to be seen whether we will continue to see children switch to other sources of insurance or see more uninsured children in 2024,” Zickafoose said. “TennCare has made significant efforts to keep people who are still eligible enrolled, but there are still tens of thousands of people who are disenrolling each month because of documentation issues.”
Mental health
The study also found that nearly 1 in 3 Tennessee children have a mental health diagnosis, including 17% diagnosed with anxiety and 10% with depression. Rates of anxiety and depression have risen steadily since the Center began the survey five years ago.
Yet while mental health diagnoses are becoming more common, access to mental health treatment remains a challenge for children in Tennessee. Overall, only 55% of children with a mental health diagnosis reported receiving treatment, with less than half of those diagnosed with anxiety (47%) or depression (39%) receiving treatment.
“Tennessee parents continue to highlight their child’s mental health as a top concern. While almost a third of children are reported to have a diagnosed mental illness, over half of these children do not receive treatment. Untreated conditions are a major concern for families and professionals alike, and Tennessee continues to rank poorly compared to other states on measures of parity and access. More needs to be done to address these gaps,” said Heather Krett, PsyD, a clinical pediatric psychologist at Monroe Carell and a member of the center.
General well-being of the child
Each year, the survey also asks parents to rate their children’s overall health. The share of parents who rate their children as having very good or excellent health is decreasing. In 2019, 87 percent of Tennessee parents rated their children’s health as very good or excellent, compared to 82 percent this year.
The survey is conducted annually and covers a range of issues, including education and schooling, behavioral health and food security. The research was funded in part by a grant from the Boedecker Foundation.
