The latest analysis of the 2024 Tennessee Child Health Poll has found that the proportion of uninsured children in Tennessee held steady from the 2023 poll, and the rates of mental health diagnoses and associated concerns from Tennessee parents remain high.
The annual poll conducted by the Vanderbilt Center for Child Health Policy has found that 4.5% of Tennessee children lack health insurance, showing a steady decline from a peak of 9% in 2020.
About 41% of parents said their child was insured through TennCare, the Tennessee Medicaid program, when the poll was fielded in late 2023, down from 46% in 2022. Children covered through employer-based or private insurance coverage increased from 51% to 54% from the 2023 to 2024 polls.
“Tennessee has made great progress in returning to the relatively low rate of uninsured children the state had before the pandemic. While the state restarted the process of assessing who is eligible for TennCare, it looks like most of the decrease in TennCare for kids in 2023 was due to switching to private insurance,” said Joe Zickafoose, MD, MPH, a pediatrician and researcher at Monroe Carell Jr. Children’s Hospital at Vanderbilt and member of the center.
In 2022, Congress ended a federal requirement instituted during the pandemic that required states to keep Medicaid participants continuously enrolled during the public health emergency. In the spring of 2023, states began redetermining eligibility after the continuous enrollment requirement ended.
“The poll was about halfway into the first year of the TennCare redetermination process, and it remains to be seen whether we’ll continue to see transitions of children to other sources of insurance or see more uninsured children in 2024,” Zickafoose said. “TennCare has made substantial efforts to keep people who are still eligible enrolled, but there are still tens of thousands of people being disenrolled each month for paperwork problems.”
Mental Health
The poll also found that nearly 1 in 3 Tennessee children had 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 polling five years ago.
Still, while the mental health diagnoses have become increasingly common, access to mental health treatment remains a challenge for Tennessee children. Overall, only 55% of children with mental health diagnoses reported receiving treatment services, 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 health condition, over half of these children are not getting treatment. Untreated conditions are a major concern for both families and professionals, and Tennessee continues to rank poorly compared to other states on measures of parity and access. More must be done to address these gaps,” said Heather Kreth, PsyD, a clinical pediatric psychologist at Monroe Carell and member of the center.
Overall child well-being
Each year the poll has also asked parents to rate their children’s overall health. A falling share of number of parents rate their children as having very good or excellent health. In 2019, 87% of Tennessee parents rated their children’s health as very good or excellent, compared to 82% this year.
The poll 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.
