The Department of Health works to promote, protect and improve the health and well-being of Tennesseans. Keeping people healthy by preventing problems that contribute to disease and injury is the overall emphasis of the Department. Responsibilities include immunizing children against measles, recruiting doctors to practice in rural medically underserved areas of Tennessee, offering early prenatal care and proper nutrition to pregnant women, ensuring that restaurants meet standards of cleanliness, and performing laboratory tests ensuring safe drinking water.
The greatest causes of premature death and preventable illness are closely related to the way we live—what we eat, whether we smoke, how much we exercise, and what we do to protect our own safety. The Department promotes healthy lifestyles by educating Tennesseans about these risks and making them more aware of the importance of individuals taking responsibility for their health and their family’s health.
The Department of Health works to ensure the quality of health care through the licensure and regulation of health professionals and of health care facilities. The Department also plays a critical role in ensuring that personal health care services are available when and where people need them and are accessible despite economic and geographic barriers. The Department provides a variety of services for all age groups through local health departments across the state, ranging from well-child visits and immunizations, to school health services, to family planning and prenatal care, to wellness programs, and to education.
Recurring epidemics of cholera, yellow fever, and other deadly diseases were a powerful force in the development of what we know today as Tennessee’s public health system. Through the mid-1800s, Nashville, Knoxville, Memphis and many smaller cities and towns experienced epidemics that threatened human life and economic well-being.
As a result, efforts began to establish a State Board of Health, and a bill was signed into law in 1877 to create such a board. For many years, the main activities of the board were combating epidemics, forming county boards of health, working on school sanitation, and maintaining vital records of births and deaths in the state.
In 1923, legislation created the Department of Public Health. Activities and responsibilities have changed and grown through the years as health needs and medical care have evolved in the state. In 1983, the Department’s name was changed from the Department of Public Health to the Department of Health and Environment to more clearly reflect its broad functions. As part of an increased focus on environmental protection and conservation, the environmental programs were transferred in 1991 to the new Department of Environment and Conservation. The Department’s name was then changed to the Department of Health.
Find a timeline of events in the history of the Department of Health here.
Tuberculosis and sexually transmitted diseases, including HIV/AIDS, continue to pose significant health threats in Tennessee. Local health departments provide testing, counseling, treatment and contact tracing to control the spread of these diseases. The Department has placed emphasis on care coordination for individuals living with HIV/AIDS. In its effort to promote childhood immunizations, the Department provides immunizations, tracks immunization rates through the Tennessee Immunization Registry, provides outreach to encourage parents to immunize their children, and is involved in coordinating the distribution of vaccine to private providers through the federal Vaccines for Children program. Flu and pneumonia immunizations, tetanus-diphtheria boosters, and hepatitis B vaccines are also available to adults at local health departments. The Department is involved in the investigation of disease outbreaks, contact tracing to control the spread of communicable diseases, and activities to assess the risk of exposure to occupational and environmental hazards. Information obtained through these efforts and surveillance activities guide the development of policies and procedures to protect the public from health threats.
This initiative is targeted at decreasing youth violence, alcohol and drug use, school dropouts, and teen pregnancy. The initiative provides early intervention services designed to protect children from risk factors common to the four targeted problems.
The goals of the section are to eliminate health disparities and increase years and quality of life for all Tennesseans. These goals are accomplished by emphasizing the importance of healthy choices, by promoting healthy behaviors through wellness, lifestyle, tobacco prevention and cessation initiatives, and through disease prevention and management efforts that target specific disease prevention strategies, coupled with disease management initiatives. The healthy and safe communities component promotes comprehensive health education, injury prevention and control programs, rape and sexual assault prevention programs, and poison control programs. Improvement of community health systems is a major focus area as well. Local health councils and the community diagnosis process regularly assess the priority health issues in Tennessee communities and seek to build initiatives that address these issues. The Rural Health and Health Access offices seek to augment underserved communities by recruiting providers for communities and by assuring adequate systems of care.
This area’s activities include inspection of food service establishments, camps, hotels and motels, bed and breakfast establishments, tattoo parlors, and public swimming pools. It also conducts environmental surveys in schools and child care facilities and monitors rabies control.
Oral disease prevention services in schools throughout the state include oral health education, the application of dental sealants, dental screening and referral, school-based fluoride programs, and daily tooth brushing programs. Fluoridation of public water supplies is another key component of the preventive dental program. Clinical dental services are provided in selected local health departments and in community initiative sites to complement needs of specific geographic areas. Mobile dental clinics provide dental services at school sites to high-risk children in select regions of the state. Oral Health Services partners with public health nurses to implement an early childhood caries intervention program involving fluoride varnish application, dental screening and education for children and parents.
The State Public Health Laboratory and its two regional laboratories across the state provide valuable support of public health issues such as newborn testing, disease prevention, and a clean environment. The laboratories provide services to program areas within the Department, local health departments, hospitals, independent laboratories, other state departments, physicians, dentists, and clinics. In addition, they provide public health services that are not available from other sources, such as rabies testing. The public health labs are a part of the National Laboratory Response Network that is the laboratory component of homeland security for analyzing specimens related to terrorism.
The Department is responsible for assuring quality in health manpower and health care facilities. The Department helps administer state laws that require health care professionals to meet certain standards. Doctors, nurses, dentists, and other health care professionals are licensed by regulatory boards. Disciplinary action is taken if state standards are violated.
Hospitals, nursing homes, ambulatory surgical treatment centers, and other health care facilities are also licensed by the Department. In addition, facilities are assessed and certified for participation in the Medicare and Medicaid programs. Ambulance services and emergency medical personnel across the state are checked to ensure that quality standards are met when emergency medical services are needed, and medical laboratories and personnel are tested and licensed.
The maternal and child population has long been a focal point of public health programs. Local health departments provide a wide variety of services aimed at reducing the infant mortality rate, lowering the adolescent pregnancy rate, encouraging early entry into prenatal care, and reducing childhood morbidity. Services include screening and follow-up for children with potential lead poisoning, outreach, intensive case management, family planning, prenatal care, mammography screening, and the development of comprehensive school health programs. Routine screening of all newborns for hearing problems, certain metabolic and inherited disorders and a regional genetic program are other important maternal and child health services. The Department has placed particular emphasis on care coordination for children with severe or chronic medical needs. Services include payment for certain medical or health-related services, home visitation, interaction with schools, coordination among multiple medical providers, assistance in accessing needed social and medical services, and education and support.
Local health departments administer programs that provide supplemental foods to low-income, pregnant, breast-feeding and postpartum women, infants, and children. In some counties, supplemental foods are also provided to the elderly. Nutrition education on how to use these foods as part of a good daily diet is also provided. A variety of preventive and therapeutic community nutrition services are provided to Tennessee citizens.
The Office of Minority Health (OMH) advocates for the development of culturally competent policies, programs, and services to respond to the health needs of minority Tennesseans and address health disparities due to race, ethnicity, age, gender, geography, poverty, or culture. Technical assistance and consultation are provided to state agencies, community organizations, and health professionals to address related concerns that impact the health of constituent populations. The OMH funds, on a limited basis, community programs that target at-risk youth through academic, skill-building, and recreational activities. The OMH collaborates with public and private sector entities to build working coalitions and networks for improved health care access, quality, and information dissemination to minority communities across the state.
The Department collects and analyzes information for the entire Tennessee population relative to such health status indicators as infant mortality, low birthweight, adequacy of prenatal care services, morbidity and mortality from disease and injury, immunization status of children, adolescent pregnancy rates, and lead toxicity in children. Statewide registries for cancer incidence, birth defects, and traumatic brain injuries, and several large data collection systems are the mechanisms used to obtain this information. The resulting data is analyzed for the purpose of informing policy and shaping the health care delivery system in the state in order to respond to identified needs and to promote and protect the health of the citizens.
Local health departments in all 95 counties offer a variety of preventive services. Comprehensive primary care services are provided in selected health departments based on the needs of the community. Clinics are staffed with physicians or mid-level practitioners working under supervision and protocol. Local health departments participate in TennCare and other insurance programs.
In addition to supporting the TennCare program by participating as service providers in the managed care organizations’ provider networks, local health departments provide other services related to TennCare. These services include outreach activities to identify and assist with presumptive enrollment of pregnant women and presumptive enrollment of women who test positive for breast or cervical cancer who need and qualify for TennCare but are not yet enrolled. Local health departments also provide advocacy activities to educate enrollees concerning covered benefits and the managed care system and assistance in accessing medically necessary services. Care coordination and home visitation services are available for high-risk TennCare families with special health care needs. The health departments provide dental screening services to school children and early and periodic screening, diagnosis, and treatment to children under age 21 pursuant to an arrangement with TennCare. The Department also provides outreach to TennCare children through a centralized call center and community outreach program.
The Department maintains a central registry of births, deaths, fetal deaths, marriages, divorces, adoptions, and legitimations in the state. Certified copies of these records are available at the Vital Records Office in Nashville, at selected county sites, and on the Vital Records Web site.