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Tennessee Giving Children a Better Start

Embargoed until Feb. 20, 2001

Tennessee’s efforts to improve access to health care are showing results, according to information in a report released today. The report, one of two on the way the states, nation and its 50 largest cities welcome new citizens into the world, finds that Tennessee is better than the national average in providing adequate prenatal care. 

Tennessee ranked 27th, its best ranking, on the percent of total births to mothers who received late or no prenatal care (3.6 percent compared to a national average of 3.9 percent). Better rankings in The Right Start: Conditions of Babies and Their Families are earned by having a low percent in this category, indicating all but a small percentage of new mothers had adequate prenatal care.

Adequate prenatal care is the only indicator on which Tennessee ranked better than the national average, and TennCare is a major factor in this ranking. TennCare pays for almost half of all births in Tennessee each year.

The state ranked 31st on the percent of births to mothers who did not smoke during pregnancy, Tennessee’s second best ranking.  The proportion of Tennessee births to mothers who smoked during pregnancy declined strikingly during the 1990s, falling from 22 percent in 1990 to 17 percent in 1998, but Tennessee was still worse than the national average on this indicator.

Although Tennessee ranks in the worst 10 percent on the measures of low-birth-weight births and preterm births, 46th worst on each, the state has made improvements on two important measures. Teen births and repeat teen births have both decreased, with repeat teen births now at the national average for the state.

A second report released simultaneously with the state book looks specifically at birth-related outcomes in the nation’s 50 largest cities. Outcomes for infants in the two Tennessee cities included in the report, Memphis and Nashville, differ greatly, reflecting in part differences in the reporting of statistics from the two cities. Statistics for Memphis measure only the central city and reflect the fact that people in the inner cities are being left behind. Nashville-Davidson County has a metropolitan government including both the inner city and the more affluent communities within the county.

The statistics for Memphis are generally substantially worse than those for Nashville, and do not reflect the more positive trends of national averages.  The only indicator with better outcomes in Memphis than Nashville and the national averages was the use of tobacco during pregnancy, perhaps in part because 72 percent of the mothers giving birth in Memphis during 1998 were African-Americans, who have a lower rate of cigarette use than Whites.

Outcomes in Memphis were substantially worse than the national averages on all other indicators. In contrast, Nashville had outcomes better than or within a percentage point of the national averages on all indicators.

The report also reflects changes in the population: The number of Hispanic births in Memphis went up more than 800 percent from 1990 to 1998. Births to Whites declined from 30 percent of all Memphis births in 1990 to 24 percent in 1998. Six percent of all births in Davidson County were to Hispanic mothers in 1998, up more than 700 percent from 1990. The percent of births to Hispanics statewide increased 450 percent in the eight-year period.

City Trends and State Trends, the two Right Start reports, were released by the Annie E. Casey Foundation through its KIDS COUNT Project. The figures in the book were provided by Child Trends. The information in the reports is available on the Casey Foundation Web site at

The Tennessee Commission on Children and Youth is the Tennessee partner of the KIDS COUNT program, which is funded by the Annie E. Casey Foundation, the nation’s largest philanthropy devoted exclusively to disadvantaged children. For more information about Kids Count or the Tennessee Commission on Children and Youth, see the agency's Web site at

For more information, contact Linda O’Neal, executive director, TCCY, or Pam Brown, KIDS COUNT director, at (615) 741-2633 or a TCCY regional coordinator from the attached list.