Better Supporting the Needs of Children in Tennessee

There is an urgent need to understand long-term health, developmental, and educational outcomes for children who experience early life stressors. In Tennessee alone, over 22% of all children live in poverty. The number of children born between 2001 and 2014 with neonatal abstinence syndrome (NAS) increased 25-fold, and children of immigrants, 36% of whom live in poverty in Tennessee, often struggle to access the social services they need to thrive.

To fill this gap, the multidisciplinary research team will work alongside key state partners to develop an actionable research portfolio that clarifies the long-term effects of these early life experiences and illuminates the ways state policies can be adapted or modified to better serve the needs of Tennessee families.

Leveraging more than a decade’s worth of data, the researchers will examine relationships between at-risk children’s health and education outcomes, as well as access to public services. This is vital information as states across the country, and Tennessee in particular, adopt new laws and resolutions that encompass a wide range of policy actions related to child health and education.

Although the research portfolio will evolve with input from partners including state agencies and non-profits focused on child outcomes, the team will focus their initial efforts around several key issues:

The Opioid Epidemic

Tennessee is one of the states most affected by the opioid epidemic, particularly among its children. Opioid-related policies operate amid a backdrop of public programs like the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and The Early Intervention Program for Infants and Toddlers with Disabilities (IDEA Part C), which seek to mitigate health and educational disparities between opioid-exposed children and non-opioid-exposed children.

The research team will begin by examining longitudinal health outcomes for opioid-exposed children, assessing how likely they are to have developmental delays, special health care needs, and adequate utilization of preventive services. The team will also examine whether county-level trends in the proportion of children with attendance and discipline problems and low test scores correlate with periods of time when neonatal abstinence syndrome (NAS) reached epidemic proportions in their counties. They will then use linked TennCare Medicaid and educational data to undertake individual-level analyses of differences in educational outcomes (e.g., attendance, discipline, and test scores) between children born with NAS and children not born with NAS.

Access to Public Services

Past research has shown that children living in poverty are less likely to complete secondary and tertiary education and more likely to lack health insurance. Children of immigrants who are eligible for public programs and benefits may also need additional support in accessing those benefits, which in turn could aid families in creating a healthier and more nurturing home environment for their development.

Since 2009, Tennessee has introduced more than 20 legislative actions addressing eligibility verification for public program participation. To better understand the impact of these policies, the research team will examine associations between these policy changes and children’s access to Medicaid coverage and other social services in Tennessee, particularly for special needs children.

In addition, the team will investigate ways to improve children’s access to essential health, education, and other social services in Tennessee by conducting key informant interviews with state and local agencies that administer programs, along with school district personnel and nonprofit organizations that assist families in accessing program benefits for children.