Annual report on status of children and youth in Tennessee provides an in-depth look at our youngest Tennesseans

Monday, January 08, 2024 | 10:00am

Contact: Richard Kennedy | | 615-532-1570

The State of the Child 2023 provides comprehensive data on Tennessee children, youth and their families, highlighting successes and opportunities.

NASHVILLE, Tenn. — Creating a state, community or neighborhood where children thrive requires a wide-ranging assessment of outcomes from birth and maternal health into adulthood, education and career readiness. Released today, The State of the Child in Tennessee 2023, an annual report from the Tennessee Commission on Children and Youth, aims to provide that assessment. The report provides a comprehensive review of available data on child well-being in economics, child care and early education, education, health, mental health, the child opportunity index, child welfare and youth justice.

Children are safer, healthier and better supported in their development when are caregivers supported and can meet basic needs of food, shelter, and health services for children. In 2022, 17.6 percent of children in Tennessee lived below the federal poverty line. This was the closest the state has been to the national poverty line which was 16.3 percent. After a significant drop in under-5 poverty between 2020 and 2021, Tennessee's under-5 poverty rate increased to one in five. Though an increase from the year prior, it is still lower than previous years.

In 2021, food insecurity among Tennessee’s children varied widely depending upon the county in which the child resided, from 0.0 percent in Williamson County to 26.3 percent in Haywood County. Programs such as the Community Eligibility Provision can help provide free school meals to all children. In 2022-23, 91 percent of schools eligible for this program participated. In that same school year, 270 schools had a school produce garden.

Tennessee families report struggling to meet household finance needs, with approximately 40 percent of households stating it was somewhat or very difficult to pay for usual household expenses in the last week. Though families are experiencing this increased financial burden, the weekly wage in Tennessee between 2019 and 2023increased by 27 percent or $268 per week. Tennessee rental households with children report facing significant challenges. One in six are behind on their rent and one in three reported they reduced or forwent basic needs to pay an energy bill.

TennCare continues to insure more than half of Tennessee's children. In 2023, 5.3 percent of Tennessee’s children were uninsured. Of those uninsured, nearly two-thirds were financially eligible for TennCare or CoverKids. Overall, 89 percent of Tennessee’s children are in excellent or very good health. The data shows that household income plays a role in overall child health. Approximately 81 percent of children living below the poverty line are in excellent or very good health compared to 94 percent of children living at 200% Federal Poverty Line or greater.

While the state has seen a continued decline in teen risk behaviors such as substance use, mental health challenges have continued to increase. Alcohol consumption among Tennessee high school students has declined over the decade from 33 percent in 2011 to 22 percent in 2021. Within the last year, 53 percent of high school girls and 30 percent of high school boys felt sad or hopeless almost every day for two or more weeks, representing a 63 percent increase since 2011.

Since 2017, all measures of suicidal ideation have increased among Tennessee high school students. In 2021, more than one in five students reported within the last year they had seriously considered taking their own life, more than one in six had made a plan of how they would do so, and nearly one in seven had attempted to end their life. In 2021, Tennessee ranked among the top 20 states in the rate of suicides among ages 9-17 and in the top 10 in the rate of firearm suicides among the same ages. Since 2018 the firearm suicide rate among young adults (18 to 24) has increased from 10.3 per 100,000 to 14.1 per 100,000.

“Our state does better when all children have access to the resources, supports and services they need to thrive. We hope this report can serve as a guidebook for where we as a state are getting things right and where we can focus our investment and attention to improve outcomes” said Richard Kennedy, executive director of the Tennessee Commission on Children and Youth.

In 2021, Tennessee had 3,962 first-time victims of abuse, representing the fourth-lowest rate in the country. Across all victimization, both first-time and recurring, Tennessee ranks 15th, indicating the state experiences higher instances of recurring abuse than others. One in four children entering foster care was re-entering after a prior episode. Of those, half were re-entering care after less than 12 months. Of infants with prenatal substance exposure, 98.7 percent had a plan of safe care, much higher than the national average of 70.4 percent.

Of first-time foster children entering the system in 2022, more than one in three had been in three or more placements by June 30, 2023. More than half of exits from foster care were to reunification. In FY2023, 369 youth accepted Extension of Foster Care Services, representing the second largest number of youth ever served.

After a slight post-pandemic anomaly, youth crime continues to follow a decades-long decline. Over the last decade, the youth crime rate has dropped from 24.7 per 1,000 in 2012 to 20.1 per 1,000 in 2022.

Between 2012-2022, Shelby, Davidson and Hamilton counties all experienced a decline in the under-18 crime rate. Davidson and Shelby were among the top 10 counties with the largest declines.

Youth are much more likely to be the victim of a firearm crime than to perpetrate one. In 2022, there were 1,561 crimes involving a firearm where the offender was under 18. During that same period, there were 4,490 under-age-18 victims of crimes involving a firearm.

Improving outcomes for children starts with communities where children feel safe, stable and supported. Where families have access to economic and financial support, medical care and mental health services, safe and stable housing, high-quality early education, and where residents feel connected to each other. The investment and communities we build today to address children’s needs and support their development will determine our state's future health, economic and community success.

Release Information

The State of the Child in Tennessee 2023 can be found at Our Data Highlights document can also be found at and provides an abbreviated look at some of the key data contained in the 2023 report.

About Tennessee Commission on Children and Youth

The Tennessee Commission on Children and Youth is an independent state agency created by the Tennessee General Assembly. Its primary mission is to lead systems improvement for all children and families through data-driven advocacy, education and collaboration. Information on the agency is available at