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Jo Edwards, EdD, MTSU Adams Chair of Excellence in Health Care Services.

At the end of last October, public health professionals and state officials convened for the inaugural event of the Tennessee Institute of Public Health (TNIPH), a collaborative effort between the state's higher education leadership and the Tennessee Department of Health developed to improve the health of Tennesseans through education, research and policy analysis.

"Today, Tomorrow, Together: Improving the Health of Tennesseans" brought academicians from public and private institutions, gubernatorial staff, state lawmakers, public health officials and private sector stakeholders to the table to discuss ways to improve Tennessee's health status rankings.

"This institute is the higher education community's call to action for a healthier Tennessee," said interim executive director Jo Edwards, EdD, in announcing the new initiative.

According to Edwards, who is the Adams Chair of Excellence in Health Care Services for Middle Tennessee State University, the impetus for this new agency came from discussions across the University of Tennessee (UT) and Tennessee Board of Regents systems about creating schools of public health. As a result of those talks, East Tennessee State University has now launched a degree program; UT is discussing such an addition in Memphis; and Tennessee State University in Nashville is adding new programming and coursework tied to public health.

The idea, explained Edwards, was to create the Tennessee Institute of Public Health as the research arm of this larger public health agenda. The hope, Edwards said, is that the TNIPH will become a clearinghouse for meaningful research that is already underway, linking together public and private facilities "across disciplines … across campuses … for the practical application of improving the health in Tennessee."

Edwards continued, "It's also a way to have an independent voice provide information about health issues to legislators and the population in general."

TNIPH is a member of the National Network of Public Health Institutes (NNPHI), which is comprised of institutes established nationwide, including those in 26 other states as well as 16 more, such as Tennessee's, that are in the process of building and maturing programs. Funded in part by the Tennessee Higher Education Commission, the new organization is also applying for a variety of federal grants to support the program of work.

"We've done extremely well in a very short time to get the infrastructure in place," Edwards said, noting the next steps include obtaining legislative authorization this spring, naming a board of directors from the public/private sector and completing an inventory of ongoing research.

The need for speed in setting up the TNIPH becomes abundantly clear when looking at how Tennessee fares nationally when it comes to health status. Each year for 17 years the United Health Foundation has published "America's Health Rankings™," which looks at a variety of indicators from premature death to prevalence of risk factors. Tennessee has shared the dubious distinction of being among the unhealthiest states in America along with Louisiana and Mississippi. After being ranked 48th for three consecutive years, the state did move to 47th for 2006, according to a report released last month.

"I think when you rank 48th consistently and you look at the economic impact of spending that much of your dollars on healthcare, as well as the physical cost to your citizens, (it's clear) we need to do some things to improve our health status," Edwards pointed out. "Not only do we need to do something … we really must do something to improve our health status."

As a companion tool to the state health rankings, in early December the TNIPH released the first-ever County Health Rankings 2006 Index breaking down where each of the state's 95 counties fall in terms of public health. Edwards said the institute looked at 35 parameters divided into health outcomes and health determinants to create the rankings. While many of the parameters are directly tied to health conditions, others are broader in nature such as socioeconomic and education levels.

"Tennessee is very spread out and has regional differences," she noted, adding that knowing what the greatest needs are within a community or within the state is the first step in creating programming to address those needs.

"It works down from the health status of the state to the health status of each county to the health status of each individual," Edwards pointed out.

"The agenda," she continued, "is pretty set for us by the rankings themselves."

Obesity, cardiovascular disease and diabetes are recurring themes. Edwards added that the institute anticipates interacting with other programming that has recently been rolled out through the governor's office, various county departments and school systems to address some of these same issues.

"It takes resources from all the collaborators," she said. "We're all focused on a singular mission."




January 2007

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