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Category: Health Care & Insurance

  1. Home
  2. Health Care & Insurance

Child and Adolescent Mental Health in Tennessee

Teen group

A growing share of adolescents report poor mental health, symptoms of depression, and attempting suicide. Youth suicide death rates have also increased.

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2021 Income, Poverty, Health Insurance Coverage, and Education in Tennessee’s 95 Counties

Tennessee’s 95 counties continue to experience differences in income level, poverty rates, health insurance status, and educational attainment.

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2021 Census Data on Health Insurance Coverage in Tennessee

Tennessee’s Uninsured Rate Held Steady in 2021

Men, Hispanics, younger adults, the unemployed, and people with less education and income are the most likely to be uninsured in Tennessee.

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2020 Income, Poverty, Health Insurance Coverage, and Education in Tennessee’s 95 Counties

Tennessee’s Urban Counties Tend to Have Higher Incomes and Less Poverty than Other Parts of the State

On average, Middle Tennessee’s urban counties have the state’s highest education and income and the lowest poverty and uninsured rates.

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Income, Poverty, Education, and Insurance Coverage in Tennessee in 2020

Couple sitting on sidewalk

Census Bureau estimates show Tennessee lagged the U.S. on income, poverty, education, and health insurance coverage in 2020.

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How Medical Debt Affects Health

Worried mother with daughter

Research shows medical debt can affect health outcomes, exacerbate already poor outcomes, and worsen existing health disparities.

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2019 Income, Poverty, Education, and Insurance Coverage in Tennessee’s 95 Counties

Tennesseans with at Least an Associate’s Degree (2015-2019)

Census data for Tennessee’s 95 counties continue to show large differences in household income, poverty, education level, and health insurance coverage.

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2019 Census Data on Health Insurance Coverage in Tennessee

Couple and doctor with clipboard

The Tennesseans least likely to have health insurance in 2019 were men, Hispanics, younger adults, the unemployed, and people with less education & income.

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A Deep Dive into Health Insurance Coverage in Tennessee

doctor looking at xray

For better or worse, robust access to the U.S. health care system is largely predicated on having health insurance.

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2018 Income, Poverty, Education, and Insurance Coverage in Tennessee’s 95 Counties

Tennessee Children Living In Poverty (2014-2018)

Census data for Tennessee’s 95 counties continue to show large differences in household income, poverty, education level, and health insurance coverage.

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The Sycamore Institute Is an Independent, Nonpartisan Public Policy Research Center for Tennessee

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Mandy Pellegrin

Mandy Spears

Deputy Director

Mandy Spears is the Deputy Director of the Sycamore Institute, an independent, nonpartisan public policy research center for Tennessee. A seasoned policy expert and strategic thinker, Mandy is a trusted guide to elected officials, journalists, and citizens who seek to better understand and shape our society.

As a founding member of its leadership team, Mandy helped establish Sycamore’s accessible, objective, and evidence-based approach to explaining complex issues. She has overseen the production of hundreds of publications with clear and actionable information on the state budget, health, education, criminal justice, and beyond.

Mandy has over 15 years of experience supporting federal and state policymakers – including as a Presidential Management Fellow and advisor to senior leaders at the U.S. Department of Health and Human Services under Presidents George W. Bush and Barack Obama. She also served as a legislative aide to former U.S. Representative Lincoln Davis (D-TN) and policy adviser to U.S. Representative Bill Pascrell (D-NJ). A native Tennessean, she started her public policy career in the state Comptroller’s Office of Research and the Tennessee General Assembly.

Mandy is a member of Leadership Tennessee and Young Leaders Council and serves on the boards of the Civic Design Center and Governmental Research Association. She is an adjunct professor of public policy at Vanderbilt University’s Peabody College and Lipscomb University’s College of Leadership and Public Service. In 2022, the Nashville Business Journal recognized her as one of the region’s Women of Influence. Mandy holds a master’s degree in public policy from Georgetown University and a bachelor’s degree in political science from Lipscomb University.

Mandy maintains strong ties to her local community through volunteer activities and her creative endeavors. She now calls East Nashville home.

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Judge Calloway

Sheila Calloway

Board Member

Sheila Calloway, a native of Louisville, KY, came to Nashville, Tennessee in 1987 to attend Vanderbilt University Law School. She received her Bachelor of Arts degree in Communications in 1991 and her Doctor of Jurisprudence in 1994. After graduating from law school, Sheila Calloway worked at the Metropolitan Defender’s Office in the adult system as well as the juvenile system. In January 2004, she was appointed by Judge Betty Adams Green to the position of Juvenile Court Magistrate and served in that position until November 2013, when she announced her intention to run for the position of Juvenile Court Judge.

Sheila was elected Davidson County’s Juvenile Court Judge in 2014 and was sworn into office for her eight year term on August 28, 2014. She was re-elected for another eight-year term in August of 2022. Judge Calloway also serves as an Adjunct Professor at Vanderbilt University Law School where she teaches Trial Advocacy, and an Adjunct Professor Belmont College of Law where she teaches Juvenile Law.

Judge Calloway uses her unique combination of humor, passion, and judicial wisdom to change the way we look at justice in the United States. 

Grace Baron

Communications & Engagement Manager

Grace Graves Baron serves as the Communications & Engagement Manager at the Sycamore Institute, an independent, nonpartisan public policy research center for Tennessee. She is passionate about reducing political polarization by making complex ideas accessible to a wide audience. At Sycamore, she works to build strong relationships across the state through community events and manages Sycamore’s online presence. In her previous role, Grace worked for Q Ideas, curating speakers and content for events that reached thousands of faith leaders across the country.

An East Tennessee native, she cares about crafting sound, evidence-based public policy that addresses the distinct issues facing the Volunteer State. In her free time, she has served as a volunteer for civic organizations like tnAchieves. She holds a B.S. in government and a Master of Business Administration from Bryan College.

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Posts by Grace

Doug Overbey

Doug Overbey

Board Member

Doug Overbey is a partner and co-founder of the Knoxville law firm Owings, Wilson & Coleman, where he focuses on white-collar defense, high-stakes litigation, healthcare, and state and local government law. 

From 2017-2021, Overbey served as U.S. Attorney for the Eastern District of Tennessee—a position appointed by the president and confirmed by the U.S. Senate. As chief federal law enforcement officer for his district, he was responsible for investigation and prosecution of all violations of federal law, civil defense of matters in which the U.S. was a defendant, and affirmative civil enforcement actions brought in the name of the U.S. government. In addition, he served as co-chairman of the Tennessee Dangerous Drug Task Force and Chairman of the Executive Board for the Appalachian High Intensity Drug Trafficking Area. 

When appointed U.S. Attorney, Overbey was in his third term as a Tennessee state senator. He previously served eight years in the state House of Representatives and two terms on the Blount County Commission. While a member of the General Assembly, he served on the Finance and Health Committees of both chambers, as Chairman of the Senate Ethics Committee, and as Vice-Chairman of the Senate Finance and Judiciary Committees. 

Overbey currently serves on the national board of directors of Human Rights for Kids, a bipartisan non-profit organization dedicated to the promotion and protection of human rights for children. Among his honors and awards, he received the 2011 Bud Cramer Award from the National Children’s Alliance, the 2012 Distinguished Alumnus Award from Carson-Newman University, the 2017 Presidential Award from the Tennessee Judicial Conference, and the Knoxville Bar Association’s “Law & Liberty” Award in 2009.  Overbey has been a frequent presenter for continuing legal education programs for the Knoxville and Tennessee Bar Associations.  

Overbey graduated Order of the Coif from the University of Tennessee College of Law and earned his undergraduate degree, magna cum laude, from Carson-Newman College. 

Overbey resides in Maryville with his wife, Kay. They have three married daughters and six grandchildren and are parishioners of St. Andrew’s Episcopal Church in Maryville. He currently serves on the Standing Committee of the Episcopal Diocese of East Tennessee and has twice been published in the Anglican Digest.  

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Joseph Page

Special Projects Manager

Joseph Page is the Special Projects Manager for the Sycamore Institute. In this role, Joseph coordinates a wide range of programs and activities that advance the organization’s mission. In addition to managing Sycamore’s network of Tennesseans working on criminal justice fee and fine policy, he also provides support to the leadership, research, and communication teams. Joseph joined the Sycamore Institute in 2023 after serving as the Campaign Manager for the SEIU Local 205 and Regional Organizing Manager for The Equity Alliance, where he managed political and community outreach projects.  

Joseph comes from a background of political organizing, having previously worked in Chattanooga and Memphis. He became interested in policy and research after serving as an intern in former Chattanooga Mayor Andy Berke’s office. 

Joseph grew up in Memphis and holds a bachelor’s degree from the University of Tennessee at Chattanooga in Political Science with a minor in Business Administration.  

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Kerry Hayes

Kerry Hayes

Board Member

Kerry Hayes is the founder and principal of Coeo, a public affairs and communications consultancy he founded in 2021 after serving as Chief of Staff to Chattanooga Mayor Andy Berke.

Kerry’s career as a communicator and strategist includes senior leadership roles in agencies large and small, experience in the private, public, and nonprofit sectors, and successful consulting engagements for scrappy start-ups and venerable institutions alike. His public affairs campaigns and strategic guidance on earned media and digital content creation have helped build audiences, raise funds, and influence legislation for brands, businesses, and causes around the country.

Over the course of his career, Kerry has worked with community development organizations, small businesses, advocacy groups, public health organizations, schools and universities, government agencies, and philanthropic foundations who are engaged in making communities more sustainable, equitable, and prosperous.

Ed Roberson

Ed Roberson

Board Member

Edwin S. “Ed” Roberson is a former CEO of Christ Community Health Services, which provides health care to the underserved in Memphis, and a past partner in the accounting firm of KPMG.

Now retired, Ed has served on numerous nonprofit boards, including Methodist Le Bonheur Healthcare as chairman, Duke University Divinity School, and Porter-Leath. He also serves on corporate boards including Consol Energy, W.M. Barr, and Infocare. Ed has been involved in fundraising for numerous political campaigns in Tennessee, including those of Senators Bill Frist, Fred Thompson, Bob Corker, and Lamar Alexander, and he is a former treasurer of the state Republican Party.

Ed is active in Germantown United Methodist Church and many community endeavors.  He is married with two children and 4 grandchildren. He received his undergraduate degree from the University of North Carolina at Chapel Hill and an MBA from the University of Georgia.

Brian Straessle

Brian Straessle

Executive Director

Brian Straessle is the Executive Director of the Sycamore Institute, an independent, nonpartisan public policy research center for Tennessee. As a public policy generalist and veteran communicator, he helps to equip decision-makers and advocates from all perspectives with clear, reliable information on our state’s toughest challenges.

A founding member of Sycamore’s leadership, Brian leads a bipartisan team of experts dedicated to the organization’s mission of producing impartial and actionable policy research and analysis. Their work is respected for being both rigorous and accessible, and is used by governors, executive branch leadership, legislators, media, community leaders, and citizens to better understand and craft solutions to the state’s most complex challenges.

Previously, Brian shaped policy and public relations efforts for Congressman Tom Price (R-GA), the U.S. House Republican Study Committee, and the American Petroleum Institute. Those experiences include active roles in debates over economic policy, health care, welfare, energy, transportation, and the federal budget, and he started his career as an intern at the Heritage Foundation in Washington, D.C. In college, Brian pursued a broad liberal arts education at the University of Florida and came out the other side with a degree in history, French, and business administration.

Brian and his family live in East Nashville, where he plays for the local vintage base ball club, plants trees with Root Nashville, and harvests fresh fruit from his yard. He is a graduate of Nashville’s Young Leaders Council, a member of the American Enterprise Institute’s Leadership Network, and serves on the boards of Cumberland Region Tomorrow and the United Ways of Tennessee.

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Leslie Hafner

Leslie Hafner

Board President

Leslie Hafner has served in senior leadership roles for multiple Tennessee governors and top lawmakers during an extensive career in and around state and local government. Having staffed campaigns in various positions since age 11, Leslie is native to the world of election analysis, political insight, booth-manning, and issue advocacy.

Leslie is currently senior vice president, governmental affairs for OMNIA Partners, Public Sector, the largest group purchasing organization for public and private sectors. In this role, she leads OMNIA Partners’ nationwide efforts in lobbying, government, and regulatory affairs.

She has worked in both chambers of the Tennessee General Assembly, most recently as chief policy officer to the first female Speaker of the House of Representatives, Beth Harwell. In this role, she focused on juvenile justice reform and steps to address the growing opioid crisis.

For the six years prior, Leslie served as senior advisor and chief lobbyist to Governor Bill Haslam. She maintained a 95% passage rate of all administration legislative initiatives, recruited and trained a network of professional departmental liaisons, and coordinated the daily agenda for the governor’s senior staff.

Leslie also served in the administration of Governor Don Sundquist. She held positions on the governor’s communications, legislative, and special projects teams before moving to the Department of Finance and Administration as the commissioner’s executive assistant and lead lobbyist.

Since 2013, Leslie has helped to host groups from Israel, Japan, and the Philippines as an ambassador for the American Council for Young Political Leaders.

Deidre Malone

Deidre Malone

Board Secretary

Deidre Malone is the President/CEO of The Carter Malone Group, LLC (CMG), a public relations, marketing, advertising, and government relations firm headquartered in Memphis, TN, and an office in Jackson, MS. Before opening the agency in May 2003, Malone served as Vice President of Marketing Development for ALSAC/St. Jude Children’s Research Hospital. ALSAC is the fundraising arm of St. Jude Children’s Research Hospital. She also held the position of Director of Public Relations for St. Jude Children’s Research Hospital. Malone is a former broadcast journalist. She served as a news producer for WMC-TV Action News 5 in Memphis.

Malone served as a member of the Economic Development Growth Engine (EDGE) Board and the Memphis and Shelby County Port Authority Board. She is a member of the Memphis Regional Chamber, Black Business Association, Mid-South Minority Business Continuum, Public Relations Society of America and PRSA Counselors Academy. Malone is a founding member of the Tennessee Public Relations Alliance with MP & F Strategic Communications in Nashville, Moxley Carmichael Public Relations in Knoxville, Q Strategies in Chattanooga, and Hispanic Marketing in Nashville.

Malone plays an active role in the Memphis community. She was elected to the Shelby County Commission in 2002, where she served as chair of the budget, community services, and housing and economic development committees and vice-chair of the education committee. In September 2008, Malone became the first African American woman to chair the Shelby County Commission and the first female to chair the budget committee. Malone ran for Mayor of Shelby County and is the first woman to win a major party nomination for that position. Malone is the 1st Vice President of the National Women’s Political Caucus, past President of the Tennessee Women’s Political Caucus, former Vice President of the Shelby County Democratic Party, Past President of the NAACP Memphis Branch, Philanthropic Black Women of Memphis, and is a trustee at Bethlehem Missionary Baptist Church.

She is a 1999 graduate of Leadership Memphis and in 2001 served as Leadership Memphis Alumni Association President and a member of Beta Epsilon Omega Chapter of Alpha Kappa Alpha Sorority, Inc. She serves as Vice President of the Best Media Properties, Inc. The board of Directors, the ownership group for the New Tri-State Defender, is also an M1TV Network partner.

A graduate of Jackson State University, she received a Bachelor of Science Degree in Mass Communications and a minor in Marketing. Deidre and her husband, Dr. Patrick Malone, have two sons, Patrick II and Brian. She is the proud grandmother of Patrick III “Trey” and Bailee Christian.

Matt Marshall

Matt Marshall

Board Member

Matt Marshall serves as President/CEO of the United Way of West Tennessee.  He was formerly Executive Director and Head of School at Hands Up! Preschool, a non-profit Early Childhood Education program in Jackson, TN. Before that, he spent eight years in Higher Education at his alma mater, Union University, where he did his undergraduate work in Christian Ethics and then earned a Master’s in Education.

During his time at Union, Matt served as the Director of the Center for Racial Reconciliation, and the Director of Student Success.

He is passionate about our state and longs to see the day when every Tennessean has access to an equitable and healthy life, a quality education, and a financially stable home.

He’s the Co-founder of the Jackson-Madison County Equity Project; Chair of the United Ways of Tennessee State Association; Past-Chair of the Anti-Poverty Task Force for the City of Jackson; member of the United Way Black CEO Alliance; member of the City of Jackson Recovery Court; and the Jackson-Madison County School System Parent Council. He also serves as the Young Adult Pastor at the Historic First Baptist Church.

Matt is the recipient of the David Hallock Award for Outstanding Non-profit Leadership, The William H. Graves Humanitarian Award, the Tennessee Commission on Children and Youth Jim Pryor Award, the WestStar Emerging Leader Award, the Jackson Madison County Branch NAACP Race Relations Award, and the Broadman & Holman Ministerial Award, among others.

He is a native Jacksonian, but when not serving in the community, he enjoys spending time with his wife, children, and extended family.

Sarah Henderson

Sarah Henderson

Senior Policy Analyst

Sarah Clark Henderson is a Senior Policy Analyst at the Sycamore Institute. In this role, she turns complex data and research into clear, actionable information on Tennessee public policy. Sarah joined Sycamore in 2022 after three years with Vanderbilt’s Department of Health Policy, where she managed a research hub using statewide health and education data to evaluate child outcomes over time. In addition, she supported research faculty on topics that ranged from prescription drug policy to Medicaid policy in Tennessee.

Sarah found her passion for population health, policy, and research-practice partnerships in 2013 while evaluating a county-wide school nutrition intervention in South Carolina. She led several community-based projects as a graduate student, including a needs assessment for a federally qualified health center. She also coordinated a patient navigation program for metastatic breast cancer patients at Emory University’s Winship Cancer Institute and Grady Hospital.

Sarah graduated from Furman University with bachelor’s degrees in Health Sciences and Spanish and earned her Master of Public Health degree from Emory University.

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Posts by Sarah

Gabe Roberts

Gabe Roberts

Board Treasurer

Gabe Roberts is the Founder and Chief Executive Officer of the Roberts Consulting Group (RCG).  RCG is an advisory firm that partners with health plans, providers, and government/health plan vendors to assist them in identifying and operationalizing market opportunities, driving enterprise value, and advancing strategic priorities.  It also provides strategic health care and regulatory insight to private equity and venture capital firms.

Prior to founding RCG, Roberts served as the Chief Executive Officer of the Tennessee Medicaid agency (“TennCare”) as a member of Tennessee Governor Bill Lee’s Cabinet.  In this role, he was responsible for, among other things, the day-to-day operations of the $12 Billion annual budget, leading 1,200 employees, providing essential health care services to 1.4 million Tennesseans, and designing/implementing/driving further adoption of nation-leading policies that ensure the long-term fiscal sustainability of the Tennessee Medicaid program.  During his tenure, Roberts was elected to the Board of Directors of the National Association of Medicaid Directors and was named a Fellow with the Medicaid Leadership Institute (a program run by the Robert Wood Johnson Foundation and the Center for Health Care Strategies).  Prior to serving as the TennCare CEO, Roberts served as the agency’s COO and General Counsel.  Prior to joining TennCare, Roberts was a corporate attorney with the Nashville law firm Sherrard, Roe, Voigt and Harbison, and, before entering law school, he was a CPA with Ernst & Young.

In addition to his work through RCG, Roberts serves as a Board member and Advisory Board member to multiple health care companies and is a Fellow with the Nashville Health Care Council.  He is active in community having served as a Board member for multiple city and statewide not-for-profits and is an active member, with his wife Ashleigh and their five children, of Covenant Presbyterian Church in Nashville.

Roberts is a graduate of Vanderbilt University Law School, where he was a member of the Vanderbilt Law Review, and of the University of Mississippi, where he graduated with degrees in Accountancy and Economics and was inducted into the University’s Hall of Fame.

Brenda Gadd

Brenda Gadd

Board Member

Brenda Gadd is the president of Rethink Public Strategies a woman-owned, public affairs firm that brings experience in delivering results in strategic advocacy development and implementation in all levels of government and focuses on engagement tactics such as coalition building, direct and grassroots lobbying, collective impact, messaging, and solutions to public policy needs.

For more than 15 years, Brenda has been influencing public policy at the highest levels of state government and politics in Tennessee, helping to shape legislative and budgetary outcomes as well as elections and advocacy campaigns. Her work has supported the goals of countless businesses and nonprofits and impacted the use of millions of dollars in tax revenue.

Having served as both a legislative liaison in the governor’s administration and in numerous lobbying and public policy roles in the private sector, Brenda understands all facets of effective advocacy and organizing from developing grassroots support to leveraging grass-tops outreach. The combined experiences of successfully managing a statewide campaign for three state Supreme Court justices in 2014 and serving as the Tennessee Bar Association public policy director, give her a comprehensive understanding of politics and policy from the campaign trail to policy making.

Brenda spends most of her free time giving back to her community and lifting up causes in which she believes. She serves on several boards such as The Equity Alliance Fund, Tennessee Equality Project, as well as the domestic violence center and shelter the Mary Parrish Center. She received the Athena Young Professional award for her leadership, work and service to her community in 2019.

She is a proud board member of the nonpartisan public policy research center The Sycamore Institute, Tennessee Lobbyist Association, Lawyers’ Association of Women’s Marion Griffith chapter, Nashville Cable (women’s leadership organization) and a former chapter director of the New Leaders Council. She’s proud to encourage women to run for office and to be one of the founders of Emerge Tennessee and serves on national Emerge board of directors. She is a regular contributor and a consultant at the Center for Nonprofit Management on Advocacy and a national trainer for Vote Run Lead. When she’s not working or volunteering she is back home in East Tennessee hiking the mountains or visiting with family.

Jason Rogers

Jason Rogers

Board Member

Jason B. Rogers serves as Vice President for Administration and University Counsel at Belmont University in Nashville, Tennessee. In this capacity he is responsible for Belmont’s legal affairs as well as its government and community relations, risk management, regulatory compliance, and campus security functions.

Jason joined Belmont University in 1998 after ten years of practicing law in Nashville. While in private practice, he advised and represented nonprofit corporations including numerous colleges and universities. Jason has earned academic degrees from Baylor University (B.A., with honors), Vanderbilt University (J.D.) and the University of Pennsylvania (Ed.D., with distinction). At the University of Pennsylvania, his research focused on the impact of religious mission on the civic engagement initiatives of urban universities in the northeastern United States.

A 35 year resident of Nashville, Jason is committed to the local community and charitable activities and has served as the treasurer of The Healing Trust, president of the board of directors of The Next Door, Inc., a program committee co-chair of Leadership Nashville, and a representative to the Parent Advisory Council of Metro Nashville Public Schools.

Karen Pershing

Karen Pershing

Board Member

Karen Pershing serves as the Executive Director of the Metro Drug Coalition in Knoxville, Tennessee. A Certified Prevention Specialist II and a 2014 graduate of the UT Consortium for Social Enterprise Effectiveness, she earned her Bachelor of Science in Human Development and Family Studies as well as her Master’s Degree in Public Health from the University of Tennessee.

Ms. Pershing’s numerous honors include the Tennessee Public Health Association’s 2016 Partners and Leadership Award, the 2017 FBI Community Director’s Leadership Award for the Knoxville Field Office, the 2018 Knox Biz Healthcare Heroes Award for her work in addiction and recovery, and recognition from the Tennessee Department of Health for work in prescription drug abuse prevention.

Karen is a member of the Tennessee Public Health Association, Executive Women’s Association, UT Chancellor’s Associates program Class of 2016, the Women’s Addiction Services Leadership Institute Class of 2014, and the Leadership Knoxville Class of 2013. She also serves on the boards of Harmony Family Centers and the Prevention Alliance of Tennessee.

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