title: The three Tennessees: child and infant health in the three Grand Divisions of Tennessee.
abstract: Tennessee consistently ranks low among all states in measures of health. This study was undertaken to examine the differences in child and infant health conditions in the state's three Grand Divisions and the impact of these differences on Tennessee's overall rankings. An analysis of county-level data selected from the Area Resources File demonstrated that, for most measures of infant health and child health, the three divisions ranked very differently and that the overall state ranking did not accurately reflect the conditions in the divisions. Some regions, most often Middle Tennessee, ranked much higher than did the state as a whole; other regions, most often West Tennessee, ranked lower. The single overall state ranking masked these regional differences while suggesting that the entire state had equally low health outcomes. The striking health variations among the divisions that were demonstrated highlight the need to examine health conditions and implement health improvement efforts on a regional rather than a statewide basis.
authors.affiliation: College of Medicine, University of Tennessee Health Science Center, Memphis 38163, USA.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Mabry
authors.forename: David M
authors.initials: DM
authors.lastname: Mirvis
mesh_terms: D002648:Child; D002669:Child Welfare; D006305:Health Status Indicators; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007229:Infant Welfare; D007231:Infant, Newborn; D011787:Quality of Health Care; D012040:Regional Health Planning; D012111:Residence Characteristics; D013714:Tennessee