Tennessee Department of Health (TDH)

Tennessee's County Health Departments are vital to communities! From essential health services to wellness and prevention programs, dedicated healthcare staff work tirelessly to ensure Tennesseans have access to the resources they need to lead health e access to the resources they need to lead healthy lives. A few basic health services include: breast and cervical cancer screenings, breastfeeding support, community health access and navigation, dental and oral health services, health education, immunizations, newborn screenings, nutrition counseling, pregnancy testing, tobacco cessation, tuberculosis control, vital records access, voter registration, well-child screenings, & WIC (Women, Infants & Children). Telehealth services are also available at county health departments, and appointments are quick and convenient. The Tennessee Department of Health (TDH) serves as the principal public health agency for the state, offering direct and indirect services across all 95 counties through a robust infrastructure of rural and metropolitan health departments, regional offices, and central leadership. As of 2014, around 1.4 million of Tennessee's then-6.6 million residents received direct services through its 89 rural and six metro health departments, underscoring its vast reach and importance. TDH creates an annual state health plan in collaboration with communities to guide its strategic direction and prioritize initiatives impacting population health. Established in 1923, the department has been led by 15 commissioners, with Dr. Ralph Alvarado currently serving in that role since 2023. The commissioner is appointed by the Governor and supported by an executive leadership team overseeing a diverse range of responsibilities, ensuring that the department’s mission is effectively executed. TDH operates seven regional offices that coordinate with local county health departments, ensuring that state-wide public health policies and services are implemented efficiently and tailored to the specific needs of different areas. Although metro health departments—in Davidson, Hamilton, Knox, Madison, Shelby, and Sullivan counties—function semi-independently, they remain closely integrated with TDH’s regional and central teams, collaborating on programs and services. By law, county and metro health directors are appointed by the TDH Commissioner in consultation with county mayors, and metro health departments, serving about 40% of the population, often act as hubs for innovation and best practices that are later adapted by rural counterparts. Oversight at the local level is provided by county boards of health, whose members are typically appointed locally, serve without compensation, and often include at least one physician; these boards operate independently of the health councils that also exist in every county. Together, these entities provide checks and community engagement in local public health efforts. A vital aspect of TDH’s role is emergency preparedness, and county health departments regularly work with the Tennessee Emergency Management Agency to prepare for natural and man-made disasters. Licensing and regulation are major functions of TDH, which staffs 24 Health Professional Boards, three committees, two councils, and four registries that collectively oversee licensing for over 260,000 individuals across more than three dozen healthcare professions in the state. These boards, which have existed since 1947, ensure safety, quality, and ethical standards in healthcare delivery. Additionally, the Office of Health Care Facilities licenses and inspects 14 types of health facilities, numbering over 2,400 across Tennessee. Public access to information is a priority, with online portals available for checking the status of health professional licenses and facility inspections, allowing citizens to stay informed about providers and institutions. County health departments form the backbone of community healthcare services in Tennessee, offering a wide range of programs such as well-child checkups, immunizations, nutrition counseling, prenatal and family planning services, assistance through the Women, Infants and Children (WIC) program, care for children with special needs, the HUGS (Help Us Grow Successfully) program, and vital record services. Some departments also offer treatment for acute and chronic illnesses, and even dental care, depending on location and resources. Vital records—such as birth and death certificates—can be obtained through local departments, while other records, including marriage certificates and some genealogical resources, are managed at TDH’s central office or the Tennessee State Library and Archives. In terms of environmental health, TDH regulates and inspects a broad spectrum of establishments, including hotels, motels, public swimming facilities, spas, body art establishments, and correctional institutions, working alongside the Tennessee Department of Agriculture (TDA) to oversee food service providers. TDA handles those located within retail settings like gas stations, while TDH is responsible for stand-alone food service establishments. The department is also tasked with protecting the public from vector-borne and zoonotic diseases such as West Nile Virus, La Crosse Encephalitis, and Rocky Mountain Spotted Fever, which, though rare, are known to occur in Tennessee. Through effective vaccination programs and public awareness campaigns, rabies has become exceptionally rare in the state. While environmental health was once part of TDH’s purview, those responsibilities were transferred to the Tennessee Department of Environment and Conservation in 1992. Despite this separation, public health and environmental health remain interconnected areas of concern. Overall, the Tennessee Department of Health represents a multifaceted and essential component of state government, blending regulatory oversight, clinical services, emergency preparedness, community engagement, and public health innovation into a single agency focused on improving the health and well-being of all Tennesseans. ...view more