Public Health

Health & The Big Four

For a region to thrive, its people must be healthy. A healthy population has fewer chronic diseases, enjoys lower health care costs, misses fewer days of work, and helps build a more engaged and socially connected community. The Tennessee Department of Health has identified the “Big Four”—excessive caloric intake, physical inactivity, tobacco and nicotine addiction, and drug and opioid abuse—as primary causes of the state’s health crisis. Together, the Big Four contribute to all 10 of the top 10 leading causes of death in Tennessee.

Drug & Opioid Abuse

Abuse of prescription medications and other substances is creating unprecedented levels of addiction and dependency throughout our region and across the state. The percent of admissions to publicly funded treatment centers due to opioids has tripled in Tennessee over the past 10 years. According to the Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS), 221,000 Tennesseans used pain relievers non-medically in the past year. Of these, 58,000 were young adults ages 18-25. In total, Tennessee experienced 1,818 opioid deaths in 2018.

Opioid prescriptions have declined sharply across the region since 2014, but overdoses, both fatal and non-fatal have continued to rise as individuals turn to black market options. Counterfeit prescription drugs, which are smuggled into the United States and sold illegally, look identical to popular name-brand prescription drugs, but are often dangerous mixes of illicit narcotics and chemical compounds such as fentanyl and carfentanil. Heroin use is also on the rise: statewide in 2009, there were 18 deaths from heroin overdoses; in 2016, there were 367. This drug and opioid crisis is decimating families and communities. Overdoses and treatment costs are also ballooning budgets for local governments, health departments, and law enforcement agencies. Employers cannot hire addicts to operate machinery or vehicles, creating worker shortages. It is essential for the region to recognize this public health crisis and support state and national efforts to reduce opioid abuse.

Hepatitis & HIV Risk

In 2015, Scott County, Indiana—a rural community of 24,000 with a 97.6% white population—experienced an HIV and Hepatitis C outbreak spurred by sharing dirty needles to inject opioids. Nearly 200 people contracted the HIV virus, with more than 20 new cases being diagnosed every week during the height of the outbreak. The following year, the Center for Disease Control released a report that identified 220 counties at risk for a similar outbreak based on factors including poverty, rural setting, previous drug abuse patterns, and other factors. As of 2018, local at-risk communities identified by CDC include Bledsoe, Meigs, Polk and Rhea.

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