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Healthy Debate 2018: Health and Well-Being in Tennessee
By: Mandy Pellegrin, Courtnee Melton, Laura Berlind and Brian Straessle
Adverse Childhood Experiences, Public Health
The health status of the average Tennessean is worse than the average American. To improve our state's health outcomes, policymakers should understand the complex set of factors that influence them. This section of Healthy Debate 2018 summarizes the state of health in Tennessee and several unique challenges facing rural areas of the state. It also introduces the Tennessee Health & Well-Being Index, a tool created by The Sycamore Institute to track the drivers of population health in Tennessee.
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The State of Health in Tennessee
Tennessee trails the rest of the nation in many key health indicators and outcomes. Adults rate both their own and their children's overall health status worse in Tennessee than nationally. Additionally, Tennessee has higher rates than most other states of infant mortality and chronic conditions like diabetes, depression, cardiovascular disease, and adult and childhood obesity.
Seven of the top 10 leading causes of death in Tennessee can be attributed to chronic health conditions. The leading causes of death in Tennessee largely mirror the nation's leading causes. However, for each of the top 10 causes of death, Tennessee's mortality rates are higher than the national rates.
Tennessee typically ranks in the bottom 10 states on national health rankings because of these differences in both death and disease rates. (1)
Health disparities are prevalent in Tennessee. Population-based averages often hide differences in health between particular groups. Racial and ethnic minorities, individuals with lower levels of education and income, and individuals living in rural areas experience poorer health outcomes largely due to differences in the drivers of health.
Source: See citation (2) in References and Notes
The Drivers of Health
Health means more than just health care. While access to clinical care is a contributing factor, health behaviors and our social and economic environments are the leading drivers of health outcomes. For example, poor nutrition, lack of physical activity, and tobacco use all increase one's risk of developing a chronic condition. Risk also increases as income and education decline. These factors interconnect in complex ways. For instance, our environments can encourage or discourage certain health behaviors.
Many key factors that contribute to poor health are more prevalent in Tennessee than nationally. Tennessee has higher rates of smoking and poverty and lower rates of exercise and insurance coverage than the U.S. as a whole. In fact, nearly 1 in 4 adult Tennesseans smoke cigarettes, a higher rate than all but 7 states. (4) Smoking is the most preventable cause of premature death in the country, and it is associated with heightened risk of coronary heart disease and stroke. (5)
Adverse Childhood Experiences (ACEs)
Adverse childhood experiences (ACEs) are among the best examples of the complex set of factors that influence health. Childhood and adolescence are critical times for human brain development. Science has found a clear link between experiences at this age that cause chronic and severe stress — such as exposure to household dysfunction or psychological, physical, or sexual abuse — and health and well-being later in life. As exposure to ACE-related toxic stress increases, so does the risk of a wide variety of outcomes with long-term negative effects, such as alcohol abuse, drug abuse, smoking, and heart disease.
Increasing children's resilience to toxic stress can reduce or overcome the effects of ACEs. Successful approaches to ACEs recognize that a wide variety of influencers (e.g. the health care system, education, child welfare, and criminal justice) can play a role in supporting children, parents, and families. Identifying and addressing sources of childhood toxic stress can have a lasting, multigenerational impact on Tennesseans' health, productivity, and prosperity.
The Tennessee Health & Well-Being Index
The Sycamore Institute's Tennessee Health & Well-Being Index is a tool for measuring the drivers of population health in our state and tracking them over time. Using the most recent data available, the Index measures factors that influence health at the state and regional level. It also highlights health outcomes and areas of relative strength and opportunities for improvement in the drivers of health. First published in 2017, it will be updated regularly.
Tennessee's Rural Health Challenges
Tennessee's rural areas face unique demographic, economic, health, and health system challenges. About 1.5 million Tennesseans (or 22%) live in a rural area. (8) Tennesseans living in rural areas tend to be older, sicker, and have lower incomes on average than those in other areas. (9)
Compared to urban areas, Tennesseans living in rural areas:
Are older.
Have lower per capita incomes.
Are more likely to be unemployed.
Have less education.
Suffer from higher rates of diabetes, obesity, heart disease, chronic obstructive pulmonary disease, prescription drug overdoses, and premature death.
Residents of rural areas often have less access to health care due to provider shortages, hospital closures, and increased travel distances to providers. Since 2010, 8 rural hospitals in Tennessee have closed, resulting in a loss of 326 inpatient care beds. (10) As of 2015, almost 1 in 4 Tennessee hospitals was at increased risk of closure. (11) Hospital closures leave many people without a local source of care, particularly for emergencies. In 2015, Tennessee's rural hospitals provided more than $292 million in uncompensated care. (12) Hospitals also provide employment and produce economic growth for the communities they serve.
Related Work by The Sycamore Institute
Tennessee Health & Well-Being Index
How Childhood Experiences Affect Lifelong Health
America's Health Rankings for 2016 (TN Ranking: 44th), 2015 (TN Ranking: 43rd), and 2014 (TN Ranking: 45th) (https://www.americashealthrankings.org/explore/2016-annual-report/state/TN)
The Sycamore Institute's analysis of:
2016 Behavioral Risk Factor Surveillance System – all adult health indicators (accessed on October 26, 2017 via https://www.cdc.gov/brfss/brfssprevalence/)
CDC WONDER – 10 leading causes of death (2015) (accessed on October 26, 2017 via https://wonder.cdc.gov/ucd-icd10.html)
CDC's National Center for Health Statistics – infant mortality (2014) (accessed on October 27, 2017 via https://www.cdc.gov/nchs/pressroom/sosmap/infant_mortality.htm)
CDC's National Vital Statistics System – low birthweight infants (2016 – preliminary) (https://www.cdc.gov/nchs/data/vsrr/report002.pdf)
Tennessee Department of Health – low birthweight (2016) (https://www.tn.gov/content/dam/tn/health/documents/TN_Births_Low_Birth_Weight_-_2016.pdf)
2016 National Survey of Children's Health – all other child health indicators (accessed on October 26, 2017 via www.childhealthdata.org)
The Drivers of Health exclude the role of genetics and are based on analysis by Hyojun Park et al (http://www.countyhealthrankings.org/sites/default/files/Park_AmJPrevMed_2015.pdf) and Harry Heiman et al (http://kff.org/disparities-policy/issue-brief/beyond-health-care-the-role-of-social-determinants-in-promoting-health-and-health-equity/). Data are based on The Sycamore Institute's analysis of:
2016 American Community Survey – educational attainment, poverty, insurance coverage rates (accessed in September 2017 via https://factfinder.census.gov/)
2016 Behavioral Risk Factor Surveillance System – health behaviors, primary care provider (accessed on October 27, 2017 via https://www.cdc.gov/brfss/brfssprevalence/)
2017 County Health Rankings – housing issues, access to exercise opportunities (accessed via http://www.countyhealthrankings.org/app/tennessee/2017/overview)
The Sycamore Institute's analysis of the 2016 Behavioral Risk Factor Surveillance System (accessed on October 27, 2017 via https://www.cdc.gov/brfss/brfssprevalence/)
The U.S. Surgeon General's "The Health Consequences of Smoking 50 Years of Progress" (2014) (https://www.cdc.gov/tobacco/data_statistics/sgr/50th-anniversary/index.htm)
The Sycamore Institute's analysis of 2014 Behavioral Risk Factor Surveillance System – adult ACEs prevalence (obtained from the Tennessee Department of Health's Office of Surveillance, Epidemiology, and Evaluation)
S. Department of Agriculture's Economic Research Service state data for Tennessee – unemployment, education, income (accessed on October 27, 2017 via https://data.ers.usda.gov/reports.aspx?StateFIPS=47&StateName=Tennessee&ID=17854)
2016 American Community Survey– poverty (accessed in September 2017 via https://factfinder.census.gov/)
Tennessee Department of Health Death Certificate Data – 2015 mortality rates (https://www.tn.gov/content/dam/tn/health/documents/TN_Deaths_-_2015.pdf)
U.S. Department of Agriculture's Economic Research Service state data for Tennessee (accessed on October 27, 2017 via https://data.ers.usda.gov/reports.aspx?StateFIPS=47&StateName=Tennessee&ID=17854)
University of North Carolina's database of rural hospital closures since January 2010 (accessed on September 4, 2017 via http://www.shepscenter.unc.edu/programs-projects/rural-health/rural-hospital-closures/). Differs from a June 22, 2017 TSI report that cited 9 closures and 354 beds, which was based on the same data source as accessed on May 22, 2017. At that time, the UNC database did not yet reflect the reopening of Scott County Community Hospital in Oneida, TN.
The North Carolina Rural Health Research Program's Geographic Variation in Risk of Financial Distress Among Rural Hospitals (page 1) (January 2016) (accessed via http://www.shepscenter.unc.edu/product/geographic-variation-in-risk-of-financial-distress-among-rural-hospitals/)
The Tennessee Hospital Association's 2017 Rural Impact Report (page 2) (https://secure.tha.com/files/pr/Rural%20Impact%20Report%202017%20Final.pdf)
Mandy Pellegrin, Policy Director
Mandy joined The Sycamore Institute in 2016 as the Policy Director. She has the lead responsibility for developing the organization's research plan and conducting and curating research and analysis. Mandy holds a master's degree in public policy with a health policy concentration from Georgetown University and a bachelor's degree from Lipscomb University. Mandy brings with her over a decade of experience in health policy – including as a Presidential Management Fellow at the U.S. Department of Health and Human Services advising senior HHS leadership under both President George W. Bush and President Barack Obama on budget policy issues and as the Health Policy Adviser to U.S. Representative Bill Pascrell (D-NJ), who served on the Ways and Means Committee during the drafting, consideration, and passage of the Affordable Care Act. She began her career in policy as an intern and then bill clerk in the Tennessee General Assembly.
THE SYCAMORE INSTITUTE IS AN INDEPENDENT, NONPARTISAN PUBLIC POLICY RESEARCH CENTER FOR TENNESSEE
© 2018 The Sycamore Institute
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Karen Pershing
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.
Sheila Calloway
Sheila Calloway is Davidson County's Juvenile Court Judge, winning election to an eight-year term in 2014. A native of Louisville, KY, she came to Nashville in 1987 and earned her bachelor's degree and law degree from Vanderbilt University.
After graduating from law school in 1994, she worked at the Metropolitan Nashville Public Defender's Office in both the adult and juvenile systems. In January 2004, she was appointed by Judge Betty Adams Green to the position of Juvenile Court Magistrate, where she served until announcing her intention to run for the position of Juvenile Court Judge in November 2013.
Judge Calloway was sworn into office as Juvenile Court Judge on August 28, 2014. She uses her unique combination of humor, passion, and judicial wisdom to change the way we look at justice in the United States.
Sheila also serves as an Adjunct Professor at Vanderbilt University, where she teaches in the Law School, and at Belmont University's College of Law, where she teaches Juvenile Law.
Pamela Carter is a retired President of Cummins Distribution Business, a Global Fortune 200 company, and the first African American woman elected as a state attorney general in the United States. She began her career as a litigator and prosecutor, served as deputy chief of staff to the governor of Indiana, and was elected attorney general of Indiana in 1992.
Carter is Chair Elect of the Nashville Symphony Board and serves on the boards of four public companies: CSX Inc., Hewlett Packard Enterprise, Enbridge Inc., and Broadridge Financial Solutions. Carter is a member of Teach for America National Board. She is a graduate of the University of Detroit (A.B.), the University of Michigan (M.S.W), Indiana University School of Law, and Harvard's Kennedy School. She retired in 2015 and is married with two married children and two grandchildren.
James W. White is managing member of the law firm of Farmer Purcell White & Lassiter, PLLC, in Nashville, Tennessee. Previously, he served as Executive Director of the Fiscal Review Committee in the Tennessee General Assembly, as Counsel to the Speaker of the Tennessee House of Representatives, and as Counsel to the Tennessee House Finance, Ways & Means Committee. He is a past Staff Chair of the Budgets and Revenue Committee of the National Conference of State Legislatures.
His undergraduate degree is from the University of Tennessee and his law degree is from Georgetown University Law Center, where he was an editor of the Georgetown Law Journal. He is admitted to practice before the United States Supreme Court, the Tennessee Supreme Court, and all federal and state courts in Tennessee. He is an occasional op-ed columnist for The Tennessean, having written on the impact of the Great Recession on Tennessee's state budget and the consequences of the federal "fiscal cliff." He has also been published in Judicature, the publication of the American Judicature Society on the topic of maintaining the independence of state judiciaries. He currently serves as a member of the board of the Nashville Symphony.
Kyle Spurgeon
Kyle Spurgeon is president/CEO of the Jackson Chamber, Jackson, TN. The organization represents 1100+ business members in Jackson/Madison County and parts of West Tennessee.
Before joining the chamber, Spurgeon was vice-president, corporate relations for Jackson Energy Authority. He has also served as marketing director for the Tennessee Department of Economic and Community Development. He has helped facilitate project locations representing more than $2.5 billion in capital investment.
He holds a B.S. in public relations/marketing from Murray State University.
In 2006, Kyle was awarded the Community Service Award by the Jackson/Madison County Sports of Hall. In 2009 and 2015 respectively, he was awarded Community Service Awards by the Mother Liberty CME Church in Jackson and the West Tennessee Healthcare Foundation. In 2018, he was honored by the University of Memphis with the Gene Smith Friend of Lambuth Award.
He is a past president of the Tennessee Economic Development Council, past president of Tennessee Chamber of Commerce Executives, and past board member of the Southern Economic Development Council. He presently serves as chairman of the Tennessee Economic Partnership. He is a board member of The Sycamore Institute, The Tennessee Sports Hall of Fame, Complete Tennessee Advisory Board and the Governors Foundation for Health and Wellness. Kyle is a 2017 (Class IV) graduate of Leadership Tennessee. He was recently named the 2019 Tennessee Chamber of Commerce Executive of the Year.
Kyle is married to Melissa, and together they have five children and one very happy/spoiled dog. They enjoy running and traveling.
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.
Ed Roberson
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.
Kristen Keely-Dinger
Kristen Keely-Dinger is the President and CEO of The Healing Trust, a private foundation created to provide grants and support to nonprofits that foster healing and health for vulnerable populations in Middle Tennessee. Kristen has experience in prevention education, community organization, and volunteer administration. Kristen received her Bachelor's of Science in Neuroscience from Vanderbilt University, her Master's of Science in Social Work from the University of Tennessee, and is currently a Licensed Advanced Practice Social Worker. Kristen was selected as a 2007 Southeastern Council of Foundation Hull Fellow and is a graduate of the 2011 Nashville Emerging Leaders Class.
Brenda Gadd
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.
Stewart Clifton
Stewart Clifton is an attorney and since 2001 a public policy advocate with a practice focused on nonprofit organizations. He provides advocacy, monitoring and consulting services for several health, social welfare, justice and environmental groups, including:
Alzheimer's Tennessee, Center for Nonprofit Management, League of Women Voters of Tennessee, National Association of Social Workers – Tennessee Chapter, Radnor to River, SchoolHouse Connection, Tennessee Alliance for Legal Services, Tennessee Association for Adult Day Services, Tennessee Association for Children's Early Education, Tennessee Association of Pastoral Therapists, Tennessee Conservation Voters, and United Ways of Tennessee.
A Nashville resident since 1969 and member of Tennessee Bar since 1977, Clifton received a BA and JD from Vanderbilt University and Vanderbilt Law School. He served as a staff attorney for the Legal Aid Society (Nashville and Middle Tennessee) and staff attorney and executive director of the Tennessee Alliance for Legal Services for over two decades.
Clifton serves as a founding board member of The Sycamore Institute, a volunteer member of the Tennessee Bar Association government affairs committee, and a board member of Tennessee Interfaith Power and Light. He recently completed two terms as a trustee for The Healing Trust and 10 years of service as chair of the public policy committee and board member of United Ways of Tennessee.
He served from 1987-1999 as the elected Metro Nashville Councilmember for District 18 and from 2000-2017 as an appointed member of the Metro Planning Commission.
Jim Bryson
Jim Bryson is Founder/President of 20|20 Research, Inc., a qualitative research firm started in 1986. The company provides global online research software and services and operates qualitative research facilities in Nashville, Charlotte and Miami. Jim serves as Deputy Commissioner for Parks and Conservation for the State of Tennessee where he is responsible for all the State Parks.
He has been active in state politics, serving four years as a Tennessee State Senator and was his party's nominee for Governor of Tennessee in 2006.
Jim previously served on the Board of Directors for the Marketing Research Association, the Marketing Research Education Foundation, and as a community board member for the Baptist Healing Trust. He served three terms as President of the Qualitative Research Consultant's Association, an international association of qualitative research professionals. Research Business Report named Jim as its Market Research Executive of the Year for 2013.
Jim is also Founder/President of The Joseph School, a school for poor and orphaned children in Haiti. He is a graduate of Baylor University and received his MBA from Vanderbilt University.
Brittney Anthony
Associate Director of Operations and Engagement
As Associate Director of Operations and Engagement at The Sycamore Institute, Brittney provides support for day-to-day management and operations and leads the team's statewide engagement efforts through community events and symposiums.
Brittney joined Sycamore in 2019 with nearly a decade of experience in community engagement and public policy at the Tennessee General Assembly and the Knoxville Utilities Board. Most recently, she worked for State Senator Raumesh Akbari (D-Memphis) and served as Press Secretary for the Tennessee Senate Democrats. Brittney earned a master's degree in Corporate Communication from Austin Peay State University and a bachelor's degree from the University of Tennessee at Knoxville.
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Brian Straessle
Director of External Affairs
As Director of External Affairs for The Sycamore Institute, Brian manages all communications, marketing, and outreach to policymakers, journalists, and the public. He works closely with Sycamore leadership on organizational strategy and fundraising and with the policy research team on content, editing, and publication.
A veteran public policy communicator who joined Sycamore in 2017, Brian has shaped messaging and public relations efforts for U.S. Representatives Tom Price (R-GA) and Jim Jordan (R-OH), the Republican Study Committee, and the American Petroleum Institute. His congressional experience includes active roles in debates over the Affordable Care Act and the federal budget, and he began his career with an internship at The Heritage Foundation. Brian earned a bachelor's degree in history from the University of Florida.
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Laura Berlind
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Laura Berlind joined The Sycamore Institute in 2015 as the founding executive director. She provides Sycamore's organizational vision, strategic planning, and day-to-day management. Laura holds a master's degree in public policy with a focus on business and government from Harvard's Kennedy School of Government and a bachelor's degree from Boston College. Her role at Sycamore reflects her longstanding commitment to using data and research to bring together diverse stakeholders and work complex problems.
Laura brings with her almost fifteen years of nonprofit and government finance experience, most recently serving as the CEO of Renewal House, a holistic residential treatment center for women and their children affected by addiction and poverty. Prior to her role at Renewal House, she worked as a financial analyst at Vanderbilt University and as a vice president in the public finance department at Ambac Financial Group in New York, NY. At Ambac, Laura worked with wide range of government and nonprofit clients to evaluate and execute publically funded capital projects ranging in size up to $800 million.
Laura maintains a strong connection to her local community through service on nonprofit boards and other volunteer activities. She is currently serving as the chair of the Tennessee Department of Mental Health's Planning and Policy Council and is an active member of Rotary Club. In 2014, Laura received the Volunteer of the Year award from the Tennessee Association of Alcohol, Drug and Other Addiction Services. She was also recognized as one of the Nashville Business Journal's 2014 Forty Under 40 award winners and was a member of the 2016-17 class of Leadership Tennessee.
Bill Bradley is a retired director of the Division of Budget, Tennessee Department of Finance and Administration. He worked for Tennessee state government for 39 years, including 32 years in the Budget Division, where he was director for 14 years, and 7 years in the State Planning Office, Local Planning Division. He earned a B.A. with honors at the University of Tennessee, Knoxville, majoring in political science, and earlier was an air traffic controller in the U.S. Air Force. He was awarded a Life Membership in the National Association of State Budget Officers in 2013. He retired in 2013 and lives in Nashville.
Lewis Lavine
Lewis Lavine served as a Board Member of The Sycamore Institute from its inception until he passed away in 2018. His professional career included two stints with The Ingram Group, a Nashville and Washington based business consulting firm, first as a chairman and later as a senior strategist. In between, he served as the president of the Center for Nonprofit Management. While at CNM, the agency expanded to serve more than 800 nonprofits, offering 120 workshops and nearly 100 consulting engagements each year.
His career also included a number of government posts including chief of staff to then-Governor Lamar Alexander. In 2011, he assisted current Tennessee Governor Bill Haslam during his transition into state leadership. Lewis served on nonprofit and government boards in Tennessee and Washington, including the Nashville Metropolitan Transit Authority, The Sycamore Institute, and the Nashville Public Education Foundation. In 2006, Lewis served as co-chair of Celebrate Nashville commemorating the city's 200th birthday.
A graduate of Davidson College, he earned his master's degree in economics from Vanderbilt University. He was awarded the Jane Eskind Community Leadership Award by Family and Children's Service, and the Ned R. McWherter Leadership Award by the Tennessee Center for Performance Excellence.
Mandy Pellegrin
Policy Director
Mandy joined The Sycamore Institute in 2016 as the Policy Director. She has the lead responsibility for developing the organization's research plan and conducting and curating research and analysis.
Mandy holds a master's degree in public policy with a health policy concentration from Georgetown University and a bachelor's degree from Lipscomb University. Mandy brings with her over a decade of experience in health policy – including as a Presidential Management Fellow at the U.S. Department of Health and Human Services advising senior HHS leadership under both President George W. Bush and President Barack Obama on budget policy issues and as the Health Policy Adviser to U.S. Representative Bill Pascrell (D-NJ), who served on the Ways and Means Committee during the drafting, consideration, and passage of the Affordable Care Act. She began her career in policy as an intern and then bill clerk in the Tennessee General Assembly.
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