Nashville

blue

Get smarter, faster on what matters in Nashville with Nate Rau and Adam Tamburin.

Axios Nashville

Standard

A daily look at the most significant and interesting stories affecting Nashville. Written by Nate Rau and Adam Tamburin.

Axios Nashville Thought Bubble

Thought Bubble

Nashville Alerts

Alert

Axios Nashville Partners

Nashville Members

Membership

Sen. Marsha Blackburn could appoint her own replacement in the Senate

If Marsha Blackburn wins the Tennessee governor's race, she wants to appoint her own Senate replacement.tktktktktktktktktktktktktktktktktktktktktkktktktktk

Politics

<a class="gtmContentClick" data-vars-link-text="U.S. Sen. Marsha Blackburn" data-vars-click-url="https://www.axios.com/local/nashville/2026/08/07/tennessee-governor-marsha-blackburn-jerri-green" data-vars-content-id="b7f73d62-7165-4a2c-9d4c-97606c9388f6" data-vars-headline="Sen. Marsha Blackburn could appoint her own replacement in the Senate" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/local/nashville/2026/08/07/tennessee-governor-marsha-blackburn-jerri-green" target="_self">U.S. Sen. Marsha Blackburn</a> plans to appoint her successor to the Senate if she wins the Tennessee governor&#x27;s race in November.Why it matters: The unusual political dynamic adds a layer of intrigue to the governor&#x27;s race.

Inside Clarksville's record growth: Big deals, and a population surge

From an ambitious economic development project to affordable housing, Clarksville is booming.

News

For generations, Tennesseans have referred to the state&#x27;s big four cities: Nashville, Memphis, Knoxville and Chattanooga.<ul><li>Yes, but: It&#x27;s time to start thinking in terms of the Big Five.</li></ul>Why it matters: Clarksville is at a tipping point after decades of meteoric growth.<ul><li>The once-sleepy Middle Tennessee town an hour away on Interstate 24 is attracting massive mixed-use developments that are on par with Nashville&#x27;s current East Bank overhaul.</li></ul>

Nashville's packed Labor Day schedule: Fireworks, football and more

There's something for everyone looking to unwind.

Things to Do

Free music, fireworks and football. There&#x27;s something for everyone looking to unwind this Labor Day Weekend.Why it matters: The holiday weekend marks the unofficial end of summer, and an opportunity to commemorate the hard-fought victories of the labor movement.

Massive Marcelina project dreams big for Montgomery County

The development features residential, commercial and civic components.

Business

A 423-acre mixed-use development in Montgomery County is one of the most ambitious in all of Middle Tennessee.Why it matters: The project, called Marcelina, would have seemed destined for Nashville a few years ago. But Montgomery County sealed the deal.

Tenn. grant offers "lifeline" for family caregivers — but it's starting small

About 393,000 family caregivers in Tennessee take care of a relative with dementia.

Health

One Tennessee voter&#x27;s conversation with a lawmaker led to a new program supporting families facing Alzheimer&#x27;s disease or dementia.Why it matters: As Tennessee&#x27;s population <a class="gtmContentClick" data-vars-link-text="continues to age" data-vars-click-url="https://www.axios.com/local/nashville/2025/07/01/tennessees-senior-population-growing" data-vars-content-id="1c9b2284-cd3e-4474-87d0-21ed89bbad12" data-vars-headline="Tenn. grant offers &quot;lifeline&quot; for family caregivers — but it&#x27;s starting small" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/local/nashville/2025/07/01/tennessees-senior-population-growing" target="_self">continues to age</a>, more and more people are taking on caregiving work for their elderly family members. Often they&#x27;re also juggling jobs and child care.<ul><li>It can be grueling, and state officials say <a class="gtmContentClick" data-vars-link-text="government support will be necessary" data-vars-click-url="https://www.axios.com/local/nashville/2023/01/24/tennessee-elder-care-home-care-workers" data-vars-content-id="1c9b2284-cd3e-4474-87d0-21ed89bbad12" data-vars-headline="Tenn. grant offers &quot;lifeline&quot; for family caregivers — but it&#x27;s starting small" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/local/nashville/2023/01/24/tennessee-elder-care-home-care-workers" target="_self">government support will be necessary</a> to meet this growing challenge.</li></ul>

Family says error at St. Thomas Midtown paralyzed patient

St. Thomas confirmed an "event" at the hospital had affected four patients.

A Middle Tennessee woman&#x27;s family said a medical mixup last week at St. Thomas Midtown left her paralyzed following a routine knee replacement surgery.<ul><li>In a statement responding to reports about the matter, Ascension St. Thomas confirmed to Axios that an &quot;event&quot; at the hospital had affected four patients. The statement did not disclose the nature or cause of the event.</li></ul>

Fewer Tennessee kindergarteners got vaccines in 2025-26, per CDC

The share of Tennessee kindergartners with any vaccine exemption reached 4.8%.

Education

More kindergarten students in Tennessee skipped vaccines during the 2025–2026 school year, according to exemption figures Centers for Disease Control and Prevention <a class="gtmContentClick" data-vars-link-text="reported" data-vars-click-url="https://www.cdc.gov/schoolvaxview/data/index.html" data-vars-content-id="58b320b8-b3f2-4a47-8a57-52742d7c4b57" data-vars-headline="Fewer Tennessee kindergarteners got vaccines in 2025-26, per CDC" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.cdc.gov/schoolvaxview/data/index.html" target="_blank">reported</a> on Monday.Why it matters: Tennessee&#x27;s rate of vaccine exemptions saw its biggest annual increase in years as vaccine skepticism continues to grow.<ul><li>The change coincided with continued efforts by the Trump administration to make controversial <a class="gtmContentClick" data-vars-link-text="vaccine policy changes" data-vars-click-url="http://axios.com/2026/08/10/trump-order-split-up-mmr-vaccine" data-vars-content-id="58b320b8-b3f2-4a47-8a57-52742d7c4b57" data-vars-headline="Fewer Tennessee kindergarteners got vaccines in 2025-26, per CDC" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="http://axios.com/2026/08/10/trump-order-split-up-mmr-vaccine" target="_self">vaccine policy changes</a>.</li></ul>

Tennessee has the highest rate of opioid use disorder in the nation

The diagnosis rate has skyrocketed since 2021.

Tennessee had the highest rate of <a class="gtmContentClick" data-vars-link-text="opioid" data-vars-click-url="https://www.axios.com/local/nashville/2022/08/01/opioid-fight-new-laws-tennessee" data-vars-content-id="2c23f17f-b78c-486a-9e3f-3a1afc8addce" data-vars-headline="Tennessee has the highest rate of opioid use disorder in the nation" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/local/nashville/2022/08/01/opioid-fight-new-laws-tennessee" target="_self">opioid</a> use disorder diagnoses last year, according to data from FAIR Health&#x27;s <a class="gtmContentClick" data-vars-link-text="Opioid Tracker" data-vars-click-url="https://www.fairhealth.org/fh-trackers/opioid-abuse-map" data-vars-content-id="2c23f17f-b78c-486a-9e3f-3a1afc8addce" data-vars-headline="Tennessee has the highest rate of opioid use disorder in the nation" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.fairhealth.org/fh-trackers/opioid-abuse-map" target="_blank">Opioid Tracker</a>.Why it matters: The ongoing opioid epidemic has ravaged Tennessee for years, and the new data shows that the challenge has continued to snowball.

Williamson County tops Tennessee health rankings again

That gels with Williamson's status as the wealthiest county in the state.

Williamson County retained its crown as the <a class="gtmContentClick" data-vars-link-text="healthiest" data-vars-click-url="https://www.axios.com/local/nashville/health" data-vars-content-id="8504fc94-14b1-4c52-bafd-a53b0f57548e" data-vars-headline="Williamson County tops Tennessee health rankings again" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/local/nashville/health" target="_self">healthiest</a> place in Tennessee in an annual data review.Why it matters: The <a class="gtmContentClick" data-vars-link-text="County Health Rankings" data-vars-click-url="https://www.countyhealthrankings.org/health-data/tennessee?year=2025&amp;measure=Community+Conditions" data-vars-content-id="8504fc94-14b1-4c52-bafd-a53b0f57548e" data-vars-headline="Williamson County tops Tennessee health rankings again" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.countyhealthrankings.org/health-data/tennessee?year=2025&amp;measure=Community+Conditions" target="_blank">County Health Rankings</a> analysis offers a broad check-up on key quality-of-life metrics like housing affordability, air quality, income inequality and child care cost burden — essential drivers of long-term health.

Mental health crisis in music industry inspires new initiative

It's the "furiously fastest growing need" in the music industry.

There is a mental health crisis in the music industry, many insiders agree. A Nashville nonprofit is teaming up with Universal Music Group to deal with it.Why it matters: The crisis touches everyone from aspiring young musicians in the tumultuous early stages of their careers to top Music Row executives navigating high-stress jobs.

Tennessee sees big drop in flu shots for kids

Flu shots can help prevent kids from getting sick.

Childhood flu <a class="gtmContentClick" data-vars-link-text="vaccination" data-vars-click-url="https://link.axios.com/click/37859372.2191/aHR0cHM6Ly93d3cuYXhpb3MuY29tLzIwMjQvMTIvMTIvdHJ1bXAtcmZrLWNoaWxkaG9vZC12YWNjaW5hdGlvbi1wcm9ncmFtcy1hdXRpc20_dXRtX3NvdXJjZT1uZXdzbGV0dGVyJnV0bV9tZWRpdW09ZW1haWwmdXRtX2NhbXBhaWduPW5ld3NsZXR0ZXJfYXhpb3Nsb2NhbF9ib3N0b24mc3RyZWFtPXRvcA/610c4e3224241d4f337f4dd3Bab31397c" data-vars-content-id="5287b88d-9f31-49c9-9843-b46fa0dfbc7e" data-vars-headline="Tennessee sees big drop in flu shots for kids" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://link.axios.com/click/37859372.2191/aHR0cHM6Ly93d3cuYXhpb3MuY29tLzIwMjQvMTIvMTIvdHJ1bXAtcmZrLWNoaWxkaG9vZC12YWNjaW5hdGlvbi1wcm9ncmFtcy1hdXRpc20_dXRtX3NvdXJjZT1uZXdzbGV0dGVyJnV0bV9tZWRpdW09ZW1haWwmdXRtX2NhbXBhaWduPW5ld3NsZXR0ZXJfYXhpb3Nsb2NhbF9ib3N0b24mc3RyZWFtPXRvcA/610c4e3224241d4f337f4dd3Bab31397c" target="_self">vaccination</a> is down so far this season in every state but Iowa, per new CDC data.<ul><li>Tennessee ranks near the bottom of the pack, with a 15-point drop this season.</li></ul>

VUMC logs record year for transplants

VUMC completed 809 organ transplants during its fiscal year.

It takes about 150 people to work on a single <a class="gtmContentClick" data-vars-link-text="organ transplant" data-vars-click-url="https://www.axios.com/local/nashville/2022/09/14/million-organ-transplant-milestone-tennessee-impact" data-vars-content-id="41a94180-5653-4350-8d89-88de8411540d" data-vars-headline="VUMC logs record year for transplants" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/local/nashville/2022/09/14/million-organ-transplant-milestone-tennessee-impact" target="_self">organ transplant</a>, and the Vanderbilt Transplant Center performed a record number in fiscal year 2024.

Report: Illinois top abortion destination for Tennesseans

Illinois was the top state where Tennesseans traveled for abortions in 2023, according to a new estimate by an abortion rights group.

<figure><img alt="A bar chart illustrating the estimated number of Tennessee patients traveling for abortions in 2023. Illinois received the most patients at 7,120, followed by North Carolina with 1,280. Georgia and Virginia had 950 and 880 respectively, while California and South Carolina had the fewest, at 220 and " height="900" id="9c0ad396-cde3-4dd7-81f4-efd70aff1d8c" src="https://images.axios.com/0KQn5pw-d8_mWVKTI7jT9fYdx-Q=/2024/06/18/1718739198852.png" width="1600"/><figcaption>Data: Guttmacher Institute; Note: Includes procedural and medication abortions provided at brick-and-mortar health facilities as well as medication abortions via telehealth and virtual providers in 2023. Counts less than 100 not shown.; Chart: Axios Visuals</figcaption></figure>Illinois was the top state where Tennesseans traveled for abortions in 2023, according to a new estimate by an abortion rights group.By the numbers: Tennessee residents obtained 10,570 out-of-state abortions, according to estimates from the Guttmacher Institute.<ul><li>Illinois led the way with 7,120 followed by North Carolina with 1,280.</li></ul>

CDC director promotes mental health support in Nashville visit

She met with Tennessee health officials and toured a mental health clinic during her stop.

CDC director Mandy Cohen visited Nashville Monday to see how Tennessee organizations work to bolster mental health and prevent suicides.Why it matters: More than 1,200 people died by suicide in Tennessee in 2021, according to <a class="gtmContentClick" data-vars-link-text="CDC data" data-vars-click-url="https://www.cdc.gov/nchs/pressroom/sosmap/suicide-mortality/suicide.htm" data-vars-content-id="315c0408-11ca-420a-8f7a-b8c966b09d44" data-vars-headline="CDC director promotes mental health support in Nashville visit" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.cdc.gov/nchs/pressroom/sosmap/suicide-mortality/suicide.htm" target="_blank">CDC data</a>.

Axios Future of Health Care

Axios Vitals

A choropleth map of U.S. states showing the rate of opioid use disorder diagnoses per 100k patients in 2024. Tennessee has the highest rate at 1,447 diagnoses per 100k, while D.C. has the lowest at 219. Appalachian states have higher rates than states in the Great Plains.

Opioid use disorder diagnoses per 100k patients in 2024

A choropleth map of North Carolina counties showing 2025 County Health Rankings. Counties were ranked by the quality of community conditions that affect local health outcomes, such as social and economic factors, physical environment and health infrastructure. Orange County, N.C. ranked the highest in the state, while Robeson County, N.C. ranked the lowest.

2025 County Health Rankings

Data: County Health Rankings; Note: Community conditions include social and economic factors, physical environment and health infrastructure; Map: Axios Visuals

Health 🩺

Tenn. grant offers "lifeline" for family caregivers — but it's starting small

Family says error at St. Thomas Midtown paralyzed patient

Fewer Tennessee kindergarteners got vaccines in 2025-26, per CDC

Tennessee has the highest rate of opioid use disorder in the nation

Williamson County tops Tennessee health rankings again