As the United States celebrates its 250th anniversary this year, Knoxville ranks the 129th largest city in the nation.

Knoxville's $50,994 median household income trails Memphis's by $217 and Nashville's by $24,000, but Tennessee's flat statewide pricing assigns all three cities the same $14,029 infant tuition. The result is a 27.5% household-budget burden — the worst affordability reading in this report cluster. The supply-and-cost squeeze appears to be settling on the second-earner question: only 58.9% of mothers with kids under six are in the labor force, almost ten points below the national rate, suggesting that for many Knoxville families the second paycheck would be eaten whole by an infant slot. East Tennessee's lower cost-of-living gives childcare workers a 64% wage-to-living-wage ratio, second-best in the cluster. Knoxville ranks fifth of five in Tennessee, 235th of 250 nationally.

Key highlights & actionable takeaways

Score 35 (Strained), ranked 235 of 250; last of Tennessee's five cities — flat $14,029 infant price is 27.5% of $50,994 median income.
Mothers' labor force participation 58.9% — almost 10 points below the 68.2% national rate, signaling cost pricing second earners out.
Single-parent share 45.5%, well above the 31.8% national norm; childcare workers earn 64% of a local living wage, second-best in cluster.

Actionable takeaways

Mothers' LFP at 58.9% is the cleanest signal of the price trap. Almost 10 points below the national rate and consistent with East TN households where the second paycheck would be eaten whole by an infant slot — a structural, cost-driven labor market exit.
The flat-pricing trap is most punishing here. Identical $14,029 Nashville tuition against a $50,994 income produces the worst affordability burden in the cluster (27.5%) — Knoxville and Memphis are essentially the same arithmetic.
U Tennessee creates a small two-track market. Faculty/medical households drive what little nanny-share and au pair demand exists; broader Knoxville families fall back on kin care and informal networks.

Affordability — 25/100

Knoxville and Memphis sit within $200 of each other on median household income, and Tennessee's flat NDCP pricing applies the same $14,029 infant care figure to both cities. That translates to a 27.5% household-budget burden in Knoxville — five and a half points above the national 21.9% norm and almost identical to the Memphis reading, the highest two affordability burdens in this report cluster. Median rent is $1,116, putting childcare costs at 105% of monthly rent. A typical Knoxville family with one infant in center care spends roughly $4,600 more per year, as a share of household income, than a national-median family on the same care, the same arithmetic that drove the Memphis reading.

Supply — 48/100

Knox County reports about 15,452 licensed slots against 32,350 kids under five with working parents — 47.8 slots per 100, the same Tennessee proportional allocation as Nashville and Memphis. Knoxville is not in childcare-desert territory by the strict definition. The county has 88 licensed establishments at 3.27 providers per 1,000 kids under five — a slightly thinner density than Memphis but better than Nashville. Tennessee's statewide gap of 21.6% on the BPC's potential-need methodology applies here as everywhere in the state, and Knoxville's working-family base appears to be operating with about half the licensed capacity it would need to fully cover demand.

Workforce — 67/100

The median Knoxville-area childcare worker earns $13.96 an hour, or $29,030 a year, against a Knox County single-adult living wage of $21.84 — 63.9% of self-sufficiency, the second-strongest workforce reading in this report cluster after Memphis. With 1,820 workers in the local industry, the labor pool is small enough that program closures and openings move the wage floor visibly. The 66.5 dimension score reflects that East Tennessee's lower overall cost-of-living base lets a $14-an-hour wage do more work than the same wage in higher-cost metros — though the gap to self-sufficiency remains real.

Family strain — 13.3/100

The family-strain dimension is the lowest reading in this report cluster. Single parents head 45.5% of Knoxville households with children, well above the national 31.8% share and above the Tennessee state norm. Mothers' labor force participation for kids under six runs 58.9%, almost ten points below the national 68.2% and near the bottom of the index. That combination — high single-parent share with low maternal employment — suggests the affordability and supply constraints documented above are translating directly into mothers staying out of the workforce, particularly in households where the second income would be quickly absorbed by an infant care slot.

Policy support — 23.6/100

Tennessee's policy environment is identical for every city in the state: 20% of four-year-olds enrolled in state pre-K at $4,902 per child, meeting 9 of NIEER's 10 quality benchmarks; 1% of three-year-olds served. There is no state paid family or medical leave. CCDF subsidies reach 15.7% of eligible children. Knoxville families inherit the same low-access pre-K environment as the rest of the state; policy is measured at the state level.

In-home care in Knoxville

In-home care in Knoxville typically reflects metro-wide nanny market patterns, with full-time live-out rates running modestly below the Tennessee average given the lower household-income base. The University of Tennessee's faculty community generates some demand for shared in-home arrangements, and nanny shares between two families have become a recognizable workaround for households facing the affordability math at the city's wage levels. Au pair placements through J-1 sponsor agencies remain a small share of the local market, more concentrated in the dual-academic and medical-professional segment than in the broader Knoxville family base.

Methodology: The the score is a 0-100 composite score across five dimensions: Affordability (30 pts), Supply (25 pts), Workforce Health (15 pts), Family Strain (15 pts), and Policy Support (15 pts). City-level prices and supply use the city's primary containing county. Policy Support is measured at the state level. Full methodology and data sources: beverly.io/research/methodology.

Sources: U.S. Census Bureau ACS 2019-2023 5-year estimates; U.S. Department of Labor Women's Bureau National Database of Childcare Prices; U.S. Bureau of Labor Statistics OEWS (May 2024) and QCEW; Buffett Early Childhood Institute / Bipartisan Policy Center / Child Care Aware childcaregap.org (Sept 2025); NIEER State of Preschool Yearbook 2024; HHS ACF CCDF FY2023; National Partnership for Women & Families (March 2026).

Methodology. The State of Childcare Index is a 0-100 composite score across five dimensions: Affordability (30 pts), Supply (25 pts), Workforce Health (15 pts), Family Strain (15 pts), and Policy Support (15 pts). Each dimension draws on publicly available federal data: U.S. Census ACS (5-year), DOL Women's Bureau NDCP, BLS OEWS and QCEW, the Buffett/BPC/CCAoA childcaregap.org dataset, NIEER State of Preschool, and HHS ACF CCDF reports. City-level prices and supply use the city's primary containing county. Policy Support is measured at the state level. Full methodology and data sources: /research/methodology.