During the early days of the Association, public health was really just getting established in Tennessee. For instance, in 1928 there were only 23 full time county health departments, and in 1939 there were 56 counties that had full time health departments. 

After the Association was chartered, an official Executive Committee was established. Annual dues of $1,00 were approved. The following sections were officially established: Health Officers, Clerical, Nursing and Sanitation. Total membership for 1939-40 was 426; and total expenditures for 1940 were $199.54. This compares to a total membership of approximately 1300 in 2002.

Dr. J.B. Black was the first President of TPHA, and he also served as the official representative to the American Public Health Association Governing Council. Dr. R.H. Hutcheson, Sr., was the first Secretary-Treasurer of the Association, a position he continued to hold until 1943 when he became Commissioner of the Tennessee Department of Public Health. Officers of the Association are elected by the membership with the exception of the Secretary-Treaurer which is appointed by the Board of Directors and offers continuity and assistance as new officers assume their office. Others serving as Secretary-Treasurer were: Dr. Monroe F. Brown, 1943-54; Dr. Cecil B. Tucker, 1954-61; Dr. C.P. McCammon, 1963-1968; James L. Church, 1968-69; Dr. William H. Armes, Jr., 1969-71; Dr. Durward R. Collier, 1971-91; Dr. Fredia S. Wadley, 1992-94; and Dr. James A. Gillcrist, 1994 to 2003. TPHA has had paid staff  beginning with Louise Patterson, 1971-73;  Sandra Whittle from 1973 to 2003; and currently Doris Spain is the Executive Director and Rick Cochran is Treasurer.. 

The first printed program on file is for the 1940 meeting held October 14-16 at the Andrew Jackson Hotel, Nashville. Subjects discussed were: Symposium on Malaria Control; Tuberculosis and What Is Being Done About It: Methods of Ways for the Nurse to Assist the Teacher in the Health Program; Practical Suggestions in Teaching Nutrition in a Public Health Nursing Program; Interpretation of the B-Coli Test on Water; The Rat and Its Eradication; and How Clerk and Sanitation Can Coordinate Their Activities. This gave us some idea of the problems facing the public health employee at the time TPHA was first organized. 

Membership dues remained $1.00 until 1966 when they were increased to $2,00; they increased to $5.00 in 1973, $10.00 in 1977, $15.00 in 1985, and $20.00 in 1992. Membership increased steadily for a high of 1,804 in 1976. Since 1976 membership has gone up and down. In 2002 there were approximatey 1300 individuals members, including 180 Life members, and 130 agency members. Until 1972, membership was limited primarily to those individuals employed in the Tennessee Department of Public Health at the local, regional and state levels. However, in 1972 when the Constitution and Bylaws were revised, membership was expanded to include persons connected with agencies and organizations engaged in public health work, person engaged in teaching and research in the field of health or a related field, and other persons who have demonstrated a genuine interest in health. 

In addition to the original four sections (now Physicians, Management Support, Nursing, and Environmental), the following have been added: Dental; Health Education/Health Promotion; Communicable Disease; Administration, Management and Planning; Nutrition; and Computers and Statistical Systems.

During the early years of the Association, each year at the annual meeting, TPHA recognized those public health workers who had completed 20,30 and 40 years of public health service. In 1973 an award was established to honor a "Public Health Worker of the Year"" later the awards program was expanded to include the "Distinguished Service Award" for contributions to the Association; the "R.H. Hutcheson, Sr., M.D. Career Award"; the "Alex B. Shipley, M. D. Award", a career award for contributions on the local or regional level. The "Public Health Group/Unit Department Award" was established in 1993. The newest award, the "PAL (Partners and Leadership) Award" was established in 1999 to recognized individuals and /or groups outside public health who have ad a major impact on public health.

A scholarship program has been established to assist public health workers in continuing their education. The first awards were made in 1988 and approximately $23,000 in scholarships have been awarded through 2002. The top scholarship awarded each year is the "Dr. Durward Collier Award" which is named in honor of Dr. Collier who served as Secretary-Treasurer of the Association from 1971-91. 

The Tennessee Public Health Association is an affiliate member of the Southern Health Association and the American Public Health Association and is represented on the Boards of each organization by a member elected by the TPHA Board of Directors