Many Fights, One Big Fight

Historian’s book traces the long, difficult struggles of an Appalachian healthcare union’s attempts to stay the course

Strike at Cabell Huntington Hospital, 1977. (Image: Lee Bernard, Huntington Herald Dispatch.)


A Union For Appalachian Healthcare Workers: The Radical Roots and Hard Fights of Local 1199.” by John Hennen | West Virginia University Press, November 2021

By Eric Neudel | For

The 19th century British parliamentarian Lord Acton wrote, “Power tends to corrupt, and absolute power corrupts absolutely.” Resisting those corrupting forces is the story of Local 1199.

Many healthcare workers view their jobs as a calling, but the self-sacrifice attached to that calling is a double-edged sword. On one hand, healthcare workers are indispensable contributors to their communities. On the other, they have been undervalued and taken for granted. John Hennen’s, A Union For Appalachian Healthcare Workers: The Radical Roots and Hard Fights of Local 1199 (West Virginia University Press, 2021) subtly contends with this problem by chronicling the history of a small, respected union that represents the overlooked and previously unrepresented workers of Local 1199.

Hennen’s book conveys the human longing for fairness within an often heartless industry.

The author and historian’s simple and accessible style offers a way for ordinary people to understand the history of ordinary people just like themselves. For scholars, it is a meticulously researched window into the dynamics of a small activist union.

Recently, the Covid pandemic has given the American public a new perspective on the overwhelming responsibilities healthcare workers feel they have to the people in their communities. As Hennen writes: “The workers who feed us, protect us, clean up after us, drive us around, deliver our stuff, teach our children, and care for the old, the sick, and the injured are not just assistant people. They are ‘essential.’”

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Even so, the selflessness of workers like this has been used against them. “A Union For Appalachian Healthcare Workers” is the story of the reaction of working-class people in the healthcare industry to the indifference to their contributions and the dismissal of their value and rights. Simply put, the book conveys the human longing for fairness within an often heartless industry.

The union’s roots trace to the 1930s in New York City, as the brainchild of Leon Davis, a communist during that desperate time in history. Davis understood the disadvantages of the label and later separated from it. But the baiting never stopped, and there is a “Red Thread” that has woven its way through the fabric of 1199’s history.

In practice, there was more to Leon Davis’s thinking than demeaning labels, and he never abandoned the content of his message that “marginalized workers in the hospital industry — Blacks, Puerto Ricans, poor whites, women — were human beings who should be recognized, respected, and paid a decent wage.“

Juanita Jenkins of Glen Manor Nursing Home in Cincinnati (l) and Joyce Lunsford of Fairmont General in Fairmont, at a 1983, delegates’ meeting. The two were critical ‘organic leaders’ of the 1199 union.

The organizers of 1199 consistently felt the sting of highly paid “union avoidance” consultants, who portrayed the union’s organizers as “reds, communists, and socialists.”  Throughout the hard fights for recognition, hospital managements used these taunts to dissuade workers from joining the union and to disparage workers who had already joined 1199 affiliates.

The people who became union members knew that these were just taunts. They understood that the solution to fundamental issues in their everyday lives depended upon the acquisition of power through the collective strength that unions can provide. They knew viscerally they had real-life issues: low wages and how they could put food on the table, pay their rent or mortgage, and take care of their children and elders.

And they had issues on the job as well. Among them: how they were treated as workers (and as human beings); inadequate benefits such as healthcare coverage and vacation pay; the indignities they faced on the job; and issues of proper staffing. Without union power behind them, workers’ requests were met with a common refrain: “If you don’t like it here, you can be easily replaced. Take it or leave it.” 

People like Leon Davis, Don West, Danie Stewart, Tom Woodruff, Kay Tillow, Larry Harless (and so many others) are not household names — but they answered the challenge posed by the managements of the healthcare industry.

Healthcare workers had a need for social and economic justice, and 1199 answered it through more than eight decades. These organizers were determined to make a difference in the lives of some of the most exploited and mistreated people in Appalachia. As such, Hennen’s narrative spins us through a sweep of history, weaving 1199’s many hard fights into one large fight. 

Without union power behind them workers’ requests were met with a common refrain: “If you don’t like it here, you can be easily replaced. Take it or leave it.” 

His story focuses on ordinary people. These are unsung heroes within the labor movement, activists who were literally beaten and then forgotten. Hennen knew about this untold story because he is no stranger to it. He lived part of it himself, working briefly as an organizer for 1199 in the 1990s. He has met many of the characters and has studied these hard fights through decades of research about them. As a result, the story has the feel of someone who knows this history personally and is comfortable telling it.

His descriptions of the characters who populate this book convey the warmth and respect he has for them. As he writes: “The contributions of regular working people are still too often airbrushed out of standard narratives of American history.”

The author seeks to put them back into the picture.

Image Gallery (click to enlarge)

Hennen chronicles this fight from its radical beginnings in Depression-era New York City, through the antiwar and civil rights years of the 1960s. He tackles the hard fights for union recognition and good faith bargaining in the 1970s and the transformation of the  healthcare industry during the anti-union Reagan years of the 1980s. He traces the inescapable adjustments the union was compelled to make to counter the consolidation within the hospital industry and the resistance to unionization by increasingly hostile managements.

The union’s organizers continued to encounter intense opposition during the 1990s and 2000s. From drug stores in New York City, to 1199’s pioneering work in medical centers throughout Appalachia and Ohio, the author tells the stories of the union’s larger struggle to hold onto its original values. He smoothly moves us chronologically through multiple economic ups and downs, and massive changes in the healthcare industry, bringing the story up to the present. 

Healthcare workers had a need for social and economic justice, and 1199 answered it through more than eight decades.

The union has had its upheavals. But it is still Leon Davis’s, Tom Woodruff’s, and Danie Stewart’s Local 1199, a remarkable union with a multicultural and multiracial history of militant protest and direct action. There was always one goal: to confront economic and social injustice through the instrument of the labor movement.

There are many good books about the labor movement in the United States. Hennen’s carefully modulated tale is a rare find within that field of study, telling a hitherto unexplored story about people striving for basic respect. As members of 1199 say, they are “kicking ass for the working class.”

Ultimately, A Union For Appalachian Healthcare Workers” is the story of a long struggle of people trying to remember their core values. Civil rights, social and economic justice, and human dignity were consistently at the center of 1199’s platform as its leaders rejected the pitfalls of money and power.


Q&A: “Appalachia’s Long History of Unions for Healthcare Workers: Rural and urban alliances are at the center of John Hennen’s new book on labor unions in Appalachia.”

Also, this is not just a story about Appalachia. It is a story about what happens when the powerless anywhere become powerful. Today, 1199’s thirty-one thousand workers confront the same identity-challenging question. Do they fall prey to corrupting forces? Or do they hold true to themselves?

Hennen’s book offers this answer: Staying true to oneself is a daunting task, but doing so has staying power.

Finally, the staying power of a union depends upon how much union leadership stays true to the needs and aspirations of its members. So many unions have left big decisions to the “lieutenants of labor and their counterparts in the boardrooms of organized capital.” They allow the seductive forces of power and money to dilute their commitments to their members.

From its humble beginnings in New York City to its proud collection of current-day affiliates, 1199 has held on tightly to its original values. Its slogan, ”Union Power, Soul Power” emerged out of the civil rights movement and found an enduring place in the center of the aspirational heart of Local 1199.

John Hennen taught history for more than 30 years, including two decades at Morehead State University, where he is emeritus professor of history. He is the author of “The Americanization of West Virginia: Creating a Modern Industrial State, 1916-1925.”

Eric Neudel has been an editor and producer of many PBS programs. He has worked on “After The Crash” and “Eyes On The Prize” for The American Experience; “The U.S. and The Philippines: In Our Image”; “AIDS: Chapter One” for NOVA; and “Vietnam: A Television History” for World. His independent films include “Steps” (1980), “Fred’s Story” (1994), “Marie” (1995), and “Fred’s Roman Holiday” (2009). Eric directed the critically acclaimed Independent Lens film “Lives Worth Living”. | March 30, 2022 ISSUE

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