Care Beyond the Coalfields
In the summer of 1956, the New York Times heralded the opening of ten regional hospitals, together known as the Miners Memorial Hospital Association (MMHA), in Kentucky and West Virginia.1 The United Mine Workers of America (UMWA) funded these hospitals to provide much-needed access to health care for the many rural Appalachian miners and their dependents who contributed to the UMWA Welfare and Retirement Fund. However, less than a decade later, these same hospitals teetered on the edge of financial ruin. Several faced impending closure unless a buyer could be found to take the hospitals on. In transferring MMHA ownership to the newly formed Appalachian Regional Hospitals, Inc. (ARH), the hospitals were able to avoid closure, but the sale was transformative.2 Though both the UMWA and ARH used a discourse of increased community access to describe the transfer, aligning it with War on Poverty investments in local infrastructure, the shift in ownership (and subsequently, pricing structures) ultimately excluded the very mining communities the hospitals had originally intended to reach. Dr. Stephen Edelstein, a Public Health Service (PHS) doctor surveying health in Appalachia at the time of the sale, may have understood the situation best when he ominously warned, “If those hospitals close, we will never see anything like them again.”3
Edelstein’s claim was, of course, political. His choice of words, however, points to a particular emotional claim on the hospitals, and the pride of ownership that UMWA beneficiaries felt for the hospitals that their hard work had created. I am currently undertaking a research project specifically examining this transfer of the Miners’ Memorial Hospital Association from the United Mine Workers of America to the Appalachian Regional Healthcare, Inc. in 1963. While several historians have noted the importance of the MMHA, due to their physical presence and technical innovations in this underserved region, scholars have yet to examine the ways that local communities engaged with and defined themselves in terms of these medical establishments.Through the lens of this specific paper, I intend to gain a deeper understanding of the materials available that depict the engagement of local Appalachian communities in larger state and federal conversations surrounding health care access during this time period. My interests in these question are larger than a single semester can answer, and I am eager to undertake further research in the Appalachian region itself to deepen my research questions, and understand the ways that this health-oriented activism fit into broader local fights for social inclusion and benefits. In particular, I am interested in the ways that rural communities defined themselves in an era just tilting toward identity politics, and how these local conceptions of community intersected with governmental rhetoric about community-based healthcare. Subsequently, I am interested in understanding the relationships of these small towns to the services they fought for, utilized, and sometimes avoided. This, I believe, will provide powerful insights into the way that rhetoric of community care, efficiency, and even welfare were constructed.
I am seeking funding from the Yale-Sewanee Collaborative for Southern Appalachian Studies to conduct archival and community research in Appalachia this spring and summer. My first priority is to take a brief trip to Nashville, Tennessee in March, to assess and prioritize my archival plans for the summer. While in Nashville, I’d like to investigate the collections of the Tennessee Department of Health and the Highlander School hearings at the Tennessee State Archives. I’d also like to briefly visit the archives at Meharry Medical College, to further investigate the role of doctor and activist Leslie Falk, who advocated widely for miners on occupational health issues. In addition, I am eager to attend Vanderbilt’s “The Politics of Health in the US South” conference to be held on March 17th and 18th. This interdisciplinary conference will specifically address topics of health activism in the region, and emphasize the necessity of developing historical projects that connect to important health questions in the region today. Following this shorter trip, I would plan to return in the summer for a more substantial inquiry into various archives in Tennessee, including the oral histories at Eastern Tennessee State University, as well as relevant collections at Appalachian State in North Carolina.I believe that this archival work will provide me with a clear understanding of the ways that rural activists framed health issues around demands for inclusion, and the ways that rural communities articulated their group identities, as well as their material needs.
Project Alignment with the Collaborative for Southern Appalachian Studies
I am particularly eager to pursue this research in the context of the Collaborative, for I am deeply committed to its aims of interdisciplinary and community-oriented scholarship.
Ultimately, further scholarship on the complicated history of healthcare access in Southern Appalachia will shed light on the region’s contested role in healthcare politics today. I am most interested in the ways that healthcare access becomes integral to the articulation of broader fights for social justice and opportunity. Rural Southern Appalachia, with its history of professional medical neglect and labor activism, is a vital site for this study.