The Student Health Coalition (SHC) challenged traditional systems, policies, and practices for the delivery of health care in impoverished rural communities. This included pushing against the legal and cultural boundaries of the roles that nurses had been traditionally permitted to play. Forty years later, some of the same struggles to expand health care for low-income people reappeared in the campaign to implement the Affordable Care Act (ACA).
Empowering others to conduct own research
John Gaventa highlights the value of empowering others–locals in the community–to conduct their own research and act on their own knowledge against injustice. Follow this link for access to the full-length interview. Recorded October 2021. Continued
On mutual aid, solidarity, and different interactions of power
John Gaventa describes the concepts of mutual aid and solidarity as exemplified by different interactions of power. He explains that action against injustice is built from the coalition of power within ourselves and power with each other. Together, these fuel… Continued
The “Appalachianization” of rural America and around the world
John Gaventa discusses the “Appalachianization” of rural America, a trend of rising inequality, poverty, environmental damage, and deficit of public services across the U.S. No longer the exception, Gaventa emphaszies injustice in the Clearfork Valley as being relevant to the… Continued
Rethinking quiescence: “hidden transcripts” of community agency
John Gaventa reflects on his early conclusions about the role of quiescence in the Clearfork Valley, recognizing now that he may have under-appreciated ongoing forms of resistance, such as through storytelling, music, and other invisible acts. He pulls on political… Continued
The power cube
John Gaventa elaborates on his previous discussion of quiescence and the three dimensions of power with an introduction of the power cube, a rubik’s analogy he and his colleagues developed to illustrate even more dimensions at play. He explains that… Continued
What is quiescence?
Seeking to frame the role of quiescence in unjust sociopolitical structures, John Gaventa delineates the intricacies of power across three different dimensions. He cites his Oxford mentor Steven Lukes, author of Power: A Radical View, as a purveyor of the… Continued
On paternalistic industrialism: Alexander Arthur and the American Association
John Gaventa describes the British paternalism characteristic of late 19th-century industrialists, a philosophy that harnessed absentee land ownership in pursuit of capitalist economic gain. He references Alexander Arthur, Scottish-born entrepreneur, engineer, and president of the American Association, the British investment… Continued
On the interplay between land ownership and mineral rights
John Gaventa clarifies the interplay between surface land ownership and the exploitative acquisition of below-ground mineral rights by large coal companies in Appalachia. He cites The American Association, a British company that at one time owned 80,000 acres across Clairborne,… Continued
The Appalachian Land Ownership Study: an emblem of citizen-driven participatory action research
John Gaventa further describes how the 1977 flood mobilized citizens toward supplementary research into the inequities connected to land ownership, taxation practices, and other local power dynamics. They requested funding from the ARC for what over time developed into the… Continued
On the role of corporate land ownership in rural land settlement patterns
Following a 1977 flood in central Appalachia that left many people displaced, John Gaventa and others at the Highlander Center organized a study to counter conclusions by the Appalachian Regional Commission (ARC), which failed to consider the role of corporate… Continued
Findings of the 1971 land ownership study and subsequent legal action
John Gaventa elaborates on initial findings from the 1971 land ownership study and what transpired in response. With documented evidence of inequitable corporate control over land and natural resources (due in large part to unfair property taxation practices and the… Continued
Context behind and origin of the 1971 land ownership study
John Gaventa delineates the context and probing question behind his earliest research into land ownership in Appalachia, as proposed in collaboration with Bill Dow: why are some of the wealthiest, natural resource-rich counties in East Tennessee also the poorest (in… Continued
Participatory action research in practice: who owns Appalachia?
John Gaventa recaps and differentiates between two related studies concerning land ownership in Appalachia. The first was conducted during the summer of 1971 across several East Tennessee counties. It affected Gaventa’s pursuits over the next 50 years, including publication of… Continued
Charles Scott and John Kennedy ruminate on the racism intrinsic to the SHC’s work in Appalachia
Charles Scott and John Kennedy discuss the racism intrinsic to the Student Health Coalition’s work, particularly in Morgan County, Tenn. Scott underlines the importance of (1) recognizing and (2) remembering the power they (as majority White students) had in these… Continued
On the empowerment intrinsic to Linda Hart’s nursing career and its role in challenging the system
Linda Hart speaks to the evolution of her nursing career, in part influenced by connections to the Student Health Coalition (SHC). Upon being recruited by Bill Dow, she worked five years as a Nurse Practitioner (NP) at the White Oak… Continued
Diane Lauver’s response to sexism with pivot toward becoming a Nurse Practitioner
In exploration of how sexism influenced Coalitioners’ career paths, Diane Lauver describes her introduction to the Nurse Practitioner role that Loretta Ford championed and that Bill Dow and Leah Albers advocated for in the SHC approach to community healthcare. Following… Continued
Lobbying for the Rural Health Clinic Act
Kate Bradley recalls lobbying for Medicare’s funding of Nurse Practitioners (NPs), a motion that later became known as the Rural Health Clinic Act. Others involved in the effort included Irwin Venick, Wanda Lang, Bill Corr, and Byrd Duncan. Follow this… Continued
The Bradleys move to Wartburg, Tenn.
Caryl Carpenter describes Kate Bradley’s fierce commitment to making Petros a better place, naming several other community initiatives beyond the clinic. Kate, however, shares that she feels they failed and explains their decision to leave for Wartburg, Tenn. in 1993.… Continued
Overcoming adversity from Morgan County
Kate and J.W. Bradley discuss the Morgan County Health Council, from its formation around the same time as the Coalition’s health fair in Petros, Tenn. to the challenges Morgan County officials created for the clinic. These hurdles were in no… Continued
On closing the Petros Clinic
Kate and J.W. Bradley share about their decision to close the Petros Clinic amidst ongoing, relentless threats from Dr. Chester Caster and the community. Follow this link for access to the full-length interview. Recorded October 2017 in Wartburg, Tenn. Continued
On the Petros Health Council’s response to altercation with Dr. Chester Caster
Kate Bradley discusses the local Petros Health Council’s response to an altercation with the clinic’s doctor, Chester Caster. He tirelessly incited clinic opposition among community members and rallied to take over, but Kate’s determination to protect the clinic was stalwart.… Continued
Kate Bradley on a problematic provider’s attempt to take over the clinic in Petros
Kate Bradley describes the internal conflict that arose with the doctor, Chester Caster, who came to Petros after Rick Davidson. He rallied for clinic opposition among community members and made irate threats against her in what was a futile (albeit… Continued
More on local opposition to the Petros Clinic
Kate Bradley expands on the issues she explains are often characteristic of small, rural communities and how such things as ignorance and jealousy impeded their efforts to build a community clinic in Petros, Tenn. She describes a few specific examples… Continued
“We had to work with one hand and fight with the other”
Kate Bradley narrates the process by which Mountain Peoples Health Council (MPHC) acquired land to build the Petros Clinic. She describes the stiff political atmosphere in Nashville, where she went to plead her case before a judge, and explains why… Continued
Reflections on the legacy of coal camp healthcare and success of the St. Charles Clinic
Several closely tied to the St. Charles Clinic gather to discuss what contributed to its success and reminisce about past generations of healthcare in the area, namely during the time large coal companies were active. They emphasize the determination of… Continued
On core tenets of sustainability and the role of business planning in community organizing
Nancy Raybin delves into the core tenets of sustainability (such as governance, self-preservation, and long-term impact metrics) to further stress the value of bringing business planning to community organizing. Follow this link for access to the full-length interview. Recorded October… Continued
On healthcare as a catalyst for community organizing
Nancy Raybin reflects on the Coalition’s philosophic inspirations from which it modeled its approach to community organizing, naming Saul Alinsky as the primary paradigm. She also comments on her own personal interaction with healthcare as a catalyst for organizing and… Continued
On the St. Charles Clinic’s economic model: “…it had to survive beyond the goodwill of volunteers”
Nancy Raybin describes the growth and development of the St. Charles Clinic over time. She provides insight about what distinguished this one from others in East Tennessee, with emphasis on the value of applying business principles and establishing an economic… Continued
SHC influence on Rosie Hammond’s career arc: public clinics vs private practice
Rosie Hammond details how the SHC experience influenced her career arc, highlighting a nurtured commitment to Coalition philosophies (such as really listening to the patient for context and expressed needs, as well as considering all social determinants of health) and… Continued
Discussion about the SHC’s degree of influence on approaches to nursing
Margaret Ecker and Rosie Hammond discuss their difference in perspective about the Coalition’s degree of influence on participants, namely as it regards those who went on to pursue nursing. They ponder how much certain characteristics (such as fierce autonomy and… Continued
On Vanderbilt’s first PrimEx program and its role in the movement toward Nurse Practitioners
Rosie Hammond describes her life post-SHC, beginning with an invitation to participate in Vanderbilt’s first PrimEx program during her Senior year. PrimEx was a government-sponsored initiative designed to provide primary care training for nurses. It functioned as a pivotal step… Continued
On John Kennedy’s management of UMW’s Black Lung Treatment Programs, Kentucky and Tennessee
John Kennedy describes the evolution of his career and transition to Washington in 1974. Upon suggestion from Eula Hall, Director of the Mud Creek Clinic, and with an official offer from Tom Ludwig, the union rep responsible for occupational health… Continued
On the East Tennessee Research Corporation (ETRC) in eastern Kentucky
In supplement to ETRC’s involvement with the Black Lung Association in LaFollette and the Black Lung Clinic in Jacksboro, John Kennedy describes its ongoing activity outside of East Tennessee, too. Namely, he discusses his role setting up clinics in eastern… Continued
Development of the Jacksboro Black Lung Clinic, 1973-1975
John Kennedy provides further insight to the Black Lung Association’s legal processes and evolution as an organization that could govern the proposed Jacksboro Black Lung Clinic. Prominent folks involved in getting said clinic up and running included, but were not… Continued
Progression of black lung care toward government-funded clinics, 1973
John Kennedy describes monumental developments in black lung care during the summer of 1973, primarily as it pertains to the establishment of state and federally funded clinics. He details the complex effort in acquiring these funds, including the role key… Continued
On SOCM’s early days and development as a threat to strip mining
John Kennedy elaborates on Heleny Cook’s and Jane Sampson’s role with Save Our Cumberland Mountains (SOCM), their organizing efforts having grown directly out of John Gaventa’s strip mining research and related work about the American Association. For more information on… Continued
Progression of the Black Lung Association under new union leadership, 1972-1973
John Kennedy details progression of the Black Lung Association (BLA) between 1972 and 1973, following its first successful objective in replacing Tony Boyle with Arnold Miller as president of United Mine Workers (UMW). For more information on John Kennedy’s involvement… Continued
John Kennedy’s introduction to the Black Lung Association in LaFollette, Tenn.
John Kennedy describes his introduction to the Black Lung Association in LaFollette, Tenn. The organization’s primary functions were twofold at the time. First, supporting legislation that would secure black lung benefits for coal miners, and along with it, providing legal… Continued
On miner’s limited access to health and/or legal support for Black Lung Disease management
John Kennedy describes the initial inundation of legal clinics with Black Lung cases, due largely to nonexistent dust control in underground mines and extremely limited access to physicians and lawyers who could help with disease management. He provides further insight… Continued
On the investigation of East Tennessee Development Districts
John Kennedy describes Bill Dow’s motivation to coordinate an investigative review of potential corruption in East Tennessee economic development districts, explaining that said corruption could reinforce power systems–namely, the allocation of state and federal funding to health and other community… Continued
On John Kennedy’s involvement with the Coalition and its early law school projects
John Kennedy shares about his introduction to the SHC while finishing up his degree at Vanderbilt Law School (1971), recollects others who were involved in the Coalition’s early law school projects, and delineates his role researching the East Tennessee Development… Continued
On the Center’s multi-phasic identities and development over time
Irwin Venick, Joe Little, and Bob Hartmann reflect on the birth and growth of the Center for Health Services (CHS) over time, tracing its stages of development from its initial Medical School partnership to its later social-science orientation and eventually,… Continued
On the role of institutional support in community-driven change
Bob Hartmann and Irwin Venick respond to Gillian’s question about how they would approach or encourage others to approach similar student and/or community-led projects today. Bob provides insight into what the Coalition did right and what it could have done… Continued
Resistance to institutionalization: then and now
Bob Hartmann, Irwin Venick, and Joe Little reflect on how the SHC process became institutionalized and the widespread (but split) resistance to it. Bob concludes that if they’d known more about how universities work or approached the formalization process retrospectively,… Continued
Competing visions and growing pains: on the Center’s origins
Irwin Venick expands on the competing visions between the SHC and the Center for Health Services (CHS), explaining that once the Center was established, Coalitioners faced the challenge of adjusting to a structure they hadn’t had to in previous installments… Continued
Margaret Ecker reflects on unique nature of the Coalition’s power
Margaret Ecker reflects on the power of the Coalition, however invisible at the time, and its success in changing institutions, unconventional and inchoate though it was. She brings John Gaventa’s conclusion on the matter, as further detailed in his book… Continued
Coalescing visionary spirit with stabilizing structure: on the Center’s origins
Irwin Venick and Joe Little define the central conflict pertaining to the development of the Center for Health Services (CHS) as the challenge of retaining a Bill-like figure to keep the spirit, vision, and focus of the Coalition alive, yet… Continued
Sir George Pickering visits East Tennessee
Bob Hartmann shares the story of his trip escorting Sir George Pickering, a well-respected hypertension specialist from England who was at the time visiting as a guest professor, and Dr. Grant Liddle and his family to East Tennessee as an… Continued
On institutional benefit of student-led Coalition energy and notoriety
Margaret Ecker and Bob Hartmann discuss how the university seemed to be feeding off of and trying to control Coalition energy and notoriety in the effort to recruit foundation dollars. He shares the story of his trip escorting Sir George… Continued
On the contrast between Coalition and Center approaches to healthcare in Appalachia
Margaret Ecker and Irwin Venick summarize the differences and ensuing conflict between the Coalition’s and the university’s motivations, priorities, and framework of their approach to healthcare in Appalachia. Irwin makes an important distinction between the Medical School’s focus on community… Continued
SHC resistance to university-driven formalization: on the Center’s origins
Bob Hartmann shares the suspicion and intimidation he and others felt in the wake of developing the Center for Health Services (CHS), since the fuel behind it seemed to be coming primarily from and out of the Medical School for… Continued
Irwin Venick on what prompted development of the Center for Health Services
Irwin Venick characterizes the formation of the Center for Health Services (CHS) as an “institutional overlay imposed upon from on high” rather than an impulse among Coalition participants. He explains that most of the university-driven energy to formalize and take… Continued
Bob Hartmann on the Coalition’s pre-Center days
Bob Hartmann contrasts the informal and independent nature of the Coalition’s early, pre-Center days with that of the kind of student work he sees most often today. He draws on the metaphor that, prior to the formalization of the Coalition’s… Continued
Outside convention and against the grain: what set the Coalition apart
Bob Hartmann frames the Coalition work as having absolutely been outside convention and against the grain, in large part due to Bill Dow’s talent at generating and following through with big, extraordinary ideas. He then elucidates one of his favorite… Continued
The role and impact of MIHOW outreach workers
Barbara Clinton frames the Maternal-Infant Health Outreach Worker Project (MIHOW) as a sustainability-driven next step to the care and relationships initiated by Coalition health fairs. She delineates the role outreach workers filled and the immense impact local women had on… Continued
Criteria for and selection process of outreach workers with MIHOW project
Barbara Clinton explains how partnerships between local community health clinics and the Center for Health Services (CHS) facilitated the development of the Maternal-Infant Health Outreach Worker Project (MIHOW). It was up to the community-run clinics to outline criteria for and… Continued
Sharon Roberson on institutional racism and her invitation to Chancellor Heard’s home
Sharon Roberson shares what she’s most proud of from her time in West Tennessee, explaining how it cultivated greater depth to her critical understanding of institutional racism and the ensuing drive to educate others on the matter. Full footage… Continued
On the anti-establishment origins of the Coalition and Center for Health Services
Sharon Roberson and Margaret Ecker discuss how Vanderbilt University no longer has a Student Health Coalition or Center for Health Services, in part due to an unspecified anger more characteristic of the 1960s and 1970s student generation, on top of… Continued
Differences between West and East TN core injustices and approach to community organizing
Sharon Roberson describes community organizing work over time and the growing tension that transpired among Vanderbilt students from one summer to the next, particularly in light of apartheid in South Africa and the ongoing domestic fight for civil rights. Many… Continued
Sharon Roberson on her family stay and community relationships in West TN
Sharon Roberson provides insight into the dynamic of student stays with local families and developing community relationships, including the mutually shared desire not to disrupt existing social norms that would persist after they left. Full footage of Sharon Roberson’s… Continued
Appealing to community leaders, the health fair model, and rights and benefits counseling in West TN
Sharon Roberson describes the student-led approach to community organizing in West Tennessee, such as appealing to established community leaders (namely, ministers from local churches). She also details the health fair model and rights and benefits counseling, both of which were… Continued
Sharon Roberson on Black deference to White people in West Tennessee
Sharon Roberson describes an air conditioning situation in the Haywood County Public Health Services building which, to her surprise, highlighted how Black people, according to custom and engrained mentality, demonstrated deference to the White demographic. Full footage of Sharon… Continued
“Get your hand off my shoulder.”
Dick Burr tells the story of a heated confrontation that ensued between him and a middle-class community member during a gathering of organizers strategizing how to empower the poorest in the community. His reflections on this confrontational style of organizing… Continued
Grant proposal process for the Douglas Community Health Center
Jean Carney details the convoluted grant proposal and approval process for establishing the Douglas Community Health Center, and the lengths to which she and others had to go to make it happen. Despite the several setbacks, she persisted and the… Continued
Origins of the Douglas Community Health Center’s Board of Directors
Jean Carney recounts the story of how the Board of Directors for the Douglas Community Health Center in Stanton, Tenn. first came to be, as well as the role Irwin Venick‘s feasibility study played in determining the community’s need for… Continued
Inadequacies of healthcare system in Stanton, Tenn.
Jean Carney discusses the several, primarily race-related inadequacies of the healthcare system in Stanton, Tenn. prior to the 1977 establishment of the Douglas Community Health Center. Full footage of Jean Carney’s tour and narrative of the Douglas Community Health… Continued
Art Van Zee on the first health fair in St. Charles and early clinic history
Art Van Zee shares about the first health fair in St. Charles, Va. (1973) and expands on the origins of the clinic that still stands today. Recorded March 17th, 2013. Full footage of Art Van Zee’s interview. Continued
The role of community control in structure of Stone Mountain Health Clinics
Art Van Zee discusses the impact of community agency on the success of the St. Charles Clinic and the key role local ownership plays in rural healthcare centers. Recorded March 17th, 2013. Full footage of Art Van Zee’s interview. Continued
Art Van Zee on the opioid epidemic in southwestern Virginia
Art Van Zee was among the first physicians in the U.S. to warn people about the dangers of OxyContin and take a multi-billion dollar pharmaceutical company head on for its marketing blunders. He describes his witness of the problem rapidly… Continued
Minnie Bommer’s encounter with hospital segregation
Having overcome the adversity of racially biased employment discrimination imposed upon her at the outset of her nursing career, Minnie Bommer shares also about the realities of healthcare inequities and segregation experienced post-hire at a hospital in Covington, Tenn. Recorded… Continued
Minnie Bommer on racially charged employment discrimination and her journey to nursing career
Minnie Bommer shares her tumultuous experience at the outset of her nursing career, detailing the extent of racially biased obstacles intended to bar her from hire at hospitals in Tipton County, Tenn. Recorded on June 1, 2018. Full footage… Continued
Where can the SHC go from here?
Charles “Boomer” Winfrey and Maureen O’Connell ruminate on work left to be done in the eastern Tennessee region of Appalachia. Their focus pertains mostly to the ongoing need for augmented healthcare resources, drug education and reform, and meeting the needs… Continued
Decline of coal camp healthcare and subsequent basis of need for reform
Charles “Boomer” Winfrey and Maureen O’Connell discuss the local healthcare setting upon Save Our Cumberland Mountain’s (SOCM) and the Student Health Coalition’s (SHC) early stages of community organizing in East Tennessee. Maureen details several local factors which established a major… Continued
Reflections on the SHC’s approach to community healthcare
Charles “Boomer” Winfrey and Maureen O’Connell consider what set the Student Health Coalition (SHC) apart from other community development efforts in the Appalachian region of East Tennessee. Boomer focuses on the Coalition’s and Save Our Cumberland Mountains’ (SOCM’s) value of… Continued
Dr. Daniel Gabriel’s legacy in St. Charles, VA
Ron Carson discusses Dr. Daniel Gabriel, M.D. and his local legacy in African American healthcare as the only doctor who in the 1940s and 50s would see Black patients. Full footage of Ron Carson’s tour of the African American… Continued
Challenges facing nurse practitioners
Outside the old clinic building of what used to be Douglas Community Health Center, Margaret Ecker and Jean Carney discuss the multitude of challenges facing nurse practitioners and what legislative movement’s been made to overcome adversity of such restrictive practice.… Continued
Pushback against Douglas Community Health Center
Jean Carney shares how rhetoric against the Black-run Douglas Community Health Center manifested as several false accusations and presented various legal challenges to both the clinic and associated nurse practitioners. Full footage of Jean Carney at the old Douglas… Continued
Behind the scenes at Douglas Community Health Center
Jean Carney reminisces the early days of Douglas Community Health Center in Stanton, Tenn. Following a brief overview of the clinic’s architectural layout and functional operations, she delves into the impact of race relations on healthcare at the time. … Continued
Barbara Clinton on the concept of psychological defensive denial and Medicaid expansion
During discussion with Randall and Meryl Rice about Medicaid expansion, Barbara Clinton comments on the role of psychological defensive denial in both the rejection of reality and voting against one’s best interest. Recorded on June 2, 2018. Full footage… Continued
Randall and Meryl Rice on the miseducation about Medicaid expansion
Randall and Meryl Rice discuss misconceptions about and resulting aversions to Medicaid expansion, as well as the repercussions of refusing to adopt it—namely, rural hospital closures. Recorded on June 2, 2018. Full footage of their discussion about rural healthcare. Continued
Randall and Meryl Rice call for political change in the interest of Medicaid expansion
Randall and Meryl Rice discuss the influence of Tennessee’s political climate on Medicaid expansion and affordable healthcare in rural communities and introduce the resolution which developed in response, an initiative known as Insure Tennessee. They highlight the importance of applying… Continued
Meryl Rice shares an Affordable Care Act enrollment success story
Meryl Rice shares an enrollment success story focused on the impact of the Affordable Care Act (ACA) across party lines. Her assistance in this case speaks to the importance of the expansion of affordable healthcare, particularly in low-income rural communities… Continued
Randall and Meryl Rice on the Affordable Care Act’s enrollment process and their role as navigators
Randall and Meryl Rice explain the internet connectivity and computer literacy hurdles of online enrollment in the Affordable Care Act (ACA) in rural West Tennessee and expand on their role as navigators in problem-solving the complexity of this process. Barbara… Continued
Randall Rice on the activist response to challenges imposed on the Affordable Care Act in West TN
Randall Rice discusses state-sanctioned roadblocks to the expansion of affordable healthcare among rural populations in West Tennessee. He also shares about his and others’ success in overcoming these challenges with the support of the nonprofit public policy advocacy organization, Tennessee… Continued
Randall Rice on the origins of his and Meryl’s work rolling out the Affordable Care Act in West TN
Randall Rice shares about his and Meryl’s involvement in assisting with open enrollment of the Affordable Care Act (ACA) in rural West Tennessee communities. Their work began in 2013, developed from a need left by the absence of major enrollment… Continued
Connecting the dots: from SHC to ACA
In 2013, just as the Affordable Care Act (ACA) was about to get rolled out, Bill Corr took time out of his busy schedule as Deputy Secretary of Health and Human Services to reflect on the resonance between the Coalition… Continued
Nurse Practitioners, in the beginning…
Community leaders recognized early on the added value nurses with expanded roles brought to the table. In this video clip, community leaders Marie Cirillo and Betty Anderson recollect their efforts to lobby for legal changes that would continue to support… Continued
Bill Dow on Healthcare Policy, 1973
A clip from Appalachian Genesis, courtesy of Appalshop Film Archives (Whitesburg, Ky.). Continued
“Imagine, if you can, these two young Turks trying to give advice to the Governor of Mississippi”
[Contributed John WIlliams] Bill had a friend named Fortenberry. He was a staffer for the Mississippi State Senate in the 1970s. In 1976, lignite coal (a low grade of coal) was discovered in Mississippi, so the state started considering the… Continued