Untold thousands of black North Carolinians suffered or died during the Jim Crow era because they were denied admittance to white-only hospitals. With little money, scant opportunities for professional education and few white allies, African American physicians, nurses and other community leaders created their own hospitals, schools of nursing and public health outreach efforts. The author chronicles the important but largely unknown histories of more than 35 hospitals, the Leonard Medical School and 11 hospital-based schools of nursing established in North Carolina, and recounts the decades-long struggle for equal access to care and equal opportunities for African American health care professionals.

Few career opportunities were available to minority women in Appalachia in the first half of the 20th century. Nursing offered them a respected, relatively well paid profession and - as few physicians or hospitals would treat people of color - their work was important in challenging healthcare inequities in the region. Working in both modern surgical suites and tumble-down cabins, these women created unprecedented networks of care, managed nursing schools and built professional nursing organizations while navigating discrimination in the workplace. Focusing on the careers and contributions of dozens of African American and Eastern Band Cherokee registered nurses, this first comprehensive study of minority nurses in Appalachia documents the quality of healthcare for minorities in the region during the Jim Crow era. Racial segregation in health care and education, and state and federal policies affecting health care for Native Americans are examined in depth.