Resolution on the Right for Employee Free Choice to Form Unions

  • Date: Nov 08 2006
  • Policy Number: 20068

Key Words: Occupational Health And Safety, Unions


Historically, unions have helped bring economic and social democracy to American society. The Employee Free Choice Act as introduced in 2005 is an example of landmark legislation that would strengthen protections for workers and their freedom to unionize by requiring employers to recognize a union after a majority of workers authorize representation. It also would provide for mediation and arbitration of first-contract disputes and authorize stronger penalties for violation of the law when workers seek to form a union. This resolution advances the agenda for current and future public health by supporting the organizations that defend the rights of workers to improved access to health care.

The American Public Health Association,

Wishing to promote respect for human rights, including workers' freedom to form unions1,2 and bargain collectively3,4 without employer interference; having a history of support for freedom to form unions and the important public benefits collective bargaining provides;5 and knowing of the difficult environment in the United States with respect to protection of these important rights, as documented by Human Rights Watch; 6 and

Recognizing that recent decisions and activity by the National Labor Relations Board have rendered many workers ineligible for labor law protections, and have undermined Voluntary Recognition Agreements (VRAs) between unions and employers; VRAs enable workers to form unions without undergoing contentious anti-union campaigns- and are therefore a vital alternative to the National Labor Relations Board representation elections process,7 during which employers and their consultants typically wage anti-union campaigns that subject workers to threats of job loss and many other intimidation tactics;8,9 in the health care industry, VRAs also improve patient care by reducing conflict during workers' campaigns to form unions;10 and

Realizing that failure to protect freedom to form unions is exacting a heavy health, economic, social and political price from workers and communities throughout our nation,11,12,13 including but not limited to increased risk to workplace health and safety hazards resulting in increased injuries and illnesses,14-16 suppressed wages, decreased job quality, worsened economic inequality,17 -21 erosion of support for public education, the unraveling of public and private safety-net protections, the denial of justice and democracy in the workplace, and decreased political participation;22,23 and

Knowing that protecting the freedom to form unions is also vital to public health- because union members are far more likely than non-union workers to have adequate health insurance coverage; because where workers have greater freedom to form unions, more people- union and non-union alike- have effective health and safety programs to resolve hazards in the workplace, health insurance, the quality of care is higher, and health outcomes are better; because health care workplaces where workers have greater freedom to form unions deliver better quality care;24, 25 and because protecting freedom to form unions is essential for generating political support for urgently needed public health policies such as universal health insurance coverage;26 -28

Therefore, the American Public Health Association recommends that the following steps be taken to advance the rights of workers to freely choose whether to join unions for collective bargaining purposes and advance their economic and social well being by the following actions:

  1. Urge members of Congress to support landmark legislation that promotes public health by enabling workers to form unions by majority sign-up and expedite the negotiations to gain first contracts, while penalizing illegal employer conduct, thereby providing important, badly needed and long overdue protection for the fundamental human right of America's workers to form unions and bargain collectively without employer interference; and
  2. Urge the National Labor Relations Board to refrain from further attacks on workers' rights, such as stripping labor law coverage from more workers or imposing new restrictions on Voluntary Recognition Agreements (VRAs); and 
  3. Urge employers, especially within the health care industry but also in all sectors of the economy and throughout the nation, to uphold and respect the fundamental human right of their employees to form unions and bargain collectively, and to refrain from conduct which infringes on these rights. 


  1. American Public Health Association Policy Statement 9204: Labor Unions and Health. APHA Policy Statements, 1948-present, cumulative. Washington, DC: APHA. Available at: http://www.apha.org/legislative/policy/policysearch/index.cfm?fuseaction=search_results&YearofPolicy=1992, Accessed March 14, 2006
  2. General Assembly of United Nations Universal Declaration of Human Rights 1948 Available at: www.un.org/Overview/rights
  3. American Public Health Association Policy Statement 9924: Use of Union Hotels for Conventions and Major Meetings. APHA Policy Statements, 1948-present, cumulative. Washington, DC: APHA. Available at: http://www.apha.org/legislative/policy/policysearch/index.cfm?fuseaction=search_results&YearofPolicy=1999, Accessed March 14, 2006.
  4. Wagner Act 1935. Available at: http://www.stfrancis.edu/ba/ghkickul/stuwebs/btopics/works/wagner.htm, Accessed June 16, 2006.
  5. American Public Health Association Policy Statement 8509: Occupational Disease Prevention: Increase Worker and Union Rights. APHA Policy Statements, 1948-present, cumulative. Washington, DC: APHA, Available at: http://www.apha.org/legislative/policy/policysearch/index.cfm?fuseaction=search_results&YearofPolicy=1985, Accessed March 14, 2006.
  6. Human Rights Watch, Unfair Advantage: Workers' Freedom of Association in the United States Under International Human Rights Standards, www.hrw.org/reports/2000/uslabor
  7. Eaton, Adrienne, and Kriesky, Jill, Fact Over Fiction: Opposition to Card Check Doesn't Add Up March 2006, http://araw.org/resources/studies.cfm.
  8. Chirag, Mehta and Nik, Theodore Undermining the Right to Organize: Employer Behavior During Union Representation Campaigns. The University of Illinois at Chicago's Center for Urban Economic Development (CUED) December 2005.
  9. Masson, Elizabeth J. Captive Audience Meetings in Union Organizing Campaigns Free Speech or Unfair Advantage? by Hastings Law Journal November 2004.
  10. See NLRB Decisions - Oakwood Care Center 343 NLRB 76, Brown University 341 NLRB 42, Crown Bolt 343 NLRB 86, Lutheran Heritage Village- Livonia 343 NLRB 75, also see New York Times Labor Board's Critics See a Bias Against Workers' New York Times 1/02/05.
  11. Mishel, Larry, "How Unions Help All Workers," Economic Policy Institute, August 2003, http://www.epinet.org/content.cfm/briefingpapers_bp143, 
  12. Bronfenbrenner, Kate Uneasy Terrain: The Impact of Capital Mobility on Workers, Wages and Union Organizing by Report for the U.S. Trade Deficit Review Commission September 6, 2000.
  13. APHA has supported increasing worker and union rights regarding committees on Occupational Safety and Health [8606] -"COSH groups" APHA Policy Statements, 1948-present, cumulative. Washington, DC: APHA. Available at: http://www.apha.org/legislative/policy/policysearch/index.cfm?fuseaction=search_results&YearofPolicy=1986, Accessed March 14, 2006.
  14. Rielly, B Paci, P and Holl, P "Unions Safety Committees and Workplace Injuries," BJIR Vol. 33, 1995.
  15. Litwin, A "Trade Unions and Occupational Injuries The British Evidence," Center for Economic Performance London School of Economics, 2000.
  16. Robinson and Sullivan, "The Healthy Workplace? Judge," Institute of Management Studies, 2000.
  17. Waddoups C. Jeffrey, "Wage Inequality and Collective Bargaining: Hotels and Casinos in Nevada," Journal of Economic Issues Vol. XXXVI No, 3, September 2002, pp. 617-634. 
  18. Card, David, "The Effect of Unions on the Structure of Wages: A Longitudinal Analysis," Econometrica, 1996, Vol. 64, pp. 957-999. 
  19. Card, David "The Effect of Unions on Wage Inequality in the U.S. Labor Market," Industrial and Labor Relations Review, 2001, Vol. 54, pp. 354-367.
  20. Card, David with Thomas Lemieux and W. Craig Riddell "Unionization and Wage Inequality: A Comparative Study of the U.S., the U.K., and Canada," National Bureau of Economic Research, 2003, Working Paper No. 9473.
  21. Institute for Women's Policy Research, "The Benefits of Unionization for Workers in the Retail Food Industry," IWPR Publication No. C351, February 2002. 
  22. Radcliff, Benjamin "Organized Labor and Electoral Participation in American National Elections," Journal of Labor Research, Spring 2001.
  23. Radcliff, Benjamin and Patricia Davis, "Labor Organization and Electoral Participation in Industrial Democracies," American Journal of Political Science Vol 44, No. 1, Jan. 2000, pp. 132-141.
  24. Seago, Jean Ann and Michael Ash "Registered Nurse Unions and Patient Outcomes" Journal of Nursing Administration vol 32, No. 3, March 2002. 
  25. Ash, Michael and Jean Ann Seago, "Do Unionized Registered Nurses Reduce Heart Attack Mortality?" Industrial and Labor Relations Review Vol. 57, No 3, 2004.
  26. Buchmueller, Thomas C and. John DiNardo and Robert G. Valleta, "Union Effects on Health Insurance Provision and Coverage in the U.S.," Industrial and Labor Relations Review Vol. 55, No. 610, July 2002.
  27. Maxwell James, Peter Temin and Saminaz Zaman, "The Benefits Divide: Health Care Purchasing In Retail Versus Other Sectors," Health Affairs Vol 21, Issue 5, 224-233.
  28. Waddoups C. Jeffrey, "Health Care Subsidies in Construction: Does the Public Sector Subsidize Low Wage Contractors?", in The Economics of Prevailing Wage Laws, edited by Hamid Azari-Rad, Peter Phillips and Mark J. Prus, 2004, Ashgate Publishing Ltd.

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