The day before being sworn in as the fifth president of 1199 SEIU United Healthcare Workers East, George Gresham was waiting for his new business cards.

It had been 18 years since a new name was printed above the title of president, as Mr. Gresham will be called after a ceremonial induction today. Elected in an uncontested election in April, Mr. Gresham succeeds Dennis Rivera, who relinquished the position earlier this year and will lead a new national health care workers union, to be launched later this month.

“It’s an honor to even be considered to be president,” Mr. Gresham, 51, said yesterday, inside his office at the union’s headquarters on West 43rd Street. With the honor comes responsibility, he said, acknowledging his new task of running a union with 300,000 members in New York, Massachusetts, Maryland, and Washington D.C., including 275,000 in the New York City area.

On succeeding Mr. Rivera, often credited with uniting a union that is considered a powerful political entity, he said, “It can be intimidating, but I’m not looking at it that way. While we’re losing Dennis, the rest of the organization stays here.”

Mr. Gresham’s colleagues said that Mr. Gresham has played a central leadership role for many years, albeit in a style markedly different from Mr. Rivera’s. “George is more prone to strong understatements,” the president of Greater New York Hospital Association, Kenneth Raske, said. “Is he as strong a partner as Dennis? The answer is absolutely, yes.”

Born in Virginia, Mr. Gresham attended DeWitt Clinton High School in the Bronx, and graduated from Lehman College in 1984. His first health care job was as a housekeeper at Presbyterian Medical Center, now New York-Presbyterian Hospital, in 1975. He eventually became an MRI technician, and joined the union staff in 1988. Since 2000, he has served as secretary treasurer, overseeing the union’s annual budget of $120 million. He is a vice president of the national SEIU and is a trustee of the 1199 Health Care Employees Pension Fund.

Mr. Gresham, who said he carries a “social justice gene,” said of his union career, “It was never a question of what I wanted to do.”

Sitting at a desk surrounded by posters of Nelson Mandela and Frederick Douglass, he said, “I started life growing up in a segregated south, in a culture where it was legal to discriminate and treat people like second-class citizens.”

As he starts his presidency, Mr. Gresham, who has served in every elected position at 1199 SEIU, indicated that he did not intend to reinvent the wheel. Among his chief concerns, he said, is securing higher wages for “grossly underpaid” home care workers, and working to address a shortage of health care employees statewide.

Mr. Gresham described practical approaches to dealing with present issues, including a report by the Commission for Healthcare in the 21st Century, which last year recommended closing nine hospitals statewide to reduce costs.

Since “many of those hospitals represent members of ours,” he said, the union would ensure training is available for those seeking new jobs.

He also is taking the helm following a tense period of vocal discord between the union and Governor Spitzer over proposed cuts to health care spending.

“It was a hard year,” he conceded, adding that in the future he hoped to generate a good relationship with Mr. Spitzer. “We have much more in common than we have in differences,” he said.