Next Shift: The Fall of Industry and the Rise of Health Care in Rust Belt America

"This is the first comprehensive account of the health care workers who have been at the forefront of our fight against COVID-19. In fact, America's economy and politics have been, for years, increasingly defined by the growth of the healthcare industry,yet we have lacked convincing accounts of its rise and make-up. Winant delivers an incisive investigation of this new world"--
Men in hardhats were once the heart of America’s working class; now it is women in scrubs. What does this shift portend for our future?Pittsburgh was once synonymous with steel. But today most of its mills are gone. Like so many places across the United States, a city that was a center of blue-collar manufacturing is now dominated by the service economy—particularly health care, which employs more Americans than any other industry. Gabriel Winant takes us inside the Rust Belt to show how America’s cities have weathered new economic realities. In Pittsburgh’s neighborhoods, he finds that a new working class has emerged in the wake of deindustrialization.As steelworkers and their families grew older, they required more health care. Even as the industrial economy contracted sharply, the care economy thrived. Hospitals and nursing homes went on hiring sprees. But many care jobs bear little resemblance to the manufacturing work the city lost. Unlike their blue-collar predecessors, home health aides and hospital staff work unpredictable hours for low pay. And the new working class disproportionately comprises women and people of color.Today health care workers are on the front lines of our most pressing crises, yet we have been slow to appreciate that they are the face of our twenty-first-century workforce. The Next Shift offers unique insights into how we got here and what could happen next. If health care employees, along with other essential workers, can translate the increasing recognition of their economic value into political power, they may become a major force in the twenty-first century.
The American working class didn’t disappear with the manufacturing economy. It transformed. Instead of unionized blue-collar men, today’s working class is dominated by underpaid women in service jobs—especially health care. With recognition of this shift, Gabriel Winant argues, may come political clout.