Over the last several decades, manufacturing jobs in the U.S. have withered. Meanwhile, health care has become the fastest growing job sector in the country, and it’s been on top for years. According to Gabriel Winant, a historian at the University of Chicago, and author of The Next Shift: The Fall of Industry and the Rise of Health Care in Rust Belt America, not only are those two opposing trends related, but there are also some serious consequences to the connection.
- The link between the growth in health care jobs and the shrinkage in manufacturing comes down to a specific way that people in the Rust Belt are aging. The sweeping plant closures in places like Pittsburgh in the 1980s created an entire population of displaced workers. Health conditions associated with the stress of unemployment often caused serious health issues, including a higher mortality rate among those who had been laid off. That all culminated in a huge need for health care workers; so as factories shut down, doctors, nurses, nursing home workers, janitors, and more got to work.
- Health care now dominates the job market, but Winant calls the industry “invisible.” When politicians speak about job creation and economic revitalization, they are commonly referring to manufacturing, rather than the real economic leader in jobs. Despite their huge share in the economy, many health care and hospital workers, from RNs to janitorial staff, have seen wages, benefits, and working conditions stagnate.
- Hospitals have a huge amount of power in the cities that rely on them, which has given them the ability to grow and merge, thereby becoming massive institutions. These hospitals also run on both public and private money, which Winant says has led to a fragmentation of responsibility — not a good thing when you’re looking to do a massive vaccine rollout.