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

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.

Table of Contents:
Cover Title Page Copyright Dedication Epigraph Contents Introduction: When Workers Disappear 1. Down in the Hole: Steelmaking Pittsburgh in the 1950s 2. Dirty Laundry: Labor and Love in the Working-Class Home 3. “You Are Only Poor If You Have No One to Turn To”: Race, Geography, and Cooperation 4. Doctor New Deal: Social Rights and the Making of the Health Care Market 5. Enduring Disaster: The Recycling of the Working Class 6. “The Task of Survival”: The Commodification of Care and the Transformation of Labor Epilogue List of In-Text Abbreviations List of Bibliographical Abbreviations Notes Acknowledgments Index

Review :
The replacement of blue-collar work by pink-collar work has been much discussed, but what makes this book stand out is Winant's argument that two seemingly distinct phenomena are in fact inextricably connected...An original work of serious scholarship, but it's also vivid and readable...[An] eye-opening book. -- Jennifer Szalai New York Times A deeply upsetting book. It meticulously charts the transformation of the working class to show how the destruction of workers' unions and bodies occurred in a feedback loop, with capitalist exploitation demanding care, demanding more exploitation, demanding still more care. The demolition of state support and state protections served to speed up this feedback loop. It has long since spun out of control...Winant ably blends social and political history with conventional labor history to construct a remarkably comprehensive narrative with clear contemporary implications. -- Scott W. Stern New Republic Winant charts the rise of this new political economy and working class in his terrific new book...Offering fine-grained details of shop-floor industrial relations, the book is at once an ethnographic probe into the lives of working-class families and a comprehensive analysis of the larger dynamics of the US political economy...A useful guide to the sweeping social changes that have shaped a huge segment of the economy and created the dystopian world of contemporary service-sector work. -- Nelson Lichtenstein The Nation How the health-care industry replaced manufacturing while downgrading the quality of American middle-class life, furthering inequality, and fueling political bitter divisions is the welcome subject of Gabriel Winant's The Next Shift...Winant weaves together a convincing argument that this downward mobility has been driven by a gendered and racist political economy that values many things--from retiree health care to CEO pay--more than care work by women and people of color...Many health-care workers on the bottom rungs now find themselves, in some ways, back where industrial workers started in the nineteenth century...[An] important book. -- John W. Miller Democracy Digs deep into the stories of working people, tracing the rise and fall of two industries that, despite vast differences on the surface, have been intertwined for decades. Through stories of real people's real lives, Winant explores the move from manufacturing to care, tracing the rise of a new working class--one that looks very different from the stereotypical blue-collar worker of the Rust Belt's mythic past...A road map for how to think about the changing working class. -- Sarah Jaffe Bookforum Charts how Pittsburgh's declining steel industry gave rise to one of the country's most ruthlessly corporatized health care systems, and how the ability of each to deliver on its romanticized promises rested on the exploitation of care work. -- Natalie Shure Jacobin Winant explains in fascinating detail how Pittsburgh's working class adapted to the post-steel economy...[O]ffers a highly intelligent case study of the transformation of one key section of the working class since 1950--a vital precondition for mapping its future. -- Tom Mertes New Left Review Essential reading for anyone interested in Pittsburgh history, the labor movement or the economics of our health care system. It helps us to make sense of the region and the economy we inhabit today. -- Kate Giammarise Pittsburgh Post-Gazette The definitive account of the causes and consequences of the decline of heavy industry and the birth of the medical-industrial complex. Winant dives deeply into Pittsburgh's economic, social and cultural history to illuminate the linkages between the rise and fall of steel and the spectacular growth of health care...Essential reading for anyone wanting to understand our modern health-care industry's historical and economic foundations. -- Joshua Kim Inside Higher Ed An exquisite regional economic history, The Next Shift illustrates how health care became a primary mechanism of social reproduction--allowing the American state to govern the economic and sociological consequences of deindustrialization...Offers powerful lessons for scholars of health policy and politics. -- Philip Rocco Journal of Health Politics, Policy and Law [An] exhaustive examination of the shifting economies of the American Rust Belt...A fascinating look at labor history and the continuing struggles of blue-collar workers, particularly in light of the pandemic and the increased burden, both personally and politically, placed on health care workers. -- Pittsburgh Magazine A thorough understanding of the political economy of the post-war United States inflected through the lenses of race, gender and class. It is a masterful book that weaves together two seemingly disparate strands--the demise of heavy industry and the rise of care work--into a single thread that traces the story of a broken society. -- Ryne Clos Spectrum Culture Winant explores in his informative debut the rise and fall of Pittsburgh's steel industry as a microcosm of America's shift from an industrial to a service economy. -- Publishers Weekly Beautifully written, extensively researched, and sharply argued, The Next Shift offers a new way to think about the transformations often grouped together under the rubric of 'neoliberalism.' Winant sees deindustrialization not simply as a story of decline, but a story of the rise of a new kind of working class. -- Kimberly Phillips-Fein, author of Fear City: New York's Fiscal Crisis and the Rise of Austerity Politics A sophisticated, politically pointed, and beautiful crafted book, The Next Shift chronicles both the erosion of the white male industrial working class and the ascendance of a service sector run by the labor of white women and men and women of color. But unlike most stories of industrial decline, Winant's history bristles with hope for activism for the new world of work that has emerged. -- Eileen Boris, author of Making the Woman Worker: Precarious Labor and the Fight for Global Standards, 1919-2019 In this nuanced and powerful book, Gabriel Winant connects the slow-motion devastation of deindustrialization to the perverse political economy of care as the twin fruit of America's compromised social bargain. Through the rusting of 'Steel City, USA, ' Winant makes tragically concrete the ways that industrial job loss was transformed into a profit-driven market for health care--ensuring that caregivers can never afford the services they provide, and that the social exclusion on which the welfare state was built will swallow up ever greater majorities. -- Bethany Moreton, author of To Serve God and Wal-Mart: The Making of Christian Free Enterprise One of the most timely books of our era. The global pandemic has turned care workers into heroes while concealing the history that rendered them undervalued, underpaid, and precarious long before COVID struck. Winant recovers this history, revealing how the growth of the care industry was a consequence of, and response to, the decline of the industrial sector, and suggesting that the very laborers tasked with keeping the rest of the working class from an early grave may prove to be capitalism's proverbial gravediggers. -- Robin D. G. Kelley, author of Freedom Dreams: The Black Radical Imagination How and why has the healthcare sector taken over formerly industrial cities? Why are care work jobs so important yet so undervalued? In one of the most important works of labor, economic, and policy history to appear in years, Gabriel Winant compellingly answers these questions. This is an essential book for understanding the healthcare system, its weaknesses, and the policies necessary to create a system that is equitable for both workers and patients. -- Thomas J. Sugrue, author of The Origins of the Urban Crisis: Race and Inequality in Postwar Detroit