The Age of Care (Review of Gabriel Winant's "The Next Shift")Historians in the News
tags: economic history, book reviews, urban history, labor history, working class history
A dozen years ago, I visited the Chicago offices of the National Nurses Organizing Committee on the city’s West Side. Visible through a large window was a gigantic parking garage, an annex to one of the equally huge hospitals clustered within a dozen blocks. Cook County, Mount Sinai, and three other medical complexes employed tens of thousands of workers. Among those seeking to organize them was an African American NNOC staffer.
She told me she was the daughter of an autoworker in Flint, Mich., who’d been a militant in his union during the heyday of the battles waged between the United Auto Workers and General Motors. In Flint, she became a radical activist, inspired by the power of the UAW and the moral energy of the civil rights movement, and in time made a career as a union organizer of nurses and other health care workers.
Hearing her story, I was moved by this example of intergenerational working-class militancy, from her father’s activism in a manufacturing sector now in brutal disarray to her own shop-floor organizing in the booming world of metropolitan health care. But what I did not understand was the degree to which these two kinds of employment were dialectically connected, not just in terms of the consciousness of the workers but also as a product of the very same political economy that had decimated Chicago’s steel mills and Michigan’s auto plants. The old industrial unions had bargained not just for higher wages but for pensions and health insurance. As these unions declined, the private welfare states they had done so much to construct became central to the economies of these Rust Belt cities. With money from the federal government, new hospital complexes arose across the Midwest and Northeast, and with them, a new working class filled the economic and social vacuum left by derelict mills and factory towns.
Gabriel Winant charts the rise of this new political economy and working class in his terrific new book, The Next Shift. A study of the decline of steel and the rise of a medical-industrial complex in Pittsburgh, it explains how and why this great social, economic, and moral transformation took place in regions like Western Pennsylvania, where an old world of mid-20th-century steel mills, coal mines, and metal-bending shops was soon replaced by a new one of care work, low wages, racial stratification, and heavily female employment. 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, and it gives an expansive new meaning to the community study, which has long been a staple of labor history.
At 64 stories, the US Steel Tower dominates downtown Pittsburgh. Completed in 1971, the modernist skyscraper once represented the power and hubris of the largest corporation in one of the nation’s largest and most profitable industries—a company that employed more than 100,000 workers in the metropolitan Pittsburgh region alone. But by 2007, US Steel had become, like many of its rivals, a shadow of its former self, and a new enterprise, the University of Pittsburgh Medical Center, was the building’s largest tenant. As the employer of 92,000 health care workers in the region, the UPMC had spent nearly $1 million to place its initials in giant illuminated letters on the building. Looming over the city from all three sides of the tower, the letters symbolized more than just the medical center’s growing dominance over Pittsburgh’s economy; they were also evidence of a profound occupational transformation. The most recent regional census recorded 190,000 health care and social assistance workers, compared with just 30,000 still employed in the metal fabrication industries.