A vast literature has grappled with the causes of deindustrialization in the advanced-capitalist world. Competing readings put the stress on intensifying international competition, gluts of manufacturing capacity, high labour costs or automation. Across the us rustbelt, the growth in service-sector jobs—and above all in healthcare and social-assistance, now the largest census-designated sector of the labour market—has famously mirrored the decline in manufacturing employment. But why, Gabriel Winant asks, should capitalist interests drive the rise of healthcare, renowned for low productivity and returns? In The Next Shift, Winant offers what is in some important respects a novel interpretation. Born in Pennsylvania’s other great city, Winant teaches history at the University of Chicago and is a regular contributor on labour questions to n+1 and Dissent. The Next Shift, his first book, is a granular ethnographic study of Pittsburgh which explores the slow-motion collapse of steelmaking from the mid-1950s on, revealing the processes by which a giant hospital complex replaced the steel mills as the city’s economic motor. The former us Steel Tower still looms over the city, but now the initials upmc blaze from its summit: the University of Pittsburgh Medical Center.

Winant acknowledges that Pittsburgh is an extreme case, with perhaps the largest expansion of healthcare in the country. But precisely for this reason, he argues, it may reveal key trends in the national economy. As early as 1868, the smoke and flames of Pittsburgh’s foundries could see it dubbed, ‘Hell with the lid off’. By the end of the nineteenth century the city had become the world capital of steelmaking, led by Carnegie’s Edgar Thomson Works. Big investment bankers embarked on a spectacular series of mergers to reduce competition, resulting in the formation of us Steel in 1901, with near total dominance in the industry. The dirty and dangerous nature of steel making helped to forge a cohesive working-class community which engaged in a series of bitter struggles for union recognition, from the Homestead dispute of 1892 to the strike wave of 1919. The United Steelworkers of America would emerge from this as one of the most powerful unions in the country.

In its 1937 ruling on collective bargaining, the Supreme Court described the Pennsylvanian steelworks as ‘the heart of a self-contained, highly integrated body’, drawing in raw materials from West Virginia, Michigan or Minnesota, trucking its metal goods out across the country. These heartland northern industrial cities were the core of the New Deal’s mass base, The Next Shift argues. In 1946, a general strike saw tens of thousands of Pittsburgh steelworkers, electrical workers, bus drivers and streetcar operators down tools in solidarity with power-utility employees. But the social struggles that powered the New Deal ‘froze over’ with the Cold War, leaving what Winant describes as a ‘fragile and ambiguous equilibrium’ in class relations as the us stepped onstage as a new world hegemon, overseeing the reconstruction of the defeated Axis powers and drawing up its forces against the Soviet Union. At home, the big-business counter-offensive was launched with the notorious Taft-Hartley Act.

In Pittsburgh, the cio union leadership rallied to the anti-communist witch-hunt orchestrated by Democratic office holders, Catholic priests and the local press. The New Deal was not so much defeated as contained and compromised, Winant writes. Organized labour was no longer ‘the vanguard of a broad-based democratic movement of the working class at large.’ Unions narrowed their interests to collective bargaining, abandoning the project of national health insurance in favour of public-private welfare schemes and accepted without question the stimulus supplied by Cold War military spending that kept the now ageing and ailing steelworks afloat. It was this social compact—offering workers a limited form of ‘social citizenship’, dependent upon being inside the collective-bargaining unit—that would come under pressure with the onset of the long downturn, and which would help to forge a new post-industrial order as the old one was ‘melted and recast’.

As The Next Shift shows, the steel industry’s labour force was always racially stratified, with most skilled and unionized roles reserved for whites. For its members, the uswa secured fringe benefits and wage increases that far outstripped inflation. Yet union militants both ‘cursed and worshipped’ the mill—needing the financial stability it offered but resenting its dangerous and oppressive conditions. Because wage hikes could not be balanced by price rises without setting off an inflationary spiral, steel profits relied on squeezing maximal productivity out of staff. Rather than invest in new technologies, management devised a series of punitive time-management procedures for this purpose, aiming to speed up the existing production process. Workers fought back with a number of wildcat strikes. Surveying these industrial disputes, Winant reflects that ‘it is easy to miss how many workers hated the jobs they defended—a hate that bound workers together and made their defence formidable’. ‘Writ small’, this tension between the supposedly ‘reliable’ human core of the postwar boom and the terrifying nature of the work damaged thousands of lives; ‘writ large, it damned to profound instability the very structure of social citizenship that was organized around industrial labour.’

If the steelworks were a dangerous place, domestic life was expected to compensate. In the private sphere, women were under immense pressure to provide not only the usual drudgeries of cooking, cleaning and shopping, but the care of extended family members who were out of work or too old or injured to return to the mill. ‘Working-class women’, writes Winant, ‘worked to deliver for their families the security they were promised and thus to bring them into alignment with the consensus myth of the times.’ Domestic labour sought to bridge the gap between the fantasy image of the period—‘safe, stable, happy, equal’—and its hard realities. Though it was born in the factory, social citizenship was realized in the family.

Just as women were integral to the ‘social citizenship’ compact, yet excluded from the collective-bargaining regime by which it was constituted, so a similar disparity took root along racial lines. Winant shows that African-Americans were overrepresented in so-called unskilled jobs which lacked collective bargaining rights. As unions won better wages and conditions for their members, a two-tier labour market emerged, separating those with guaranteed forms of security from those without. Black women in particular were driven into precarious domestic employment or the low-wage health-care economy, which grew as funding poured in from steelworkers’ insurance plans. Workers’ benefits, derived from what Winant calls the ‘secure insider zone’ of the industrial economy, were thereby used to import services from an ‘insecure outsider zone’—‘like an unequal trade relationship in which one currency is far stronger than the other.’