On The Media

The old US Steel building in Pittsburgh, PA is a black monolith, symbol and fortress of industrial power, soaring above the confluence of three mighty rivers. But its vista has changed. Gone is the golden, sulfurous haze. Gone are the belching smokestacks, blazing furnaces and slag-lined river valleys snaking along Appalachian foothills. The industry that sustained a region, girded the world’s infrastructure and underwrote a now-vanished way of life has long since crossed oceans. Steel City is now Healthcare City, representing almost 1 in 4 jobs in the region. Some 92,000 of them work for just one employer, the sprawling, omnivorous University of Pittsburgh Medical Center, whose logo now adorns the black-skyscraper sentinel of the Three Rivers. But this is not just a case of a clean economy displacing a filthy one. To Gabriel Winant, author of The Next Shift: The Fall of Industry and the Rise of Health Care in Rust Belt America, the story of economic transformation in the Rust Belt is the story of disparity —