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 — of wealth, income and political power — that didn't vanish when the smokestacks came down. 

In this special hour, Winant tells Bob the real story behind the economic transformation that took place in the rust belt, and what it tells us about our economy, and our future, more broadly.

Music from this week's show:

Flugufrelsarinn — Kronos QuartetSteel Mill Blues — Joe GlazerLiquid Spear Waltz — Michael AndrewsSacred Oracle — John Zorn (feat. Bill Frisell, Carol Emanuel & Kenny Wollesen)Human Nature — Vijay IyerPittsburgh—Joe Glazer