When industrial employment dominated the nation’s economy, such worlds were formed around the lives of the industrial working class. And when industry left, the social worlds that it sustained began to crumble. What emerged in its place was a recomposition not only the economy, but of the working class itself. As Winant writes, “the collapse of the industrial core of the economy created social problems that became translated, through the mediation of the welfare state, into the form of health problems.” What replaced industry was a vast apparatus of health and social care to treat these now elderly and sick populations, and, in turn, new forms of working-class employment as nurses, carers, and the vast army of support workers that the old and poor required.

“It was not a coincidence that care labor grew as industrial employment declined,” Winant writes. “The processes were interwoven.” Industrial employment brutalized its workers, leaving them with hacking lungs and damaged bodies. Incidence of industrial disease was high, and its effects long lasting. Yet if such work was difficult, then it also made workers heroic. The masculine image of the working class was formed in the crucible of the working day. Once that day was over, many took to alcohol to wash away the harsh reality of their working lives. The social consequences of such a system run deep, and their effects linger.

However punishing the work, it was also relatively well rewarded. Thanks to the struggles of organized labor, these industrial jobs gained some measure of dignity and decent wages, as well as earning workers the right to employer-funded health insurance. The union-won family wage made single-earner households common, although as Winant points out, not ubiquitous and rarer for Black workers, particularly outside of Pittsburgh. Still, the role of such households was crucial to postwar society, enabling the social reproduction of the workers and their family, “holding in alignment the formal economy and the rhythms of the family members’ lives.” In such a world, social problems were in effect privately borne by the family and the community.

When the industries began to decline, the conditions of the post-war boom were remolded into today’s low-wage, low-productivity service economy. Many industrial workers retained access to health care long after they lost their jobs, either through retirement benefits, state medical assistance, or short-term emergency insurance programs. The people left behind may have been older, sicker, and unemployed, but they were still in some way covered. As pressure on families grew, women were increasingly forced into the labor market, and often into the now-booming care sector as nurses, carers, or nurses’ aides, thus reducing the amount of time they had for the kind of unpaid care work that had kept the post-war family afloat.

Read more in The Baffler.