Trump is About to Devastate American Cities
This article originally appeared in the Boston Globe.
The Trump administration has yet to announce an urban policy, but whether it realizes it or not, it has already launched one. And this policy may have devastating effects on American cities.
As the administration slashes federal funding to hospitals and universities, it is not only undermining important medical research, it is striking at the heart of how American cities have reinvented themselves in the postindustrial era.
"Eds and meds" — that is, higher education and health care — have become the economic engine of cities all over the country since World War II. Following the Great Depression, cities in the late 1940s and 1950s faced deteriorated downtowns, little new construction, struggling manufacturing, and the exodus of population, business investment, and retail to their growing suburbs.
Figure 1. Steel and concrete going into place rapidly as a new steel mill takes form, Columbia Steel Co., Geneva, Utah, 1942. The new plant was to make important additions to the vast amount of steel needed for the World War II effort. Photograph by Andreas Feininger. Courtesy U.S. Farm Security Administration - Office of War Information color slides and transparencies collection, Library of Congress (fsac 1a34847 https://hdl.loc.gov/loc.pnp/fsac.1a34847).
But in the postwar boom, the federal government made massive investments in research and development, both intending to catapult the United States into world leadership in science and prepare a much broader population for the kind of white-collar work that was expected to explode with postwar prosperity. The investments allowed both education and health care institutions to expand and contribute significantly to their local and regional economies over the course of the twentieth century. Today, most cities depend heavily on eds and meds for their economic health.
Figure 2. Bethlehem houses and steel mill, Bethlehem, Pennsylvania. Photograph by Walker Evans, 1935. Courtesy U.S. Farm Security Administration - Office of War Information Photograph Collection, Library of Congress (fsa 8c52905 https://hdl.loc.gov/loc.pnp/fsa.8c52905).
Take Pittsburgh, which was the leading producer of American steel until the 1980s. In 1970, nearly forty percent of overall earnings in the Pittsburgh metro area could be attributed to manufacturing. But by 2016 manufacturing amounted to less than nine percent of the area's earnings.
Pittsburgh was fortunate to have wealthy industrialists and bankers with deep roots in the city. Long before the steel mills closed, they had begun to plan for a postindustrial future. But it wasn't until the 1980s that the University of Pittsburgh and Carnegie Mellon established themselves as research hubs in the tech economy, including robotics and biotech - sectors that would come to undergird the new Pittsburgh economy.
Today, the largest portion of the local population works in health care, and the city's world-class medical facilities attract substantial amounts of research funding and generate revenue from patients. The University of Pittsburgh Medical Center is the largest employer in the metropolitan area by far, followed by the rest of the University of Pittsburgh. The Pittsburgh metropolitan area now ranks ninth among U.S. cities in research and development funding; the considerable involvement of universities has also attracted impressive private investment.
Figure 4. Aerial view of Pittsburgh, Pennsylvania, with the Allegheny River on the right and the Monongahela River, just out of the photo to the left. They come together downtown at what's called The Point and become the Ohio River. Photograph by Carol M. Highsmith, 2019. Courtesy of Carol M. Highsmith Archive, Library of Congress (highsm 58520 https://hdl.loc.gov/loc.pnp/highsm.58520).
A city does not have to be as large and economically robust as Pittsburgh to depend on eds and meds for survival.
Youngstown, Ohio, is sixty-seven miles west of Pittsburgh and was the nation's third-largest steel producer until Black Monday, September 19, 1977, when five thousand steelworkers suddenly found themselves unemployed. By the mid-1980s, the closing of all the major steel mills in Youngstown resulted in 50,000 workers losing jobs in steel and related industries.
Today, Youngstown is roughly a third the size it was at its peak, in 1940. No longer "Steeltown, USA," it substantially depends for its economic viability on the activity generated by Youngstown State University, the largest employer in the city; St. Elizabeth Youngstown Hospital; and the Mercy Health System.
Figure 5. Rusted steel-mill remnants and trains in Mahoning County, Ohio, along a stretch of abandoned mills that once bustled with activity beside the Mahoning River between Youngstown and Struthers. Photograph by Carol M. Highsmith, 2019. Courtesy of Carol M. Highsmith Archive, Library of Congress (highsm 41708 //hdl.loc.gov/loc.pnp/highsm.41708).
It is not only cities that were once major industrial powerhouses that will be affected by a retrenchment in federal support. Look at Boston and Nashville.
Boston has flourished in recent decades as home to major medical centers and hothouses for biotech tied to its prominent universities: Harvard, MIT, Tufts, Boston University, Boston College, and Northeastern, among others. Greater Boston has ranked first across the nation in life science and biomedical research since 2012, a success inextricably linked to the prominence of its universities' faculty and research activities. Boston's dozens of institutions of higher education also attract nearly 140,000 students to the city every year, many of whom remain in Boston after graduation.
Mass General Brigham — the largest hospital-based research enterprise in the United States — is the biggest employer in Boston. Similarly, in Nashville, Vanderbilt University and the Vanderbilt University Medical Center provide the greatest number of jobs. This large footprint has attracted many other health care companies, including the corporate headquarters for a major for-profit medical operator, HCA Healthcare. In 2022, Nashville's health care hub directly employed more than 170,000 people and almost twice that indirectly, and it generated billions of dollars in state and local taxes.
Figure 6. A steel statue of a penguin welcomes visitors to Youngstown State University in Youngstown, Ohio. Photograph by Carol M. Highsmith, 2019. Courtesy of Carol M. Highsmith Archive, Library of Congress (highsm 41456 //hdl.loc.gov/loc.pnp/highsm.41456).
The list of cities that may be affected by the Trump administration's withdrawal of financial support for medical and educational services and research is long. It's important to note that the cities cited here range from the purple state of Pennsylvania to the red states of Ohio and Tennessee to deep blue Massachusetts. Higher education and health care have become the lifeblood of American cities in the twenty-first century, and we undermine them at our peril.
Despite the hype around entrepreneurial initiative, it was federal dollars that built Silicon Valley into the world's nucleus of big tech. Today, our cities that nourish eds and meds, and are nourished by them in return, require no less.
Citation
Lizabeth Cohen, “Trump is About to Devastate American Cities,” PLATFORM, June 9, 2025.
