Skill and Earnings in the Healthcare Sector: Evidence From Rustbelt and Sunbelt Cities

The Rustbelt-Sunbelt regional divide has captured economic geographers’ imagination since the 1980s. Sunbelt cities have been held up as a model of openness, highly attractive to the mobile and skilled. Yet Rustbelt cities are not unattractive to skilled workers though it is unclear which skills may be driving urban vitality through higher earnings. This paper examines the effect of cognitive, social and communication skills on individual earnings in cities of the Rustbelt and Sunbelt. Focusing on healthcare occupations, it finds that cognitive skill positively influences earnings. Conversely, social and communication skills are not likely to result in income payoffs. Returns to earnings in the Rustbelt and Sunbelt are comparable, and may explain why cities in the former region can remain attractive to healthcare professionals with cognitive skill.