Health care has become America's most reliable job engine, adding 693,000 positions last year while the rest of the economy contracted by 570,000 jobs. The sector's growth stands in stark contrast to sluggish hiring elsewhere, with medical and social assistance jobs offering signing bonuses and advancement opportunities that are rare in other industries.

This expansion reflects both catch-up hiring from pandemic burnout and demographic shifts as baby boomers age. Health care now represents nearly 15 percent of total employment, up from 8.3 percent in 1990. The industry's dominance grows during recessions because people still need medical care regardless of economic conditions.

Beyond major cities, health care anchors entire communities. In Montour County, Pennsylvania, over half the workforce is employed by Geisinger Health, while Morgantown, West Virginia, absorbed a 1,500-worker pharmaceutical shutdown when WVU Medicine took over the facility. Las Vegas invested in health care during the 2009 recession, and the sector has grown 56 percent since 2015.