In 1990, the manufacturing industry employed more workers than any other sector in 36 states. Today, the picture is totally different: Manufacturing is the dominant industry in only seven states.

What happened? A few recessions, the rise of off-shoring and imports from China and the rest of the world and the explosion of the health-care industry, to begin with. Over the last two decades, employment in the manufacturing sector has plummeted, from nearly 18 million jobs in 1990 to just over 12 million jobs today. (Update: A smart reader points out that the decline in manufacturing jobs is actually more closely tied to automation rather than offshoring. The U.S. is manufacturing more now than it ever has, but much of that work can be done by machines — which don’t require salaries or health care coverage.)

In place of those missing manufacturing jobs, the health-care and social assistance industries have nearly doubled in size, from 9.1 million in 1990 to just over 18 million today, according to the Bureau of Labor Statistics. Today, the health care and social assistance industries are the largest employers in 34 states.

The transition from a manufacturing-dominated economy to a health care-driven economy wasn’t direct. As manufacturing jobs declined in the middle of the 1990s, retail trade jobs took over. By 2003, retail employers were the largest source of jobs in 21 states. Retail jobs were hit hard by the recession; between 2008 and 2009, 13 states went from retail-dominant to health care-dominant.

Here’s how the evolution happened, according to yearly reports compiled for the Bureau of Labor Statistics’ Editor’s Desk blog:

Images and data from the Bureau of Labor Statistics, gif from Reddit user mobuco.