It's the ongoing revenge of the Rustbelt, as cities once built upon steel, coal and blue-collar muscle power are now returning to vigor with new businesses and an optimism missing for decades.

In Ohio, the health care industry, led by the expansion-minded Cleveland Clinic, is transforming Cleveland's economic landscape. A couple hours to the east, in Pennsylvania, Pittsburgh, real estate is going through the roof, driven by a spate of entrepreneurial types too young to be held captive by the city's steelmaking past. And in the Wolverine state, Michigan, sales are up, companies are hiring, and the mood is upbeat.

"Small- to mid-sized business owners are experiencing substantial growth and are poised to reinvest in their business and employees in 2016," reports the November 2015 Michigan Future Business Index, published today in partnership with Accident Fund Insurance Company of America and the Michigan Business Network.

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Dan Cook

Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.