Revenge of the Tipping Point: Overstories, Superspreaders, and the Rise of Social Engineering

by Malcolm Gladwell

describe the internal workings of social contagions: the Law of the Few, the Power of Context, the Stickiness Factor.

an attempt to do a forensic investigation of social epidemics.

That’s the revenge of the Tipping Point: The very same tools we use to build a better world can also be used against us.

Social epidemics are propelled by the efforts of an exceptional few—

In epidemiology there is a term called the “index case,” which refers to the person who kicks off an epidemic. (We’re

do with where your doctor was trained, or how well he or she did in medical school, or what kind of personality your doctor has, than with where your doctor lives. Why does place matter

What he found instead were medical clusters, where the doctors in one hospital district took on a common identity, as if they had all been infected by the same contagious idea.

Parents who vaccinate their children are people who agree to defer to the expertise of the medical community. Can I tell you precisely how a vaccine works and what happens to my children’s immune systems when they are given a shot? No.

The overstory is made up of things way up in the air, in many cases outside our awareness. We tend to forget about the overstory because we’re so focused on the life going on in front of and around us. But overstories turn out to be really, really powerful.

The overstory is specific. It is tied to a place. It is powerful. It shapes behavior. And it does not emerge out of nowhere. It happens for a reason.

Willy Delgado said that under oath in federal court in February 2019. In December 2020, Philip Esformes had his sentence commuted by Donald Trump.4

Epidemics love monocultures. 4.

A monoculture, on the other hand, offers no internal defenses against an outside threat. Once the infection is inside the walls, there is nothing to stop it. Richard, the real-estate agent who knew Poplar

But in the next few chapters I want to explore the ways in which tipping points can be deliberately engineered.

But slowly doors have opened to women, and a body of research shows that having women on a board makes the board different.

I think we can go one step further. I think we can call the Magic Third a universal law. (Or at least something very close to universal.) One of the best pieces of evidence for this comes from the work of Damon Centola, who teaches at the University of Pennsylvania. Centola was one of the many scholars inspired by Kanter’s call to “investigate” tipping points.

The majority’s consensus fell apart when the number of outsiders reached 25 percent.

where the percentage of minority students exceeded 25 percent, they found the test-score gap completely vanished.4 The white students did as well as they always did. But now the black students had caught up.

ALDCs—that is, Athletes, Legacies (children of alumni), Dean’s Interest List (children of rich people), and Children of faculty.

If we are to protect the integrity of our institutions, we need to be made aware of the games being played below the surface. And exhibit A? Harvard University.

By 2013, it was at 42.5 percent. Today it’s closer to 45 percent.

So, why did Harvard go to all the trouble of adding a women’s rugby team? It’s obvious. Varsity sports are a mechanism by which Harvard maintains its group proportions.

What’s special about really good tennis players is that the only way to be a really good tennis player is to come from a wealthy family and live near a country club and have at least one parent with sufficient time on their hands to drive you all over the country for tournaments and handle the acquisition and management of the small army of coaches, trainers, physical therapists, and tutors you need to be successful.2

If you don’t think that social engineering has quietly become one of the central activities of the American establishment, you haven’t been paying attention.

Airborne viruses do not operate according to the Law of the Few. They operate according to the Law of the Very, Very, Very Few.

That’s why being dehydrated makes you more vulnerable to colds and the flu and COVID:

biggest predictors of high production of aerosols were age and body-mass index (BMI).

The older you get, the more dehydrated you tend to be. The more body mass you have, the more dehydrated you tend to be. And when you become infected [with COVID-19], you often become dehydrated. And so it turns out that the common denominator in these three groups of people is a dehydration issue.

Predicting or identifying people who might be high virus emitters, perhaps even before they are infected, is of interest because they could be prioritized for interventions to block transmission.

What does it take to change a zeitgeist overstory? Can a story on that scale be rewritten and reimagined, in a manner that changes the way those below think and feel? I believe the answer is

Least Objectionable Programming theory, or LOP, which held that a television show’s success was a function of how few people it offended.

106 million viewers. That was over 45 percent of the American public. If you walked anywhere in the United States during primetime on February 28, 1983, when the final M*A*S*H episode, “Goodnight, Farewell and Amen,” aired, the streets would have been empty.6 That’s power.

It aired for four consecutive nights, starting on April 16, 1978, and 120 million people—half the country—tuned in.

We miss the signs of change because we are looking

for them in the wrong places.

And of course, in our society, like virtually every other, it’s marriage. So then I decided that by fighting for marriage, by claiming marriage, we would be making the most powerful possible statement that we are equal and central and worthy.

you couldn’t look exclusively at the results of elections, or legal verdicts, or public-opinion polls. All those things were useful, in their own way. But they didn’t get at the heart of the matter. You had to look and see if the rules of the overstory were changing.

And his answer was, It doesn’t take a lot. Once 25 percent of the members of any group start pushing for a new name, the rest of the group quickly folds its cards and goes along.

Jessica Ho’s chart tells us that the opioid crisis is not really an international problem. It’s fundamentally an American problem.

“I find that non-triplicate states at the time of OxyContin’s introduction experienced a relative rise in both property (12%) and violent (25%) crimes compared to states with the triplicate prescription policy (triplicate states).” In their analyses, economists are used to seeing differences of 1 or 2 percent. 25 percent is unheard of. “That’s an absolutely huge impact,” Sim continued. “Honestly, when I first got this result, I didn’t really believe [it] myself.” Wherever he

All told, from 2006 to 2015, Rhodes prescribed 319,560 tablets of OxyContin.

Once the opioid epidemic was off and running, the epidemiologist Mathew Kiang calculated, the top 1 percent of doctors “accounted for 49 percent of all opioid doses.”

an epidemic doesn’t need a lot of recruits. It just needs a single superspreader, armed with some rare physiological properties, to stand at the front of a room. The lesson of the opioid crisis is exactly the same. And do you see how vulnerable it made us? The majority of doctors—the overwhelming majority of doctors—treated opioid painkillers such as OxyContin with appropriate caution. The medical community as a whole behaved admirably. They were thoughtful. They looked at the evidence. They heeded the wisdom of the Hippocratic Oath: First do no harm. But that was not enough to prevent us from the worst overdose crisis in history. Why? Because a tiny fraction of doctors was not so thoughtful.

A prescription-drug epidemic is powered by a company operating within the law, answerable to shareholders, and regulated by a government agency. The prescribers are medical professionals. Every transaction between company and physician, and every transaction between physician and patient, is recorded.

Prescription-drug deaths—the least of the three evils—go up slightly over the next decade. But the number of fatal overdoses from heroin go up 350 percent by 2017. And the number of people killed by fentanyl goes up 22-fold, from what is basically a rounding error to a problem that dwarfs every previous opioid crisis in history.

opioid problem is now so bad that the early days of the epidemic—when it was all just OxyContin—look positively bucolic by comparison. We would have been better off had we said no to Purdue’s reformulation in 2010 and kept things the way they were.

By the early 2020s, the opioid epidemic that had begun back in 1996 with the introduction of OxyContin was claiming the lives of almost 80,000 Americans a year.

That is very hard to accept. But so is the story that we tell ourselves that we bear no responsibility for the epidemics that surround us—that they come out of nowhere, that they should always surprise

They are driven by a number of people, and those people can be identified. The tools necessary to control an epidemic are sitting on the table, right in front of us. We can let the unscrupulous take them.

Or we can pick them up ourselves, and use them to build a better world.