In the city of Baltimore, there was a syphilis epidemic in the mid-90s. For decades, a couple people got syphilis every year—but something happened in the 90s that caused hundreds of people to get the disease. Many researchers blame the epidemic on the city’s crack cocaine problems—because of people’s drug addictions, they were more likely to go to impoverished parts of the city to buy drugs, during which time they might contract the disease in various ways. Another theory for the epidemic is that medical services in Baltimore declined in the 90s—there were fewer doctors per person in the 90s than in almost any earlier decade, suggesting that doctors failed to address the syphilis problem before it became an epidemic. Finally, some theorists argue that the epidemic started because of the destruction of a set of housing projects. People who lived in the projects moved to different parts of Baltimore, spreading syphilis with them.
The chapter begins with another description of a sudden, unexpected social epidemic. In this case, the phenomenon was a literal epidemic: a sudden increase in syphilis, a serious venereal disease, in the city of Baltimore. Interestingly, there are at least three major explanations for why syphilis cases shot up in Baltimore. No single one of these three explanations can completely explain the phenomenon, but—as Gladwell will show—the three explanations put together reflect three different elements of any “successful” social epidemic.
The three explanations for the syphilis epidemic all propose that there was a subtle change in life in Baltimore—a small, steady decline in doctors, the destruction of a couple projects, etc. But the three explanations also show that there are at least three different ways to “frame” an epidemic: in terms of environment (explanation one); in terms of the disease itself (explanation two) and in terms of people who have the disease (explanation three). To generalize: every “Tipping Point” is caused when there is a change in a) the “infectious agent” (the idea, behavior, product, or message being spread), b) the environment, or c) the people who transmit the infectious agent.
Contrary to intuition, social epidemics aren’t necessarily triggered by major, overt changes of any kind. Rather, Gladwell argues that social epidemics tend to be triggered by very small, almost invisible changes in the status quo. These changes fall into three main categories: changes in the product, idea, or “infectious agent” being spread; changes in the people who spread it; changes in environment or “context.” As we’ll see, these three categories define the structure of The Tipping Point.
Gladwell proposes three laws for studying Tipping Points. The first is called the Law of the Few. It’s an accepted idea in economics that often, the majority of work will be done by a minority of people, no matter what the work is. In epidemics, the “work” of spreading an infectious agent is in the hands of a particularly small group. In a study of a gonorrhea epidemic in Colorado, it was discovered that 168 people, out of the tens of thousands who’d contracted the disease, had infected the vast majority of gonorrhea patients in Colorado. These 168 people had staggering numbers of sexual partners, went out every night, and were generally unlike the average adult. Yet they had a huge influence on Colorado. Gaetan Dugas, often called “Patient Zero” for the North American AIDS epidemic (i.e., the first person known to have AIDS) had sex with more than 2,500 people—had it not been for Dugas, it’s entirely possible that AIDS would not have “tipped” to become an epidemic at all. Whether in social epidemics or viral epidemics, a small group of people plays a disproportionally large part in starting a trend—hence the Law of the Few.
The following chapter of the book will concern the Law of the Few; the principle that a few disproportionately influential individuals have a large role in social epidemics of all kinds. To illustrate his point briefly, Gladwell again brings up literal epidemics. The passage is a good example of Gladwell’s dispassionate, analytical approach to studying tipping points: Gladwell doesn’t seem to be passing strong moral judgments on the people who spread gonorrhea and AIDS. At the same time, the passage is a good example of why The Tipping Point angered some readers. Certain critics faulted Gladwell for seeming to “blame” Dugas for the AIDS crisis, arguing that Gladwell was scapegoating, or even demonizing, the homosexual community. (It’s also worth noting that Dugas’s role as “Patient Zero” has since been largely disproven.)
The second law is the Law of Stickiness. Sometimes, disease epidemics begin because of sudden changes in the deadliness of the disease. The Spanish flu epidemic of 1917, which killed millions of people, began because the influenza virus itself became more deadly, not because of any new patterns in how the disease spread. Similarly, the HIV epidemic of the 1980s emerged not because people were behaving very differently from how they’d behaved in the 70s, but because the HIV virus itself became significantly more lethal. What’s true of viruses is true of ideas as well—the idea itself has to be memorable in order for there to be a social epidemic. Advertisers spend millions of dollars ensuring that slogans and brand names are as catchy as possible—if not, people will never remember the brand in the first place, and therefore won’t spread it to other people. Gladwell calls this principle the Stickiness Factor—the memorability or reproducibility of an idea, product, or behavior.
Gladwell illustrates the second rule of social epidemics by citing the Spanish flu epidemic of the early 20th century, an epidemic that killed millions of people because of the “success” of the mutated influenza virus. In this section, the juxtaposition of a discussion of the Spanish flu and advertising techniques is disorienting and even shocking—but Gladwell’s purpose is to describe social epidemics of all kinds. While an ad campaign and an outbreak of the flu seem to have very little in common, the book will demonstrate that they obey the same underlying rules.
The third law is the Law of Context. During the famous Kitty Genovese incident in New York City, 38 people watched and did nothing while Kitty Genovese, a young woman, was raped and killed on the street. This incident was so infamous that Genovese has become a symbol for the “bystander problem,” the problem whereby, when an individual is in danger, a large crowd will remain inactive. Sociologists have argued that the 38 people did nothing to help a woman in danger because, as big city dwellers, they were used to ignoring thousands of people every day—beggars, solicitors, salesmen, etc. Others have pointed out that individual people will usually help other individuals—but a large crowd will often hesitate to help an individual, since people will assume that “someone else” will solve the problem. So the third law, the Law of Context, says that people often change their behavior because of environmental factors, such as the size of a crowd, the density of a city, etc. Armed with his three laws—the Law of the Few, the Stickiness Factor, and the Power of Context—Gladwell will try to understand why and how Tipping Points occur.
The third law of social epidemics implies that it’s not enough to analyze epidemics in terms of individual people, or in terms of the infectious agent being spread. Even with a strong infectious agent and lots of people available to spread it, an idea or product will not “tip” into a trend unless it exists in the proper environment; an environment that is conducive to the trend’s success. As the Kitty Genovese incident would suggest, “human nature” is an insufficient explanation for social phenomena. Humans behave differently in different environments, regardless of their underlying “nature.” Altogether, Gladwell’s three laws suggest a balanced approach to sociological analysis. Neither individuals nor environments nor infectious agents by themselves can cause a trend to “tip”—only a combination of all three factors can do so.