Kirkus
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A quarter-century on, Gladwell revisits his best-known book and examines some of its assumptions and conclusions. RereadingThe Tipping Point, Gladwell writes, made him realize “that I still do not understand many things about social epidemics.” Thetip point of real estate parlance—it refers to things such as the ethnic composition of a neighborhood when, once a percentage in the growth of racex is reached, members of racey will move up, on, or otherwise out—explains only so much. Often, he writes, “social contagions,” a metaphor used to describe how ideas spread like viruses, can be traced back to just a handful of innovators (or viral superspreaders, for that matter): What matters thereafter is how the ideas (or viral loads) are received and dealt with. For example, why does Illinois have a low rate of opioid abuse relative to Indiana? Because Indiana, like many states, doesn’t require monitoring, which explains why swarms of Big Pharma salespeople descended on those states to push OxyContin and other drugs to epidemic levels. Illinois, by contrast, is one of the states that require triplicate prescriptions: one copy goes to the pharmacist, one to the patient’s records, one to a regulatory agency. That three-tiered pharmaceutical pad, Gladwell writes, “evolves into an overstory,” or governing idea, “a narrative that says opioids are different, spurring the physician to pause and think before prescribing them.” Refining and deepening his and our understanding of the spread of customs, mores, and practices, Gladwell emphasizes those overstories, illustrating them with twisting and turning tales of, for example, how the wordholocaust came into general usage (surprisingly, via TV), how the idea of gay marriage gained acceptability, and how widespread social engineering "has quietly become one of the central activities of the American establishment.” Fans of the original will learn much from Gladwell’s thoughtful, carefully written reconsideration. Copyright © Kirkus Reviews, used with permission.