Tipping Towards Success

Charles Royer
September 1, 1998

There is no actual evidence that Sisyphus, that famed figure of Greek mythology, was a youth worker. But youth workers can be forgiven for sometimes feeling as he did when the giant stone that he pushed up the hill kept rolling back down.

People who have put in some years in youth development know what I’m talking about: you push and push to improve conditions for youth, but you repeatedly find yourself at the bottom of the hill pushing all over again. You learn, you grow, you try new methods. It’s frustrating, hard, repetitive work.

And you wonder: how much more will it take to roll this stone over the top, to measurably improve the health and safety of children?

The good news is that it may take less than we think, as Malcolm Gladwell argued in his compelling article, “The Tipping Point,” in the June 1, 1996, edition of The New Yorker. Gladwell attempts to explain the dramatic drop in crime and violence in New York City (and almost every other big city) by borrowing from medicine the theory of epidemics and applying it to human behavior. Some social scientists have begun to use epidemics theory to find what epidemiologists call “the tipping point”: the point at which even modest interventions can make a major difference in the progression of disease.

As the former mayor of Seattle, I know the theory best in how it applies to the deterioration of neighborhoods: graffiti left on a building, broken windows, a front lawn littered and gone to seed. Ignore these “little things” and at some point — some tipping point — you get big problems. Fix them, little by little, and at some point — some tipping point — you find that you have moved the needle back. The lesson from medicine and from neighborhoods is that turning around extraordinary problems may be well within the power of ordinary people doing ordinary things.

But where is the tipping point? What will it take to get there?

According to Gladwell, epidemiologists say there is no relationship between improvement — say, reduction in the size of an epidemic — and the effort you expend — say, reducing the number of new cases. For example, reduce by extraordinary effort the number of new AIDS cases by half, and you still don’t get a 50 percent decrease in the AIDS epidemic. In fact, the epidemic would still grow. You haven’t reached the threshold, or the tipping point. But get another 10,000 or 15,000 fewer cases and you may get an enormous drop in the epidemic, out of proportion to that relatively small, added effort.

This explanation should not be used to justify the “Theory of Wishful Thinking” or the “Theory of Sustained Funding”: just give me a few more dollars and a little more time and I will get there. That’s not the way the epidemiologists approach the attack on a disease. They are focused. They are strategic. They know their numbers. They know they must be persistent, and that the work will be repetitive and frustrating.

Crime, once at epidemic proportions in New York City, is down dramatically because police and citizens devoted attention to little things. These include graffiti, truancy, petty crimes, even jaywalking.

If teenage pregnancy, school dropout rates, and violence are contagious like infectious diseases, or if they have the same debilitating effects on neighborhoods as do broken windows and graffiti, then they should have, like other kinds of epidemics, their own tipping points.

To find that point where change occurs, we need the epidemiologist’s focus, the discipline, the best science and numbers, and most of all, the sustained attention to little things. What will it take? It will take time. It will take unwavering effort. It will take the work of individuals, institutions, and communities, some of whom have not been involved before.

But all the evidence says it will work.

Charles Royer is director of the Robert Wood Johnson Foundation’s Urban Health Initiative at the University of Washington in Seattle.

Royer, Charles. "Tipping Towards Success."Youth Today, September 1998, p. 58.

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