In 2002, the Canadian Institute for Advanced Research convened a group of social scientists to help define and explain societal success. In short, why are some societies more “successful” than others? The group responded with two central conclusions: that population health is the best available metric for success, and that institutions and culture provide potentially powerful accounts of variation across time and space. The product of this investment is an agenda-setting edited volume containing an introductory overview by editors Peter Hall and Michèle Lamont and 10 substantive chapters by an interdisciplinary team of social scientists.

The volume makes clear that the systematic study of population health is ripe for more thoroughgoing social scientific analysis, as the relative health of societies is the product of a wide-ranging set of social, political, and economic factors. The authors launch their investigations from the well-established notion of the socioeconomic gradient of health (discussed in Chapter 1 by Clyde Hertzman and Arjumand Siddiqi, and Chapter 2 by Daniel Keating). On the one hand, it has been almost universally true, across societies and over time, that increases in income and wealth are correlated with better health, generating the conclusion that “wealthier is healthier.” On the other hand, it is also clear that the steepness of the gradient varies across countries, across time, and for reasons other than differences in economic resources or per capita income. The authors set out to identify the noneconomic factors that set populations, not just individuals, on these divergent paths.

Along these lines, a great strength of the book is its presentation of a series of concrete, substantively important, and theoretically challenging puzzles: Why, following the collapse of the Soviet Union, did the health of Russians decline, while that of Czechs improved? Why do Canadians live longer than Americans? Why did a wealthier population with an arguably more effective state in Botswana not manage to reduce HIV prevalence to the same extent as in Uganda?

While acknowledging the importance of economic resources, the authors highlight that other answers are clearly needed, and they attempt to tease out the effects of institutions and culture. For the most part, the notion of institutions employed in the book relates more to informal and social institutions. Moreover, the book reflects a theoretical orientation toward a sociological institutionalism that privileges motivations of meaning, status, and social connection, rather than an economic institutionalism that might highlight individually oriented motivations of material advance. The authors consider a range of mechanisms, including state policies, societal compliance with such policies, and actual physiological responses to psychosocial variables such as stress and anxiety, that ultimately affect population health. They deliver an answer that resonates with Hall and Lamont's overview—that health is affected by the “wear and tear of daily life,” which in turn, “depends crucially on the balance between the magnitude of the life challenges facing a person and his or her capabilities for responding to such challenges” (p. 6).

Of course, this still draws questions about the origins of individual and especially collective capabilities to meet such challenges, and the focus throughout is on widening the notion of capabilities to ideational and social resources. For example, while others have highlighted the importance of social networks in explanations of population health, the editors argue that they move beyond the simple notion that social networks or social capital are just about reciprocity. Instead, networks also create meaning: moral visions, identities, symbols, and historical narratives, which have direct and indirect effects on population health (p. 10).

In what amounts to something of a second theoretical chapter, Hall and Rosemary Taylor (Chapter 3 on “Health, Social Relations, and Public Policy”) emphasize the relevance of Emile Durkheim's notions of social connectedness as a key determinant of human development. And building on the more relational ideas of Marx, and especially of Weber, these authors trace the impact of unequal social relations on ill health, highlighting mechanisms of anxiety, frustration, and resentment. They draw on evidence and scientific debates, summarized in Chapter 2, concerning the functioning of the stress-response system through the limbic hypothalamic-pituitary adrenal axis (pp. 73–74). Drawing on the results of a set of other studies, they conclude that public policies can shape the very social relations that, in turn, influence population health.

Throughout the volume, slow-moving social structures emerge as central determinants of population health, but there is ample consideration of the effects of mobilized political actors. For example, Peter Evans (Chapter 4 on “Population Health and Development”) argues that societal support for public health initiatives is an important determinant of improvements in public health, highlighting the need for a mobilized engagement on the part of civil society to advance the enactment and implementation of key policies (p. 110).

Whereas much of Evans's work focuses on the centrality of state policies as determinants of population health outcomes, Ann Swidler's contribution (Chapter 5 on “Responding to AIDS in Sub-Saharan Africa”) points out that in many cases, citizens must actively comply with such policies and programs. Ultimately, for a sexually transmitted infectious disease such as HIV, behavior change is necessary before we can observe an identifiable impact on disease prevalence. In trying to account for the reasons that some societies are more successful in this regard, she relates the idea of “cultural match.” The point here is that putting technically correct policies in place is not enough. In order to mobilize communities, as she describes was the case in the Ugandan AIDS epidemic, political strategies must align with social structures and resonate with preexisting cultural schemas.

Several chapters detail investigations of how identity-based variables such as stigma and notions of citizenship may influence population health. Lamont generates a set of hypotheses concerning the health effects of destigmatization strategies employed by low-status minority groups. Gérard Bouchard refers to the notion of collective imaginaries, or myths, that precede perceptions, motivations, and identity formation, which in turn affect health outcomes. Jane Jensen focuses on “citizenship regimes” and the effects of ideas about the collective on the politics of state responses to public health threats. Will Kymlicka takes up the debate on the adverse effects of ethnic diversity, arguing that multicultural recognition may be both empowering and, because of flexible ideas about nationhood, not as divisive as some might have imagined.

In a concluding chapter, William H. Sewell, Jr., describes the effects of macrohistorical transformations in the organization of capitalism on population health. While being careful to identify many of the advances that have been realized concurrent with the rise of neoliberalism during the past several decades, he ultimately concludes that this paradigm has depressed the extent of improvement (pp. 286–87).

In almost all cases, the chapters are self-consciously agenda setting and thought provoking, without pretension of claiming the final word on any topic. Readers will find a great deal of room for further theoretical specification and empirical testing. For example, in the case of Swidler's argument about cultural fit, one would like to be able to construct a definition that would allow us to make ex ante predictions about success, rather than simply to pronounce something “fit” because of a successful outcome. With respect to the various chapters on citizenship and intergroup relations, future scholarship will need to make more precise the claims about particular types of regimes and under what conditions the best health outcomes may be realized.

For the most part, the chapters engage in small-n analyses, making heuristic comparisons between a few cases. The benefit of this approach is the ability to narrate the theoretical ideas with illuminating case histories. But there is little in the way of hypothesis testing, particularly as the propositions were developed inductively from the cases. Evans provides the only cross-national statistical analysis in the volume, and this is a straightforward cross-sectional analysis with few regressors, and one that leaves open questions about endogeneity and omitted variables. Indeed, most of the chapters refer to their conclusions as tentative, awaiting more data and further analysis. Political scientists and other social scientists will surely want to follow up on this agenda.

Unlike many edited volumes produced out of a single conference, Successful Societies reflects a shared language and analytic framework developed from sustained collaboration and intellectual exchange. The various chapters invite the reader into conversation with the group, as they repeatedly cross-reference one another and successfully draw upon the analytic overview such that the whole is surely more than the sum of its parts. The book is written in accessible language and should be highly readable across disciplinary boundaries.