Nestled on State Street, the rectangular brick building with a black and red dragon on its garage door appears, at first glance, like an abandoned warehouse. But the garage door opens to reveal CrossFit New Haven. Mid-kick, a woman looks down to check her wrist, her movement now slightly offbeat from the rest of the synchronized group. Her next kick is even harder and stronger.
Modern society relies on instantaneous measurements, and the health industry is no exception. From increasing the number of steps you take to monitoring your heart rate, you can now check and control a variety of measurements relevant to your health. In less than a second, you take another step, both literally and figuratively, towards optimizing your performance on an array of metrics.
Fitbit’s website elaborates: “Every moment matters and every bit makes a big impact. Because fitness is the sum of your life. That’s the idea Fitbit was built on—that fitness is not just about gym time. It’s all the time.”
The rise of wearable health technology takes advantage of our ability to change these measurements: You become the agent at all times. The data presented to you is in—or wrapped around—your hands.
Wearable devices have transformed CrossFit New Haven’s workout philosophy, explained Head Trainer Aaron Poach in an interview with The Politic.
“We now talk more about a feeling and in less technical terms,” Poach said. “If the goal is for someone to be breathing heavily, then they can use their wearable monitor to gauge what their heart rate is telling them in terms of if they should be pushing harder or less to reach that feeling.”
Poach’s clients do not believe heart rate is an incomprehensible or overly technical parameter of health: It is now something they can easily access and use to improve their workout. Wearable devices are designed to provide feedback to users and increase their understanding of their activities and behavior. CrossFit New Haven is tapping into this opportunity by using their own CrossFit-specific technology—a software system called Wanify. Poach says the technology helps clients track their progress and lets them know which weights to use each time they come to the gym.
New York Times columnist David Brooks, in his 2013 op-ed “The Philosophy of Data,” notes that data does two things well: It exposes when our intuitive view of reality is wrong, and it can illuminate patterns of behavior we have not yet noticed. He cites various examples in which data has challenged people’s perceptions on everything from what constitutes a political campaign’s success to the speech patterns of confident people.
Conversations with Poach make clear how Brooks’ ideas can help us understand the benefits of data from wearable health devices. Poach explained that, in his experience, if clients feel they have reached their limit in the middle of a workout but their Fitbit data says otherwise, they are motivated to keep going. The data can challenge a client’s preconceived notions about their endurance.
But others have been more skeptical of Fitbits’ health implications.
“Sometimes the devices can interfere with a workout when people begin to obsessively check the tracker,” Poach said. He emphasized that users can become more fixated with numbers on a screen and ignore the value of exercise for its own sake.
Wearable health devices might allow more agency, but it also raises a question: what does being an agent mean in a data-driven world saturated with distorted views of health, especially for young people?
Just this September, Stroud High School, an all-girls school in Gloucestershire, U.K. banned Fitbits and other smartwatches. The deputy headteacher expressed concerns that girls were monitoring the calories they burned and steps they took to a dangerous extent. At Stroud, some girls skipped lunch if they hadn’t taken enough steps in the morning.
Indeed, it is difficult to separate fitness from 21st century obsessions with body shape and weight. DoSomething.org reports that in the U.S. alone, approximately 91 percent of women are unhappy with their bodies and resort to dieting to achieve their ideal body shape. Fitbits and other tracking devices may serve as vehicles to further unhealthy obsessions.
A study published in Eating Behaviors in August 2017 found that, among 493 college students, those who reported using calorie and fitness tracking technology had higher levels of eating concern and dietary restraint. The use of fitness tracking was uniquely associated with eating disorder symptoms, and, while the study provided only preliminary data, it suggested that “for some individuals, these devices might do more harm than good.”
Many of these wearable health tracker companies branded their devices as a means for people to understand themselves better, as opposed to promoting comparison. An advertisement for Jawbone’s UP fitness tracker reads, “Know yourself. Live better.” A Microsoft Band advertisement reads, “This device can know me better than I know myself, and can help me be a better human.”
Both companies attempt to inculcate a mindset where constant data collection is the ticket to becoming one’s best, most productive, most successful self. The lure may seem personal and intimate—just the consumers and their wearables. But the devices don’t just collect data—they also encourage users to think about themselves in terms of metrics, standards, and norms. When users begin comparing their metrics to a global network, they can become distracted from personal improvement and fixate instead on how they stand compared to others, playing into a culture of self-doubt and self-negativity.
Health technology’s data can be used for purposes beyond individual growth. In April of 2004, the Bush Administration promised to establish electronic health records (EHRs) for most U.S. residents within 10 years. Through executive order, President George W. Bush ’68 created the role of National Coordinator of Health Information Technology to oversee how the federal government could integrate private and public sectors by using technology to strengthen existing health infrastructures.
Wearable fitness trackers and health monitors have significant potential to inform EHRs. Wearable devices can be used in conjunction with these records to improve individual health care and the overall health of communities.
Former National Coordination of Health Information Technology Karen DeSalvo, who served in the Obama Administration, told The Politic that health technology is allowing more people control over their health information.
“Health technology has the potential to democratize health and health care in a lot of ways, and as time goes on, more people will have access to cellphones, smartphones, and internet and thus to health technology,” she said.
EHRs are one of the most promising applications of health technology, since technology could provide direct access and instant updates to patient records at any time. This potential may prove especially helpful for patients who move locations frequently or who live in remote areas without access to doctors who know their health history.
Data-enhanced EHRs also allow for better research on disease outbreaks. This is particularly true for vulnerable populations who do not receive the benefits of typical health prevention statistical modeling.
“There is an exciting new frontier of how this technology can be used to support surveillance of emerging infections like Ebola, seasonal infections like influenza, or chronic diseases like the risk of diabetes in a community,” DeSalvo explained. “Instead of everything being just a data collection record, we’re starting to learn how to use health information technology to shape practice and to predict the future, so how we find high risk neighborhoods, people, and populations.”
Using health information technology and electronic health records to improve outcomes is no longer just a government goal. Companies like Apple have tapped into the trend and are seeking to improve their own outcomes and profits. DeSalvo explained that companies are trying to figure out how to incorporate individual data from Fitbits, electronic health records, internet synced devices, social services data, and purchasing data into what she called, “a health record and not a health care record.”
But with the rise of health technology come privacy and cybersecurity concerns. Fitbit maintains a lot of information about its users, who give the company access to many of their devices. If companies were to also obtain their users’ medical history, the company could theoretically tailor advertisements specifically to them.
According to DeSalvo, “That’s why lot of big companies like Apple or Amazon are really interested in health care, because there’s a lot of money to be made from knowing this information. If you give your electronic health record over to a company, they are not really regulated. Protecting the consumer in that space is challenging and an interesting area of policy and work going forward. But it’s actively happening.”
The implications of wearable technology are far-reaching. They have become tied to our societal expectation of a perfect body image. Their advertisements play into 21st century pressures to be hyper-productive. And not only do these devices have the potential to build a holistic view of a person’s health, but they might also allow companies to profit on user health information. Wearable technology may be small, but its power is much greater than its size.