“Know your numbers” proclaims the American Heart Association, health care providers, employer ‘wellness’ programs, and multiple well-meaning but annoying relatives. We are continually admonished to monitor our weight, blood pressure, hours of sleep, caloric intake, and blood sugar/cholesterol levels–even the numbers of steps we take every day. It is becoming easier to self-monitor many of these numbers, what with the Fitbits, Jawbones, Fuelbands, Nudges, and the soon-to-be released and oh so aptly named iWatch. There is even a pregnancy monitoring app, Wildflower (really? who picked this name?), which keeps track of pregnancy weight gain and other pregnancy milestones. We have entered the age of the Quantified Self, the Quantified Self being a term, a movement, and a blog of the same name developed Wired Magazine San Fransisco-based journalist Gary Wolf. But is the Quantified Self craze making us healthier and more self-aware or just making us crazier and more self-absorbed?
As medical sociologist Deborah Lupton writes in her forthcoming book chapter/article You Are Your Data: Self-Tracking Practices and Concepts of Data (see resources below), quantified self-tracking discourses:
include the notions that quantified data are powerful entities; (…) data (and particularly quantified or quantifiable data) are an avenue to self-knowledge; (…) quantifiable data are more neutral, reliable, intellectual and objective than qualitative data, which are intuitive, emotional and subjective; self-tracked data can provide greater insights than the information that a person receives from their senses, revealing previously hidden patterns or correlations; self-tracked data can be motivational phenomena, inspiring action, by entering into a feedback loop; (…) and data about individuals are emblematic of their true selves.
Besides the very real and potential misuses and abuses of self-tracking health data, including bias and discrimination by the U.S. Big Brothers of employers and health insurance companies, the use of these health data devices can become addictive and can trigger distorted body image and eating disorders. They also feed into our propensity to fall into the traps of ableism and healthism: judging and blaming people (and ourselves) when they (or we) aren’t thin enough, fit enough, happy enough, ‘able’ enough, healthy enough, fill-in-the-blank enough. We start to aim for the highest attainable and measurable ideal of bodily health instead of viewing health as something that allows us to do the things that give life meaning–things like family, community, spirituality, and fulfilling work.
I love health promotion and public health, but those of us working in this field can be a boring and sanctimonious lot. I stopped attending American Public Health Association (APHA) national meetings because I always felt I was joining a cult or attending a mass religious revival. Flocks of people wearing sensible shoes. I imagine many if not most of the APHA members are early adopters of all these get fit and health monitoring gadgets.
People like Deborah Lupton have conducted research and written wise critiques of the Quantified Self movement. I haven’t seen much discussion of the inherent classism of the movement, besides people pointing out the barriers of cost of all these gadgets. But beyond the purchase price cost of the gadgets, access to the internet for tracking and analyzing and comparing data, there’s also the fact that poor people don’t have the luxuries of eating good, healthful food, or the time to exercise. And then there’s the ‘bigger picture’ fact that all these self-monitoring health activities have much less impact on our health and longevity than we believe. Even access to high quality health care doesn’t matter as much as we think it does. One of the biggest factors in our health status–especially here in the pull-yourself-up-by-the-bootstraps U.S.–is where we are on the socio-economic ladder. The other little known fact is that the decidedly subjective self-rated overall health status of people remains the single best predictor of future morbidity and mortality. So, instead of wedding yourself to a Fitband, consider asking yourself on occasion, “In general, I would say my health is: Excellent, Good, Fair, or Poor?”
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See the 3-5-15 post “Changing Representations of Self-Tracking” by Deborah Lupton on her blog This Sociological Life.
The quote included above is from Lupton’s chapter in the forthcoming book Lifelogging: Theoretical Approaches and Case Studies About Self-tracking (tentative title), edited by Stefan Selke to be published by Springer Press.
For a rather alarming report on the uses/misuses/abuses of self-tracking health data, read the Forbes article Wearable Tech is Plugging Into Health by Parmy Olson (6-19-14).
For an excellent and now almost ‘classic’ academic but accessible book related to this topic, I highly recommend Deborah Lupton’s The Imperative of Health: Public Health and the Regulated Body, Sage, 1995. I pulled my copy off of my bookshelf (along with her excellent Medicine as Culture book), and discovered this most interesting and ironic bookmark. It is a YMCA promo brochure cover photograph of me holding my toddler son. This was the year I taught Jonathan to swim. This is the year I coped with a messy divorce by swimming 2,000 miles. I logged them on the YMCA competition bulletin board (yes, I won) and I wore a Nike waterproof heart rate monitor….
JOSEPHINE ENSIGN 