Downloading Health from the App Store

Disclaimer: The contents and opinions of this blog post do not represent the views or values of Honours Review as a publication.

Between having ramen as dinner for the third day in a row and spending all-nighters unblinkingly focused on the glowing screen of a laptop, many students tend to overlook the importance of maintaining physical and mental health in their everyday lives. An increasingly popular solution to this issue is the use of mobile apps designed to help them form healthy habits, whether with a friend suggesting a useful healthy recipe app or a Top Universities article inviting you to check out the “Best Health & Safety Apps for Students” (1). In the light of this development, for better or worse concerning personal and public health efforts, could the future bring about a new spin on an old saying with “An app a day keeps the doctor away”?

A Customizable Path to Health

Reliance on technologies to master one’s body is explored in practice and presented to us in media as part of the flourishing Quantified Self movement, led by cyber-culture intellectuals Kevin Kelly and Wired editor Gary Wolf. With the goal of seeking “self-knowledge through numbers” (3), obtained from devices like Fitbit and apps like Lose It!, the movement embodies the idea that we should use the potential of the smartphone or tablet that has become a daily companion of Western student culture for more than just communication and entertainment. While calorie counting and comparing workout statistics might seem boring to some, the main appeal of such apps is their ability to gamify these number-based processes, applying game-design elements and principles in the non-game context of pursuing health (10). This can involve exercising to outrun virtual zombies in Zombies, Run! or being personified as an adorable animated plant that depends on you to stay properly hydrated throughout the day in Plant Nanny. The power of cute graphics and breaking down routines into fun, rewarding goals makes for a fascinating interplay of technology and psychology when it comes to managing personal health through apps.

Altogether, the key promise of a mobile health app is to replace the usual intermediaries – trainers, yoga teachers, dieticians – with technology that relies on your own willpower to pursue health (6). The shift from externally to internally driven formation of healthy habits can undeniably help with a range of obstacles faced by many: from lacking the money to consult a health expert or the time to physically visit the gym to having anxiety about making your weight loss efforts public due to a fear of being judged. However, this supposed freedom invites an issue of accountability; as recent studies reveal, most app users tend to lose motivation for logging information over time, deleting the app or neglecting it so that inconsistent user engagement brings no new health improvements (8, 2). Additionally, even considering dedicated mobile health app users, writer Adam Greenfield takes a skeptical view of Quantified Self movement to raise the issue of apps allowing their companies “to construct models of nominal behavior we’re all thereafter forced to comply with.” (3). Personal health data collected en masse, for example, from the Under Armour owned apps Endomondo and MyFitnessPal, is vulnerable to being exploited to promote conformity to specific lifestyles – advantageous to companies like Under Armour, which sell ways to make these lifestyles reality. These concerns should factor in when deciding which apps, if any, may be best suited for personalizing an individual road to health.

Sharing the Journey

Beyond the personal goal of self-improvement, which could just as well be achieved the old-fashioned way by tracking calories in a notebook or marking daily exercise in a calendar, mobile health apps offer the opportunity to seek health in a social, shared manner. The issue of self-motivation might thus have a solution: app users often feel more encouraged to develop their healthy habits if promised social rewards, available when competing against friends in virtual running challenges or exchanging healthy recipes. In moderate amounts, the pride found in showing the world that you are choosing health is a welcome and powerful drive to living a healthy life adapted to the digital age. Even if this pride is expressed through clichéd smoothie Instagram posts or shared Facebook articles about life-changing meditation routines, academics agree that this type of external and often eventually internalized motivation, especially when sought from family and friends, can highly increase app effectiveness (6). Besides, as mobile health apps continue to develop, users find opportunities to exercise their creativity, such as with GPS art that involves mapping your running or cycling routes to create line drawings when viewed on the map after exercising (9).

Of course, the idea of publicizing individual health journeys invites certain criticism as well, such as concerns about the potential to become obsessed with maintaining the public image of a “health nut” or feeling increased pressure to adapt to a socially conventional timeline of achieving goals. Combined with the proven risk of the science behind mental health apps in particular often being less than trustworthy (7), this means that the very apps meant to improve your health might become damaging instead if they are allowed to act – unchecked by critical thinking – as amplifiers of society’s health judgements and norms. While such liabilities are usually only realized in hindsight, when it comes to sharing health information with their apps, users themselves are most concerned with data security and privacy (5). Along with the familiar stories of data breaches and unsanctioned health data use for targeted advertising, mobile health apps present new dangers specific to the digital age. An illustrative example is the recent scandal of the fitness tracking app Strava, which accidentally revealed the location of clandestine U.S. army bases abroad when data about soldier exercise routes was released online (4). 

Conclusion

From personalizing a health journey to sharing the successes and failures with others, the nature of apps as shapers of physical and mental health holds unpredictable diversity. The apps’ core values of mobility and accessibility, perfect for maintaining and forming health habits, can also be their downfall when it comes to social conformity and data exploitation. Keeping in mind the harsh, but truthful claim that “Apps aren’t a substitute for willpower” (2), the future of mobile health apps remains reliant on the willingness of their users to accept that the final burden of sharing health data and remaining motivated lies with the humans, not the technology.  

References:

1. Abdi, A. (2017, October 7). Best Health & Safety Apps for Students. Top Universities. Retrieved from https://www.topuniversities.com/blog/best-health-safety-apps-students 

2. Chittal, N. (2019, January 2). Habit-tracking apps are the latest self-improvement trend. But do they work? Vox. Retrieved from https://www.vox.com/the-goods/2019/1/2/18158989/habit-tracking-apps-new-years-resolutions 

3. Greenfield, A. (2018). Radical Technologies: The design of everyday life. London and New York: Verso.

4. Hern, A. (2018, January 28). Fitness tracking app Strava gives away locations of secret US army bases. The Guardian. Retrieved from https://www.theguardian.com/world/2018/jan/28/fitness-tracking-app-gives-away-location-of-secret-us-army-bases 

5. Krebs, P., & Duncan, D. (2015). Health app use among us mobile phone owners: A national survey. Jmir Mhealth and Uhealth, 3(4), 101.

6. Kwon, M., Mun, K., Lee, J., McLeod, D., & D’Angelo, J. (2017). Is mobile health all peer pressure? The influence of mass media exposure on the motivation to use mobile health apps. Convergence: The International Journal of Research into New Media Technologies, 23(6), 565-586. 

7. Lipczynska, S. (2016). The health apps on your smart phone: Science or snake oil? Journal of Mental Health, 25(5), 385-386.

8. Serrano, K., Coa, K., Yu, M., Wolff-Hughes, D., & Atienza, A. (2017). Characterizing user engagement with health app data: A data mining approach. Translational Behavioral Medicine, 7(2), 277-285.

9. Strava artist draws pictures with his bike and GPS. (2016, February 19). BBC. Retrieved from http://www.bbc.co.uk/newsbeat/article/35612884/strava-artist-draws-pictures-with-his-bike-and-gps 

10. Zichermann, G., & Cunningham, C. (2011). Gamification by design: Implementing game mechanics in web and mobile apps. Sebastopol, CA: O'Reilly Media.