Research finds that health apps and wearable devices cannot help low-income groups

From fitness applications to smart watches to somatosensory games, we may be accustomed to various health-related digital devices or applications, which make exercise a portable and fun thing.

▲《Fitness Ring Adventure》.

These "digital health tools" are generally considered to be a way to reduce "health inequality" because they can package health interventions into a cheaper and easier-to-distribute form, lowering the barriers to participation in sports and fitness.

However, a study on digital health tools shows that health applications and wearable devices will only help people with high socioeconomic status to improve their physical activity levels. They cannot help low-income groups.

▲ Picture from: International Journal of Behavioral Nutrition and Physical Activity

This research is not to invest in a single project, but to use "meta-analysis" (Meta-analysis) to analyze and summarize the results of multiple related studies.

The research team selected 19 research results published in English as the research objects. These research results are distributed from January 1990 to March 2020, covering a variety of digital health tools, such as text messages, emails, websites, and wearables. Pedometer, mobile application.

They raised three research questions: whether digital health tools are effective in promoting physical activity of people with low socioeconomic status; whether digital health tools have the same benefits for individuals with higher and lower socioeconomic status; whether the number or types of digital health tools Related to the effect of intervention.

▲ Picture from: the verge

The result of the study is that no matter what kind of digital health tool, it does not show equivalent effects for people with low socioeconomic status and high socioeconomic status. For the former, there is no evidence that digital intervention is effective; for the latter, the same intervention does show effectiveness.

In other words, digital health intervention will eventually widen the health gap between groups and exacerbate the digital divide.

There are many reasons for this result. After all, not everyone has access to the Internet. The Internet penetration rate in the most developed countries is as high as 95%, and the World Internet Development Report 2020 shows that the global penetration rate is about 60%.

▲ Picture from: United Nations

But even if groups of both socioeconomic status have access to digital health tools, these tools may not necessarily reduce the health gap. The research team put forward several reasons for this situation.

First of all, people with lower socioeconomic status tend to have lower electronic health literacy, which means that they use the Internet less to obtain health information and cannot effectively apply digital health tools.

Secondly, rich consumers have more resources and leisure, and in a more friendly social and physical environment, they are more likely to have the ability, opportunities and motivation to make changes; while poor consumers do not have time to do the things suggested by digital health tools.

▲ Picture from: unsplash

Furthermore, digital health tools such as wearable devices and smartphone apps are designed for people with more funds and more education-"The goal of most consumer-centric digital health companies is to make money. Their focus is often on the customers who like to buy their products the most."

In fact, the research team used "social economic status" as a variable, basically covering all the above reasons. Behind the differences in socioeconomic status are differences in education, income, and access to medical, nursing, and health information.

▲ Picture from: unsplash

Maybe all the above results are in our expectations, but it is meaningful to focus on a small problem-it can see the human situation more specifically, and propose feasible improvement measures.

Physical exercise can bring many health benefits to individuals, and for the wider population, it is a public health strategy that "reduces the burden of non-communicable diseases and is cost-effective."

▲ Picture from: WHO

The World Health Organization reports that increasing physical activity levels globally can prevent 5 million premature deaths each year, and reduce the risk of colon cancer, breast cancer, heart disease, stroke, and diabetes. At the same time, lack of physical activity can prevent premature deaths. The damage caused by the global healthcare system is 54 billion U.S. dollars .

In addition, on a global scale, the life expectancy of a country’s population ranges from 52 years in the poorest country to 84 years in the richest country. Therefore, groups of low socioeconomic status who lack the support of digital technology most often need this kind of support. The research team proposes:

As digital technology is increasingly used for physical exercise, it becomes more important to understand how technological changes are exacerbating inequality. But we know very little about its effectiveness in low socioeconomic status groups, and it is difficult to convince developers to ensure that they benefit. Researchers and public health advocates have a responsibility to address this discrepancy and make it a public health priority.

▲ References:

(1) Complete paper: https://ijbnpa.biomedcentral.com/articles/10.1186/s12966-021-01218-4#Sec15
(2) https://www.theverge.com/2021/11/16/22785163/digital-health-physical-activity-inequity.

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