A positive future from wearables?

By: Clare Morley

As part of the development of our new ten year strategy, we have been talking as a team about future trends and how they might impact on our communities and therefore on the work that we need to do going forward to ensure that we can help to change more lives across Northumberland and Tyne & Wear by unlocking the power of physical activity.

Thanks to some excellent prompts for thought from Jane Cockerell at The Future Purpose Project, we have undertaken some thinking across a range of trends as diverse as “all the data, all of the time” to “superfoods” and “an environmental imperative”. What has struck me and the team through this process of thinking, empathising and reflecting is the role of technology and artificial intelligence on our communities over the course of the next ten years or so.

I don’t come from a tech background and can’t even begin to imagine some of the developments that are taking place in Silicon Valley or even closer to home at places like Tech Newcastle, but what is clear is that even if the tech of 2020 were to become more accessible to all members of our society, and was utilised in a different way by public services, there are a huge range of potential impacts on communities – and not all of them are positive.

Let’s take wearable technology for wellbeing, for example. In the words of the Future Purpose Project, this trend is about how “artificial intelligence and wearables will monitor our bodies for indicators of poor mental and physical health. Analysis of this input, combined with our genetic history, lifestyle and environs, will optimise our healthcare and lifestyle choices”.

On the face of it, this sounds like a very positive trend. And indeed, I truly believe there are lots of positives that can come from such developments. It’s important to remember that this is about thinking of what life might be like in 10 years’ time. If we think about wearables today, we get caught up in the concept that only people who are already physically active are wearing a Garmin, Fitbit or Apple Watch, for example, and that they are the only group who are interested in their step count, heart rate or calories burnt. So we need to shift our thinking out of our current mindset and into the future. Let’s consider how this trend might look in ten years’ time from two perspectives, that of a then 15 year old girl living in one of our region’s most deprived areas, and the other being that of a then 70 year old man living with a long term health condition.

For our 70 year old man, the now common-place use (in 10 years’ time) of the prescription of wearable technology will ensure that healthcare professionals can monitor his health and the performance of his medication remotely on a much more frequent basis than they would be able to visit him. They will have access to real-time data that will ensure that any issues are red-flagged before they progress to significant issues; blood sugar levels can be recorded remotely, atrial fibrillation (an irregular or fast heartbeat) can be identified without venturing near an ECG in a hospital, chemical imbalances in his body can be identified promptly and acted upon before they cause long-term damage; and repeat prescriptions can be automatically dispensed due to remote monitoring of how much of any one prescription has been used, saving on wasted prescriptions and pharmacy time. Perhaps all of this automation of his health feedback will mean that he is more able to stay living in his own home, rather than having to move into a care home, and thereby maintaining his sense of independence. And what if his long-term health conditions are normally made worse by poor air quality or there are concerns about his exposure to high UV levels? Wearables will be able to alert him to air pollution levels and the current UV index figures in order to help him make informed decisions about good and bad times to be outside on a minute by minute or hour by hour basis.

However, when you think a little deeper about what the above could mean, there are also a number of unintended consequences that could negatively impact upon our 70 year old man, particularly when we consider his mental wellbeing. Given that so much can be done by his healthcare professionals remotely, they no longer visit him as frequently as they might do otherwise. Likewise, his friends and family can check in on him remotely and so don’t feel the need to visit him quite so often either. His already potentially socially isolated status could become exacerbated by wearables that are designed to be improving his quality of life. Not only might he miss out on day to day interactions, but also miss out on the opportunity to discuss his long term health conditions with trained professionals and share his concerns about the management of his condition and the things that keep him awake at night; the focus on statistics may overtake the focus on his wellbeing. Unless wearables can pick up on low mood (and perhaps they will be able to) and unless there are accessible systems in place to ensure that any alerts around low mood can be acted upon promptly, then our subject’s overall wellbeing may not be better serviced by wearables, or at least as not well served as an initial review would suggest.

And of course there are data protection challenges in all of the above which are another can of worms that I won’t even begin to try to open, particularly considering the range of agencies that may need to be involved in supporting him (GP, pharmacy, adult social care etc).

For our 15 year old girl, who perhaps doesn’t have the need to monitor a particular health condition like we’ve noted above for our 70 year old man, what do wearables mean to her? Assuming they come down in price and are more affordable to a wider population, they can continue to provide an analysis of what they do already, such as steps, movement, heart rate and calories burnt, but to a broader audience. Could this data (on an anonymised basis) be collated from across her neighbourhood to give a broader picture of physical activity levels and aid in the identification of hot spot ‘areas of interest’ and the development of focussed approaches to tackling inactivity? This all sounds quite positive and productive.

If the tech develops to be able to alert her to things such as the phases of her menstrual cycle and how that might impact on her physically and mentally, and provide her with support prompts and ideas to manage any more negative times of her cycle, then this also sounds like a good thing.

But let’s also remember the vulnerabilities of many of our teenagers, where peer pressure, concepts of self-image and many other social angsts can create a perfect storm of wellbeing issues. Could an overwhelming prevalence of wearable tech and constant feedback make her feel tracked and over-analysed? Might she be at risk, via all of this feedback, of obsessing about health and body image; might she find herself in constant competition with others, which could lead to feelings of guilt, self-loathing, obsession and negative body image? How do we educate and support our young people about such issues?

Just a quick review of the above two examples highlights some of the potential unintended consequences of a world that is hurtling towards an even heavier reliance on data. Whilst it feels that there is a certain inevitability about how wearables will become an increasing part of our lives, either by choice, societal pressure or through prescription from health and wellbeing services, it is incumbent upon all of us to think around the whole topic and guard against the unintended consequences that may arise when these devices become even more engrained into our lives. We are still working out what this means for us and our strategy for Rise, as the active partnership for Northumberland and Tyne & Wear, but I’m pleased that we’re thinking about it now, and not just wondering (whilst tracking our steps and heart rate) into the wearables abyss.