Health and fitness tracking: Good for me, good for humanity!…(maybe)

This week’s play and reflect activities took me on a circuitous, complicated, and sometimes uncomfortable learning journey that began simply enough with tracking my physical activity for 3 days using my GPS watch, heart rate monitor and Garmin Connect; the application that collates and displays all the data collected during my physical activity.  My journey began in a very self-focused way, but expanded to something much bigger than I anticipated before I was done.  I took a journey through the Quantified Self and self-awareness, narcissism, technology reviews, medical reviews, sharing of health data and privacy issues, issues surrounding ownership and management of all the data being collected, and every divide or inequality you can think of, including digital / socio-economic / generational / educational.  This journey led me to question some of the things I had not thought to question previously, self-focused, self-quantifier in pursuit of self-knowledge that I am.

So I’ll start with me, and end… somewhere else.

Do I track my behaviour?

I track my physical activity (I track running, but any physical activity can be tracked) using Garmin Connect, a Garmin GPS watch and a heart rate monitor. I started using a GPS watch about 5 years ago, and that’s when I got started on Garmin Connect.  At times I track my eating using My Fitness Pal, to drop weight prior to a long-distance event. I use a digital scale to track my weight, but this is a bit old school, because it doesn’t connect digitally to anything, and I need to either remember the number, or write it down somewhere.  If I was more Excel savvy, I could put it in a spreadsheet.

Why do I track my running? 

I track my running because it gives me the data on my running.  For each individual run, I can see how far I ran, how fast I ran, how long I ran, what the temperature was, my average and maximum heart rate, calories burned, where I ran, the elevation gain/loss, cadence (i.e. how many steps I took per minute – who knew that was important in running?).

Garmin Connect Distance Graph for week

Garmin Connect Distance Graph for week

Garmin Connect can also give me reports that show me how far I ran during a week, a month, a year.

Garmin Connect Distance graph for year

Garmin Connect Distance graph for year

I can see when I don’t run (winter – it’s so cold outside!), and I can see my volume increasing over the months as I train for a long-distance event.

I can compare runs from different times to see if I am improving – if I am faster/slower, if my heart rate is higher/lower, if the temperature was higher/lower.  An extra couple of degrees Celsius can slow you down and increase your heart rate significantly.  I wouldn’t have known that if I wasn’t tracking my running using Garmin Connect. I would probably look at my time and think how slow I was, and go into a spiral of negative thoughts that would sound something like this:

“I’m so slow! I’m not getting any better at running – why do I even bother? I might as well give up!” This might then result in a prolonged period of time lying on the couch eating chocolate and potato chips.

Couch Potatoes, Daniella Urdinlaiz, https://goo.gl/c6rL0R; CC BY 2.0 https://creativecommons.org/licenses/by/2.0/

Couch Potatoes, Daniella Urdinlaiz, https://goo.gl/c6rL0R; CC BY 2.0 https://creativecommons.org/licenses/by/2.0/

However, with all my data at hand, I can see that I probably ran slower because it was 27 degrees outside with 89% humidity at 5:00 am, and not take it so personally.  It allows me to take a step back and objectively view the various factors contributing to my performance.

How does tracking my data change the way I behave?

Tracking my running gives me a sense of power and control over my running training, and a sense of satisfaction when I see that graph of my total distance going up, or my heart rate going down over time, indicating that my aerobic base is improving.  Alternatively, if things are not going that well, I can look at the data and try to work out why.

I suppose that tracking my data on Garmin Connect keeps me motivated to continue running, and continue striving to improve my performance and achieve my goals; whether that is to run 60 km this week, or 240 km this month, or complete that marathon in July.

Ok. That was the easy part. Now, come with me down the rabbit hole.  I don’t know if I can do it justice, but here goes.

Down the Rabbit hole; Valerie Hinojosa; https://goo.gl/lIwroY; CC BY-SA 2.0 https://creativecommons.org/licenses/by-sa/2.0/

Down the Rabbit hole; Valerie Hinojosa; https://goo.gl/lIwroY; CC BY-SA 2.0 https://creativecommons.org/licenses/by-sa/2.0/

How has the quantified-self movement influenced me?

I had not heard of the Quantified-Self (QS) movement until it was introduced to us in our lecture and learning materials.  I wonder if a movement can influence you if you don’t know that it exists. Perhaps it can, if the tools and paraphernalia associated with the movement permeate everyday life, and you accidentally stumble over them and start using them as a result of something you are doing (e.g. running and trying to drop a bit of weight).

I thought I should examine the QS movement to find out a bit more about it.  This short TED talk by QS founder, Gary Wolf in 2010, explains why we might want to quantify ourselves.

According to Wolf, Self-Quantification is about self-discovery, self-improvement, self-knowledge and self-awareness.  I love his last quote: “If we want to act more effectively in the world, we have to know ourselves better”.  This self-knowledge seems to refer to tracking all of one’s bodily functions, including (but not limited to) heart rate, blood pressure, blood oxygen levels, sleep, weight, food intake, mood.  It does seem to be a particularly self-focused past-time.  In the TED Talk, Wolf jokes that his narcissism score is a healthy 0.31.

I started to wonder if Self-Quantifiers are narcissists.  I started to wonder if I was a narcissist. Wolf, however, says “No” – see his response to the criticism here ; so I let this one go, but I still wondered.

Now, if I make the assumption that the act of tracking certain of my behaviours using technology implies that I have been influenced by the quantified-self movement, then yes, I would have to say that the quantified-self movement has influenced me, and that I am a self-quantifier.

Evaluate a quantified-self tool: Garmin Connect

In taking a more objective approach to evaluating Garmin Connect (rather than simply stating my opinion), I read a couple of reviews.  Wareable gives Garmin Connect 3.5 out of 5 stars in its 2015 review,  and Best Company rates it 8.3 out of 10 in its 2016 review.   Overall, these were very positive reviews.

However, the reviews pointed out (something that I had not considered) that you can only use Garmin devices with the Garmin Connect software, and many of the devices are high end, thus excluding the average person who wants to track their steps.

It seems that this software and the devices that go with it may not be the most accessible option for people just starting out on their fitness journey, and is probably aimed more towards dedicated sportspeople.

In addition, even though the Garmin Connect app is free; the cost of a device to use with it may be prohibitive for many.  So, this particular tool may exclude people on a number of levels; based on cost and activity level.

However, Best Company notes that Garmin does have an all-purpose fitness tracker, the Vivofit, which records steps, distance, elevation, duration and calories burned, which is cheaper than the high-end devices (although still more than $100) and could be used for entry-level fitness.

I could envisage that Garmin Connect, in combination with a wearable device such as the Vivofit, would be more accessible and suitable  to the general population than a high end GPS watch, and could help people improve their health by allowing them to track their physical activity.  Obviously, there are a wide variety of other fitness trackers available which may be more suitable to individual circumstances, and the individual would need to make that determination.

Discuss how Garmin Connect could impact a group of people. For example could this tool help people with mental health issues or chronic illness?

There is a lot of evidence that exercise is beneficial in the treatment of many different diseases.  See this comprehensive 2015 article by Pederson and Saltin,  which found that exercise is beneficial for the prevention or treatment of 26 different diseases, including: depression, anxiety, stress, schizophrenia, dementia, Parkinson’s disease, multiple sclerosis, obesity, hyperlipidemia, metabolic syndrome, type 2 diabetes, type 1 diabetes, hypertension, coronary heart disease, heart failure; chronic obstructive pulmonary disease, asthma, cystic fibrosis, osteoarthritis, osteoporosis, back pain, rheumatoid arthritis, and cancer.

So, if it is established that physical activity and exercise is beneficial in the prevention and treatment of a range of diseases, including mental illnesses and lifestyle diseases; and a tool such as Garmin Connect with a wearable device enable the tracking of the physical activity that is beneficial in the prevention and treatment of diseases; then surely it is intuitive to say that Garmin Connect and a wearable device could help people with mental illness or other chronic conditions improve their health?

Yes, of course!

Well…not necessarily.

There is some anecdotal evidence  of individuals with health issues having used tracking devices to improve their health; however, Ellis and Piwek, writing for the Conversation  report that there is little research that shows that fitness trackers make people healthier.

What has been found is that fitness trackers are more likely to be bought by people who are already healthy and want to track their progress. Surveys have found that more than one third of users stop wearing their device after six months and half stop using the device within a year.

The authors point out that devices are sold on the assumption that they will help improve fitness, even though there is currently a lack of evidence to support this.  They go on to say that research should be conducted into device effectiveness before they come to market.

It seems that my assumption that the use of a tool such as Garmin Connect to track physical activity could help people with chronic conditions improve their health is currently unproven, even though intuitively it makes sense.

It is also important to remember that all of these fitness trackers are only tools.  The real work of behaviour changes in diet and physical activity still needs to occur so that health and fitness can improve.  The tool by itself is not going to make anyone healthier or fitter if that work is not undertaken at the same time.

So, now that I was feeling let down by fitness tracking, I turned to look at how health and fitness tracking could be used by organisations to ‘monitor’ us.

Obviously the huge issues here are around the safe storage and privacy of our health data, but there are also questions of who owns the data.

safe for package storage, ecos systems; https://goo.gl/QoWvSF, CC BY 2.0 https://creativecommons.org/licenses/by/2.0/

safe for package storage, ecos systems; https://goo.gl/QoWvSF, CC BY 2.0 https://creativecommons.org/licenses/by/2.0/

People are accustomed to sharing personal information regarding health and fitness with their health practitioners; e.g. doctors, physiotherapists, dietitians.  Sharing health and fitness data with health practitioners has obvious benefits for the subject, as their health practitioners will have access to accurate, objective information about the subject’s health and fitness, which will enable them to make appropriate recommendations for treatment.  Health practitioners also have codes of ethics that ensure that patient information remains private and confidential, and the organisations they work for have privacy and confidentiality policies and procedures, so people feel that their information is safe.

Karen Weintraub, writing for BBC Future, discussed the issue of doctors not yet knowing what to do with all of this digital information that people want to share, and that analytic software is currently in development to allow doctors to collate and make sense of it.

Allowing health practitioners access to our data is one thing; but I don’t believe that everyone and anyone (e.g. employers, insurance agencies, health funds and marketing companies) has the right to access that information, as there is obviously a risk that the information shared or not shared could be used to the detriment of certain groups of people.

Think of the following groups of people:

  • Those who do not exercise or track their health and fitness
  • Those who do not have access to the technology or the ability to use the technology (think of digital exclusion), due to a host of barriers including educational, socio-economic, age, culture
  • Those with privacy concerns who do not want to risk the security of their information
  • Believe it or not, there are even those who see no reason to track their health and fitness!
  • And what if you are sharing your health and fitness data with your employer, health or insurance fund, and you stop exercising and eating well?

These groups could be penalised by employers, insurance agencies and health funds in the following ways:

  • increased premiums
  • exclusion from rewards programs
  • They could even be refused cover.

These are real concerns, and many writers have pointed them out:

  • Kelsey Munro, writer for SMH Digital life, discusses rewards programs and cheaper insurance premiums in the following blog post.
  • Kate Kaye of the Advertising Age, raises concerns re: people being penalised on the basis of their health data
  • Parmy Olson of Forbes Tech  warns about how employers could use employees’ fitness data to reward or penalise, how valuable fitness data would be to health insurers; and that people may be pressured by employers to use devices to monitor their health.
  • Nadia Cameron writes about MLC health insurance company giving health insurance customers the opportunity to lower the cost of their premiums in return for data on their exercise, sleep and lifestyle patterns.

And what about the safety and security of your data?

Ellis and Piwek state that a consumer typically doesn’t own the data collected by their device, and that this data is stored by the manufacturer and regularly sold to other organisations.  There appear to be no clear guidelines about whether the data is stored securely, or if it has identifying information removed; raising concerns that the data could be lost, stolen or altered.

So not only do we have to worry about the privacy of our health and fitness data and who owns it; but the safe storage of it, and management of it are also issues.

People are reluctant to store this information in “the cloud”, because they are concerned that it may be easily hacked.  Almalki et al (2013) discuss some of the issues surrounding management of the information, particularly the vast quantities of data being collected, how quickly it is growing, and how data like this is “difficult to manage in terms of organising, accessing, using, sharing and analysing in aggregate form”.  The authors discuss standards for dealing with the data, and big-data analytical tools that could be used to manage the data.

I’m not sure that I came out of the rabbit hole unchanged, or that I did justice to my journey, but it’s clear that a lot more work needs to be done in the areas discussed above to address these real concerns. I don’t have the answers, so I might finish with the wise words of Josh Cohen, writing for Prospect Magazine in his article “Quantified Self – the algorithm of life”.

Cohen questions the premise that self-knowledge can be achieved through tracking and technology.  He questions how effectively we can live our lives if we are simultaneously tracking them; suggesting that “perhaps the self you really want to know, and that always eludes you, is the one that can’t be quantified”.

Introductions

Hi everyone,

I’m Michele, and I am back in my 2nd Year of the MIS(LIP), studying part-time externally.  I live in lovely, sunny Yeppoon in Central Queensland.

I am a long-time speech pathologist, looking to change careers.  I have worked primarily with people with disabilities during my career.  I have learned a lot; about communication, speech, language, and behaviour; not to mention different approaches to therapy, including person-centred, relationship-based approaches through to didactic behaviourist approaches.  I have a special interest in the development of intentional communication, which occurs at  around the 8-10 month mark  in typical development, but may not occur at all in some people with profound disabilities.  Intentional communication is great, because it is at this stage that someone realises that they can use their behaviour to communicate a message to someone. This is where you see a whole host of communicative behaviours occurring (before the development of speech), including joint attention (this is very important – this is where a person shifts their gaze between something in the environment, to a person, and back to the something again), reaching for things, gesturing, leading people to what they want, giving and showing items, and pointing.  I love to see pointing. If I see pointing and joint attention, I think “woohoo! I might be able to teach some signs here, and this person could have a symbolic way to communicate”.  I love to use play and super-motivating activities to develop communication skills.

I could go on and on, but I won’t, because I understand that my particular area of interest may not necessarily be interesting to others.  If you have stuck with me for this long, I will wrap up by saying a little bit about what I like to do in my spare time. Actually, I don’t really have spare time. When I am not working, I am usually being a wife, mother, house-cleaner, runner, and now part-time student.  I do love to read and listen to music, and sleep.  I don’t get enough sleep.

Looking forward to the semester. I hope to have some fun playing with technology, while I am also learning.