Making wearable health tech accessible to more Americans is an excellent idea — with a huge potential catch

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In a congressional hearing this past week, Health and Human Services Secretary Robert F. Kennedy Jr. shared his views on improving the health of Americans. 'My vision is that every American is wearing a wearable within four years,' he said. And next week, his department is scheduled to launch one of 'the biggest campaigns in HHS history,' focused on encouraging Americans to use wearable technology to 'take control over their own health.'
Making wearable health technology accessible to more Americans is an excellent idea — the massive $63 billion market for fitness trackers and $12.6 billion glucose monitor sector are growing exponentially due in part to the fact that awareness of one's biometrics, from steps taken to sleep quality to calories consumed, can help improve health. But we shouldn't overstate the power of these devices to transform the well-being of Americans, both because of the limitations of these technologies and because of the administration promoting it.
Wearable health aids have a long history. Leonardo da Vinci designed the first pedometer around 1500, and Holter heart monitors were invented in 1949. Digital technology, however, has accelerated innovation in this space exponentially, such that in the 15 years since the release of the first step-counting Fitbit in 2010, devices now track sleep, breath, stress levels and more.
A federal campaign to promote wearables appeals to the commonsense idea that the more you know, the better equipped you are to improve your health — and thus more Americans should have access to this knowledge. And this initiative certainly lines up philosophically with the individualistic sensibility at the heart of the 'Make America Health Again' movement's animating definition of wellness, which elevates self-knowledge — 'do your own research' — above clinical expertise, especially if it involves pharmaceutical intervention. Indeed, in the hearing, Kennedy described friends who 'lost their diabetes' after wearing glucose monitors, thanks to their 'miraculous' awareness of the impact of their dietary choices (evidence does show that diet and exercise changes can reverse Type 2 diabetes, and that continuous glucose monitoring can be effective in motivating patients to make those shifts). Notably, the proposed HHS wearables campaign would come with a price tag of $80 a month for individuals, as opposed to GLP-3s, which can cost a person over $1,000 monthly.
You don't need to be a MAHA acolyte to find this strategy compelling for a nation struggling with both chronic illness and the cost of health care. Furthermore, large-scale advertising campaigns encouraging personal fitness are a long-standing and effective federal strategy. It was Kennedy's uncle President John F. Kennedy who most famously employed this approach, launching a national publicity campaign to encourage Americans to be more physically active, both in their personal lives and by lobbying local officials to fund physical education and community recreation programs.
That was during the Cold War, and JFK often linked the need to get moving with military preparedness. But he also talked about taking responsibility for looking good and feeling 'vigorous,' for men, women and children alike. 'Soft Americans' were morally suspect and national security risks, the then-president-elect wrote in a 1960 Sports Illustrated essay, but they also looked less attractive at the beach or the pool, the environments in which he was often photographed.
Physical education classes were as important as academic offerings, his administration emphasized in pamphlets, posters and even a special-release jingle written for P.E. classes that encouraged boys and girls through a playful, synchronized routine to 'get rid of that chicken fat.' These federal campaigns didn't solve the issues of sedentariness and obesity, but they were integral in establishing the expectation that it is the responsibility of every American to care about their physical fitness.
Echoes of the elder Kennedy's approach are unmistakable in Robert F. Kennedy Jr.'s announced advertising campaign. The differences, however, should give us pause. For one, the sophisticated wearable technology the health secretary celebrates as 'miraculous' is much more powerful than the toe touches and jumping jacks promoted in JFK's day. This is a boon, but we should be wary of the 'techno-utopianism' that assumes more sophisticated technology always yields a better future.
Psychologists, for example, track a recent rise in orthorexia, body dysmorphia and anxiety, disorders that only stand to be aggravated by access to endless streams of biometric data. More philosophically, sociologists warn of the dangerous tendency toward 'the quantified self' and attendant 'intimate forms of surveillance,' in which we normalize defining ourselves as an agglomeration of figures and metrics, existing only to be optimized.
Most immediately, as Kennedy was asked in the hearing but did not clearly answer, are concerns about data collection and privacy, especially relevant due to recent breaches like the 23andMe hack, which leaked the data of millions of users to the public and potential nefarious actors. Fitness tracker data has already created a specific liability. The Strava running app, for example, has repeatedly revealed sensitive locations of troops and political figures to the public.
These are thorny but perhaps resolvable problems. It is true that making America healthy is an urgent priority and that individuals should be empowered to be stewards of their own well-being. We must use every tool at our disposal to achieve better health outcomes, and this can include partnering with the dynamic fitness and technology industries, the innovation of which outpaces that of the public sector.
That said, we should not overstate the 'miraculous' potential of any intervention, and especially given this administration's repeated ethical breaches on questions of security and science — and even its alleged affinity for eugenics — we should be especially vigilant about how this initiative is plays out.
This article was originally published on MSNBC.com