I research, wear, and test health and fitness wearables here at Lifehacker. I also have a longstanding interest in public health. I wrote a book on disease epidemics through history, and the writing that first got me noticed by Lifehacker editors, a decade ago now, was published on a blog called Public Health Perspectives. So understand that I am not a newcomer to either of these fields when I say: wearables are not going to “make America healthy again," Mr. Secretary. What the hell are you thinking?
The brief exchange Kennedy posted was incredibly vague about what a wearable is, and how they are supposed to improve anyone’s health. (In his questioning, Troy Balderson, a representative from Ohio, referred to “wearables” that let people monitor their health and share that data with providers, and classified these devices as “innovative wellness tools.”)
But that’s not what a smartwatch does. That’s not what any conventional wearable does, really. If you want to see what’s happening to your glucose levels after you eat food, a continuous glucose monitor (CGM) can do that. (More about those in a second.)
But, OK, maybe he was getting things confused. Smartwatches, rings, and straps can track your heart rate throughout the day, as well as your physical activity (steps and exercise), which Kennedy also mentioned. He’s certainly highlighting things that the makers of wearables would love to see discussed favorably in front of Congress.
This isn’t about health at all
Ad campaigns are what you undertake when you want people to buy your product—with their own money. If you thought wearables were truly the future of public health, a suitable action might involve providing free wearables to those who need them, or subsidizing the cost of purchasing one. An even more important action would be setting up a system to study these wearables, providing rigorous data on accuracy and real-world usefulness while the models you tested are still on the market. (Currently, we don’t have a way of getting reliable data until devices are nearly obsolete.)
No, this isn’t about health at all. Kennedy seems to be working with tech companies to promote their products—expensive products that provide an aura of health-ishness. Not long ago, he met with health executives including from Whoop (a $239/year subscription product) and Function Health (lab tests well in excess of what your doctor would order, which is why you’re going to a separate company to get them, with packages starting at $499), to name just a few.
A smartwatch or continuous glucose monitor, like a field trip to a farm, is a mostly useless luxury. You’re not protecting yourself from milkborne pathogens by petting a cow, and you’re not making yourself healthier by obsessing over data from health apps.
Everything you can do with an expensive wearable, you can do for free all by yourself. You can just decide to go for a walk after dinner every day, without knowing exactly how many steps it takes or how many active zone minutes it earns you. You can go for a run without tracking your heart rate, and your fitness will improve just the same. You can go to bed early because you feel tired, rather than needing a watch to tell you you’re trending five minutes lower on deep sleep this week compared to last week. You may forget these obvious truths if you’re deep down the wearables rabbit hole, but we all know they are true, don’t we?
And this brings me to the continuous issue of glucose monitors, or CGMs, that Kennedy referred to—and that Casey Means, Surgeon General, sells at the company she founded. CGMs were originally a medical device meant for people with diabetes, but are now available to the merely glucose-curious.
Glucose monitors can't make you healthy either
But companies like Levels (Means’s company) encourage people to track their glucose for vague health-related reasons. Levels’s app costs $199/year, but you’d also pay $184 for each glucose sensor. The sensor sticks to the back of your arm and transmits data to your phone. The model sold by Levels lasts about 10 days, so it would cost thousands of dollars to use the sensor continuously for a year. CGMs are usually covered by insurance for people who need them to manage their diabetes, but if you’re just buying them on your own, you’ll pay full price.
It’s not even clear that there’s any benefit for non-diabetics to track their glucose. A study published earlier this year found that CGMs tended to overestimate glucose levels for people without diabetes, especially when the people in the study ate fruit or drank smoothies. One of the authors said of the findings that “For healthy individuals, relying on CGMs could lead to unnecessary food restrictions or poor dietary choices.”
Americans need actual health care, not wearables
They’ll never cite a particular timeframe, of course, because there isn’t a good one to pick. The 1980s, when HIV had no treatment and took countless lives? The 1950s, with frequent polio outbreaks? The 1920s, when diphtheria was known as the “children’s plague”? Perhaps sometime in the 1800s, pre-antibiotics, when surgery and infected wounds could easily lead to death? Or in the early 1900s, when 10% of babies didn’t survive their first year of life?
I’d rather have Americans be healthy now, with access to vaccines and reproductive care and good research and all the other things that we know help people to stay healthy. Wearables don’t begin to cover it.
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