Susannah Fox Q&A on Pew’s Latest Health Tracking Report

The most recent report to come out of the Pew Research Center’s Internet & American Life Project found that seven out of 10 American adults track some kind of health indicator such as weight, diet or a symptom. “Tracking for Health” also reported that about half of trackers aren’t using any formal method, rather they’re keeping score in their heads. Associate Director of the Project and lead author of the report, Susannah Fox gave her quick take on the results.

Q. What was the reason for doing this study right now?

For a few years now I have been doing fieldwork in patient communities online, and I had done some initial fieldwork in patient communities that were focused on cancer. And then I expanded and had been doing fieldwork on the website PatientsLikeMe, talking to people who were in some of their communities. Most recently I did fieldwork looking at communities of people living with rare disease.

The theme that kept coming up, especially in the communities related to rare and life-changing conditions is how much the patients or their caregivers were tracking their own health data. They were collecting symptoms and details about the home care and about the health of the person that they were caring for or their own health, that were way beyond what is reflected in an electronic medical record or a paper health record. And beyond even what people might share with a doctor or a nurse.

I was struck by how technology is giving people new tools to track their own health. So in 2010 we fielded just two exploratory questions in a national survey. We asked Internet users if they track their weight, diet or exercise routine online. And in a separate question, whether they track any other health indicator or symptom online.

The limitation to those questions is that we focused on technology. We’re the Pew Internet Project so that makes sense, but I got a lot of feedback when we published that data that that really wasn’t good enough. To really understand the role of tracking in people’s lives, we needed to widen the scope.

So in 2012 we started exploring this idea. I blogged about it. I put questions on Twitter. I did a lot of crowdsourcing and interviews with people about how they tracked their data, and we put together this questionnaire, which included some more in-depth questions. And this time we asked all adults about tracking, and we did not limit it to the use of technology. Which yielded some pretty interesting findings.

Q. I’ve come across different headlines on this study from “More Using Electronics to Track Their Health“ to “Many People Still Technology-Averse When it Comes to Tracking Health Issues.” What is your take?

One thing that I love about my job is that I get to take measurements and not pass judgement. So it’s up to other people to look at the data and say whether it’s a good or a bad thing. I feel like sometimes we are a thermometer of the American people. We’re just telling you what temperature the American public is, and then you can decide whether anybody needs to take action ― whether it’s a fever or not.

I also enjoyed the coverage, that some people see the glass half full, some people see the glass half empty. Where some people see a challenge, other people see an opportunity. So the facts are that seven out of 10 American adults say they’re tracking some aspect of health, whether it’s for themselves or for someone else. But then the follow up question: how do you track? Half are keeping track just in their heads, and the other half are using some formal mechanism whether it’s as simple as writing it down in a notebook or journal or using a spreadsheet, a website, an app, a medical device, any form of technology.

And that’s where I think the opportunity for making a judgement starts. Just at that basic level of this is potentially a very large market of people who are tracking their health. But let’s look at the reality of people’s lives and where they are now. And that is that half of them are using very informal methods to track their health.

Q. Personally, do you track anything?

I had a wonderful opportunity with this study to actually speak publicly about it before I wrote the formal report. I gave a speech about how when I was entering into this field of study, I did not have a background. I’m not a quantified self person. I don’t even own a scale. The main way that I self track is that I have a pair of skinny jeans that I know I’m at my target weight if I can fit into these jeans. And what I love is that Carol Torgan, who’s a friend of mine and is an advisor to me on this issue, actually found a study that shows that 62% of women use a pair of jeans to track their weight ― which I love!

So that’s really the extent of my tracking. That’s why it didn’t surprise me very much to find out that there are so many Americans who are using informal methods to track their health because they’re one of my people. I’m part of that group.

Q. Given that we know more technology ― more apps and more devices ― will come out, how do you expect adoption numbers to look the next time you do this exact survey? 

It’s a challenge for us as survey researchers to create questions that capture a very fast-moving industry, and when it comes to mobile devices, and technology and health, we have had to update our questions and change the wording. And I think we’re going to continue to need to do that as this field changes.

What we haven’t seen so far since we began tracking health apps in 2010, is any significant uptick in adoption. We have seen a proliferation of apps. There are many, many more apps on the market now than just three years ago, but we in our survey questions have not picked up any increase in the percentage of American adults who are using them. There are a lot of factors that could go into shifting that. One is the increase in mobile devices. Another is if there emerges a killer app ― some software application that turns out to be clinically very useful and is maybe recommended by a doctor or recommended by a whole practice field. That’s one way that thing could shift.

There could also be a consumer movement where people start to adopt a certain app or a certain technology, and it’s just so useful, they can’t help but infect their friends with excitement about it. It’s very fun to look at signals of this and to try and figure out what’s coming around the corner. But what we have is data about what’s happening right now. And right now, the use of mobile devices and apps for tracking health is still quite low.