The State of Self-Tracking

In January we started asking ourselves, “How many people self-track?”  It was an interesting question that stemmed from our discussion with Susannah Fox about the recent Pew report on Tracking for Health. Here’s a quick recap of the discussion so far.

The astute Brian Dolan of MobiHealthNews suggested that the Pew data on self-tracking for health seems to show constant – not growing – participation. According to Pew, in 2012 only 11% of adults track their health using mobile apps, up from 9% in 2011.

All this in the context of a massive increase in smartphone use. Pew data shows smartphone ownership rising 20% just in the last year, and this shows no signs of slowing down. Those smartphones are not just super-connected tweeting machines. They pack a variety of powerful sensors and technologies that can be used for self-tracking apps. We notice a lot of people using these, but our sample is skewed toward techies and scientists.

What is really going on in the bigger world? How many people are actually tracking?

A few weeks ago ABI, a market research firm, released a report on Wearable Computing Devices. According to the report there will be an estimated 485 million wearable computing devices shipped by 2018. Josh Flood, the analyst behind this report indicated that they estimated that 61% of all devices in wearable market are fitness or activity trackers. “Sports and fitness will continue to be the largest in shipments,” he mentioned “but we’ll start to see growth in other areas such as watches, cameras, and glasses.”

One just needs to venture into their local electronics retailer to see that self-tracking devices are becoming more widespread.

So why are our observations out of synch with the Pew numbers?

The answer may lie in the framing of the Pew questions as “self-tracking for health?” For instance:

On your cell phone, do you happen to have any software applications or “apps” that help you track or manage your health, or not?

Thinking about the health indicator you pay the most attention to, either for yourself or someone else (an adult you provide unpaid care for), how do you keep track of changes? Do you use paper, like a notebook or journal, a computer program, like a spreadsheet, a website or other online tool, an app or other tool on your phone or mobile device, a medical device, like a glucose meter, or do you keep track just in your head?

We think it is likely that many practices we include in our definition of Quantified Self are not being captured by the Pew Research. A person who tracks a daily run with a Garmin GPS watch might show up in the wearables data that ABI looks at, and might look to us as a self-tracker for health, but might be invisible to Pew. There may be even self-tracking practices that fall outside health or wearables. We’ve seen a large number of people who track time and productivity using computer applications such as RescueTime, apps that support well-being such as meditation trackers, mood trackers, and diet trackers; and apps that support general self-reflection and journaling, such as a life-logging app. Many self-tracking practices do not fit neatly into “health.” (Though they may influence health!)

In a way, there is a parallel here to what we found when we compared Fitbit with Fuelband data. Both of them produced different numbers for “steps.” When we got into the details, we ended up thinking that this was not a matter of one being closer to the “ground truth,” but of intentionally different interpretations of messy accelerometer data. Fitbit gives more step credit for general movement, because it is a lifestyle/activity tracker; Nike might prefer to credit intentional exercise, since the Nike brand sits closer to sports. Context matters.

This confusion about what is health tracking, what fits in the frame, is closely analogous to many other confusions in the conversation about health generally. It is common now in the healthcare world to talk about how the larger determinants of public health are outside the control of the healthcare industry; for instance, diet, exercise, stress, and exposure to environmental toxins. Sometimes people who make these observations follow them with a call for the healthcare industry to begin addressing these larger concerns; for instance, to “medicalize” tracking apps by making them prescribable and reimbursable by health insurers.

But maybe this isn’t the only approach. If the “healthcare” frame isn’t adequate to capture the most important determinants of health, we could try switching frames. What our journey through the self-tracking data suggests is that the opposite approach might be useful to consider: start with the bigger world of self-care practices, and enhance these. Why? Because that’s where we trackers already are. That is, how are we deriving meaning from self-tracking? That’s the mental framework that we typically use, and that we like to use. That’s where the growth – in terms both of us, and of cultural understanding, engagement, and knowledge-making – might really be happening.

We don’t know this for sure. We take the Pew data as evidence that this approach is worth trying.

This post first appeared on the Quantified Self Blog.

17 replies »

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  2. My question is how many people are generally self-tracking. Does self-tracking evolution is taking place in under-developed countries. I am obviously a very great admirer of self-tracking and would love any article related to this.

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  4. Majority of people take random measures without consulting the authorized personnel sometimes it give relief that is temporary and may slowly cause big trouble over long run

  5. For a more detailed conversation about what’s going here, it’s worth looking at the dialog Susannah and I are having in the original blog post at Quantified Self:


    I’m a fan of this blog. Still, it doesn’t strike me as good practice to life our whole post and republish here without permission. I’d appreciate a comment about this meta issue also. I’m not requesting it be removed, of course – I enjoy the dialog. But in the spirit of reasonable objection: I object!

  6. I’d like an SES breakdown as to who is doing self tracking?

    Dr. Rick Lippin
    Southampton, PA

  7. I do not understand why, if so many people are tracking their own data, is everyone getting so fat? Are they worrying more about their data and eating to ease the teething pain?

  8. Yes, there is some irony to this! Pew Research is exploring ways to marry organic data (aka big data) methods with our traditional survey methods in order to get an even more accurate picture of the population (for our tech research as well as political, religious, and other topics). I’d love to hear about successful examples of this type of research.

  9. I’m very happy to see THCB picking up this post from QuantifiedSelf.com. Gary & I exchanged some long comments over there and I hope you don’t mind if I paste a couple of mine here for clarification of the Pew Research findings:

    As I wrote in a comment on the January post, use caution in comparing studies. I stand by my own “soft” comparison to our 2010 self-tracking study AND the Pew Research trend data on health apps, but note that these are two separate questions. In one part of the survey, we asked about health apps — not just tracking ones, but any kind. In the tracking part of the survey, we asked about methods — paper, spreadsheet, medical device, website, etc. This was the first time that anyone (to my knowledge) has asked this question in a nationally-representative survey:

    Q26 Thinking about the health indicator you pay the MOST attention to, either for yourself or someone else, how do you keep track of changes? Do you use… [READ 1-6]
    Based on those who track a health indicator for themselves or others [N=2,183]
    % 34 Paper, like a notebook or journal
    5 A computer program, like a spreadsheet
    1 A website or other online tool
    7 An app or other tool on your phone or mobile device
    8 A medical device, like a glucose meter
    49 Or do you keep track just in your head?
    2 (VOL.) Other (SPECIFY)
    2 (VOL.) Don’t know
    1 (VOL.) Refused
    Note: Total may exceed 100% due to multiple responses.

    Do you think someone who uses wearables would not hear an option that they’d say yes to? If so, let’s work on an update to the question for the next time we field it so we capture that (probably small, but growing) segment.

    – and –

    I realized that I should also post the screener questions for the tracking section. You had to answer yes to at least one of the following to get the methods question:

    Q24 Now thinking about your health overall… Do you currently keep track of your own weight, diet, or exercise routine, or is this not something you currently do?
    % 60 Yes, keep track
    39 No, not something R currently does
    * Don’t know
    * Refused

    Q25 How about any other health indicators or symptoms? Do you happen to track your own blood pressure, blood sugar, sleep patterns, headaches, or any other indicator?
    % 33 Yes
    67 No
    * Don’t know
    * Refused

    CARE10 Turning again to the UNPAID care you provide to family, friends or others… Do you happen to keep track of any health indicators or symptoms for any of the people you care for?
    Based on all caregivers [N=1,171]
    % 31 Yes
    69 No
    * Don’t know
    * Refused

    I’m interested in suggestions for broadening these questions to be sure we are picking up everyone who tracks (note that 7 in 10 US adults are picked up by the 3 questions above though! That’s a big group already.)

  10. There is a certain irony here, don’t you think?

    We’re having trouble accurately tracking how we’re using tracking technologies? How could this be?

    Still, this is important work that will pay off in the long term

    Actually, come to think of it, the 11% number seems a little high to me – I’m not sure I’d be complaining too loudly about it.

    You were thinking 25%?

    11% isn’t a bad start at all

  11. I think it is very difficult to link sales of smart phones to how many people self track. The fact of the matter is people are more than likely listening to music, on Facebook and checking emails than tracking. I think the proof is in the state of health of Americans. Great article, thought provoking.

  12. The percentages offered are flawed, gross hype. But, it serves as a great sales pitch for the self monitoring industry. Al this as everyone is getting fatter.

    Then again, if they included scales and weight measurement, the percentage could be higher and should be higher.

    That is a brilliant idea. The US Government should require that every household own a scale, and it should subsidize the purchase, sort of like HITECH for HIT. It would be cheaper and outcomes would be better.

    Call the program SCALETECH.