When I talked with Jia, who works for an e-commerce company in Shanghai, China, she was trying to finish a “Perfect Month Challenge” on her Apple Watch. That meant closing the rings on her watch every day for a month—achieving goals for standing up once an hour across all 12 hours, burning over 400kcal calories, and exercising 20 minutes. She was fully invested in this project, until Shanghai hit a lockdown due to the COVID-19 outbreak in early 2022, and she suddenly lost the streak. “The ‘firework’ after closing the rings is so nice, and the ‘Perfect Month’ sounds attractive to me,” she said, “I was drawn into exercising, and made a lot of progress, and setting myself a new goal every now and then. But this is also a source of anxiety and stress, and once I couldn’t keep up, I would just let go.”
This experience, from obsession to disappointment, might resonate with a lot of people who have made goals to track themselves, especially after Apple Watch and other trendy wearables took over the consumer’s market. Every time I introduce myself to a crowd and say what my research is about, I always ask “How many of y’all wear Apple Watch, Fitbit, or anything like that?” A few would raise their hands with some shiny gadgets around their wrists. I then ask “Do you love them? Hate them? Or—love and hate at the same time?” They will politely laugh, or nod, admitting that although “I like how it tracks everything,” but “it’s annoying sometimes,” or “I can’t really meet my 8,000 steps goal every day.”
It is a love and hate relationship, as we gain knowledge of ourselves by numbers, getting excited about the fun parts of self-tracking, while getting disheartened at the never-achieving goal of self-improvement. Described as the “bitter-sweet ambivalence,”[1] this technological intervention is not all smooth and positive but always carries the “not working out” part that delivers negative affective elements. In addition, the technological practices indicate another layer of bitterness—hidden labor. By quantifying our health, self-tracking makes explicit the points of actions for improvements. It blurs the boundaries of health and illness. We all have something to learn, to correct, to improve in order to reach a healthier status but never perfect. In a sense, self-tracking makes managing health harder, not easier.
We are asked by society to take the harder route. This implies deep attachment to the commercial interests and modern health ethics. The living experiences from the ethnography, the feelings, emotions, and interpretations from the users reveal how users situate themselves with numbers, and give us clues about the evolving relationship between humans and technologies of personal data collection.
Easy vs. Hard
A user checks their rings on their Apple Watch. Image by Anna Shvets, via Pexel.
As Jia’s experience indicates, rather than making progress and reaching goals as a linear, smooth process, which many of the self-tracking apps propose and promises to us, users’ patterns of use across time often look like this—a ‘fun’ period, a resolution filled with enthusiasm, followed by disruptions and bounce-backs, and the worst case, a total give-up. Health-related tracking apps have long struggled with the “adherence” or “compliance” of users’ continuous use.[2] Then, users often blame themselves for not being self-disciplined or determined enough to make change happen.
Of course, we love the idea of making progress, being self-realized, and productive. This love is shaped partly by how technology imagines each of us as a high-achieving consumer of health in a marketized world. We fail to do it, not because of us being lazy or lack of self-discipline; rather, it is the making of a datafied life,[3] “outsourcing” out experiences and perceptions to objectified numbers.[4] The sensors, apps, and health promotions produce the numbers, which encapsulate and glorify the idea of personal productivity while ignoring who we are and what we do.
Sometimes, the biggest promise of self-tracking apps is that they make exercising simple and smooth. Everything is recorded via wearable sensors, and all the interactive features will guide the users through various stages of their fitness journey. There are countless design tricks that give users a “nudge,”[5] a psychological term to describe that through certain mechanisms, people can be attracted, lured, or hooked to do something subconsciously. Things like a hot red button will make users eager to click. Designers believe that such mechanisms can also be put into good use, and make users easily “addicted” to what are considered optimally healthy behaviors. A nice sound effect after every exercise? Check. A friendly notification to push users to finish their daily walk? Check. A ‘level-up’ after every consecutive 10-day tracking? Check.
However, lived experiences often differ from the imaginaries of technologies. My research focuses on self-tracking and wearables in China, especially among the overworked—those who work in the notorious “996” schemes (9 a.m. to 9 p.m., 6 days a week). Health management is seen as necessary as many of my research participants suffer from work-related stress and sedentary lifestyles, but there is a bigger challenge when it comes to self-tracking. People with a busy schedule want something that’s simple and straightforward, but have mixed emotions towards all these “make things easy and attractive” designs to boost healthy behaviors. Many of my research participants love a sense of achievement and the joy that a game-like experience could bring. However, their experience with self-tracking is far from easy. All the interactions—recording, tracking, celebrating, and summarizing—demands extra work. The interpretations of numbers are detached from their daily routine, and engaging with the tracking device calls for extra attention. The plans that self-tracking apps provide ask for a lot of information and require users to meticulously manage their change of weight, calculate the intake and consumption of calories, and take times in between shifts to finish daily exercise quota. Many of the apps break down goals to daily actions and encourage continuous record-taking. Phone notifications will ring every day at a certain time, whether or not you are eating, chilling, or in a meeting.
More than half of my interviewees work overtime, and most of them are faced with various health concerns. They recognize that fitness and health are important, and some think that they need to be making lifestyle changes. However, the conflict associated with self-tracking is not only as it relates to a lack of time—since self-tracking apps break down your daily goal into 15-min ‘easy’ tasks—but also to the amount of mental resources that the whole idea of self-management takes. The quantification of goals, tasks, and rewards resembles work and are doubtless a form of hidden labor. Contrary to the image of these tasks being of the ‘easy,’ they are mentally and physically challenging. Relentless progress, non-stop monitoring and self-monitoring, and the interruptions protruding from daily routines all make self-tracking with an app ‘hard’ work. The stress from work, from the fitness tasks, and ultimately, from the demand of self-management and self-improvement, accumulates and reinforces the sense of burnout. One interviewee, in his 40s, described his cycle of stress, mentioning that the tiredness from work was the biggest obstacle. However, the fact that he couldn’t finish the simple daily task of exercise and “lost track” added a sense of self-blame and failure, which pushed him into deeper distress. Everything added up eventually to a point that he gave up on his exercise goals.
Turning Health into Productivity
The idea of endless self-improvement is not alien to us as self-help books and “how-to” videos everywhere claim to help us make resolutions and make us hold the belief on making change for a ‘better self.’ As a society, we are also not unfamiliar with the self-blame after the resolutions fall apart and we fail to realize our promises to change. The origin of such beliefs is the individualization of society, which seeps through every aspect of our life: work, education, health, well-being, and selfhood, where we are made to believe that we are on our own. Without adequate community support and a robust social safety net, our health is also individualized, and health has become an individual choice. Self-tracking and wearable technologies epitomize such a belief. As we (seem to) gain control and knowledge of every bit of what is happening in our bodies, the responsibilities of making changes are shouldered upon us. The social norms—being fit, being efficient, and being responsible—are built into the design and internalized through our actions with self-tracking apps and wearables.
One outstanding aspect of such self-improvement is to equal productivity with responsibilities and self-care. The cult of productivity prevails as we are surrounded by such languages and discourse of producing and measuring values. Making a change is to log and register it with quantified numbers, i.e., to translate daily routines into challenges and achievements. Research has revealed that quantifying fitness and health will undermine a person’s intrinsic motivation by acting upon extrinsic numbers.[6] But in today’s culture of productivity, the line between intrinsic and extrinsic value blurs, and so as work and life, fitness and health, social and personal. The growth and improvement in numbers becomes a part of our selfhood as we detach ourselves from the environmental and social aspects of health and treat the body as a workable project.
This culture of productivity aligns with the commercial interests of health tech and with a hunger for data. For the users, their daily numbers are achievements and badges of honor for being a better self. For the Venture Capital supported businesses, the numbers are a gauge of a user’s ‘value’ of how much data can be harvested, and how many services, subscriptions and products can be sold. The hidden design language behind the frenetic narrative of improvement and progress is that the more engagement users make, the more they are valued as a savvy customer in the “ecosystem” of data. The scenario is promising, yet not enough to deliver a stable profit yet, as some of the most promising health tech start-ups, such as Peloton, are not faring well. This in turn leads us to question the long-held belief of health tech: is it actually productive to wrap fitness and health in the model of productivity? What might it mean to flatten every lifestyle change into taking courses, tailoring plans, and making achievements?
Re-contextualized Numbers
An interviewee joked about the wristband being a “digital handcuff.” “It does work sometimes,” she laughed. Scholars might agree with the Foucauldian metaphor that self-tracking is also self-surveillance. It’s about how power gets embedded in the technology and renders our bodies legible and manageable to politics.[7] But situated in living experiences, numbers acquire more meaning toward the practice of self-care. What do people talk about when they talk about their numbers? Beyond the sense of achievement, the urge for a change, and the cycle of self-blame, self-tracking has, however, given them a way to comprehend their health in a bigger picture. The human-tech relationship is a two-way bridge, that human livings are co-shaping the meanings of technology, linking to the historical, social, material and mundane context of “everyday life.”[8]
I asked my interviewees to send me screenshots and charts of their self-tracking records, and talked through the colored charts with some self-reflection questions, such as: How did you feel? What happened in your life when you achieved that number? What else did you notice throughout the tracking of your daily routine? It is a process of re-contextualizing each of their numbers, and it shows how varied and unpredictable our lives can be, versus the monotonous patterns and plans that self-tracking apps lay to them. For example, one interviewee recalled that after a stressful day and conflicts with her boss at work, she pushed herself further on the treadmill. “Look at my heart rate. It went up steadily, and I was getting into a flow where I felt in control and cleared up my mind.”
People re-associate their experiences, positive or negative, with their life events and changes, and what they value about their bodies. One important thing that many of them mentioned is the association between their workload and the fluctuation of the way their bodies perform. Self-tracking makes them more sensitive to their bodily changes, or how their bodies respond to stress, lack of physical activity, and an unhealthy diet. Some of them will choose a certain set of numbers to follow and try to maintain them at an acceptable level. For that, they tend to do less, thinning on daily tracking and recording rather than making more comprehensive plans or commitments. As one interviewee recalled, “It is enough to know roughly where I am at, and precise numbers don’t make too much sense.” The data from self-tracking are re-contextualized as life narratives, which help them maintain a balance of work and life, and negotiate a “self” that they can have control over, such as “keeping an eye on my resting heart rate.” In this way, self-tracking is seen as an interface to construct and understand their selfhood. It is a mixture of society’s expectations of self-management of health, and the social and personal restraints one must navigate.
Most of the self-tracking devices right now are commercial products, which are driven by data centric profit gains, and shape the image of a productive and responsible individual (as a consumer of health). But what we should learn about self-tracking is to look beyond the models of measuring productive behaviors towards lifestyle changes and situate them into living experiences, where data is given multiple meanings and interpretations. It can help people frame their health or illness narratives and reveal the social and structural predicaments that people struggle with.[9] There is a lot of potential for us to make the numbers our own.
Footnotes
[1] Diefenbach, Sarah. “The Potential and Challenges of Digital Well-being Interventions: Positive Technology Research and Design in Light of the Bitter-sweet Ambivalence of Change.” Frontiers in Psychology 9 (2018): 331.
[2] Kelders, Saskia M., Robin N. Kok, Hans C. Ossebaard, and Julia EWC Van Gemert-Pijnen. “Persuasive System Design Does Matter: A Systematic Review of Adherence to Web-Based Interventions.” Journal of Medical Internet Research 14, no. 6 (2012): e152.
[3] Ruckenstein, Minna, and Natasha Dow Schüll. “The Datafication of Health.” Annual Review of Anthropology 46 (2017): 261-278.
[4] Smith, Gavin JD, and Ben Vonthethoff. “Health By Numbers? Exploring the Practice and Experience of Datafied Health.” Health Sociology Review 26, no. 1 (2017): 6-21.
[5] Thaler, Richard H., and Cass R. Sunstein. Nudge: Improving Decisions About Health, Wealth, and Happiness. Penguin, 2009.
[6] Lister, Cameron, Joshua H. West, Ben Cannon, Tyler Sax, and David Brodegard. “Just a Fad? Gamification in Health and Fitness Apps.” JMIR Serious Games 2, no. 2 (2014): e3413.
[7] Ajana, Btihaj. “Digital Health and the Biopolitics of the Quantified Self.” Digital Health 3 (2017): 2055207616689509.
[8] Fors, Vaike, Sarah Pink, Martin Berg, and Tom O’Dell. Imagining Personal Data: Experiences of Self-Tracking. Routledge, 2020.
[9] Ruckenstein, Minna. “Charting the Unknown: Tracking the Self, Experimenting with the Digital: Reflection.” In The Palgrave Handbook of the Anthropology of Technology, pp. 253-271. Singapore: Springer Singapore, 2022.
References
Ajana, Btihaj. “Digital Health and the Biopolitics of the Quantified Self.” Digital Health 3 (2017): 2055207616689509.
Diefenbach, Sarah. “The Potential and Challenges of Digital Well-being Interventions: Positive Technology Research and Design in Light of the Bitter-sweet Ambivalence of Change.” Frontiers in Psychology 9 (2018): 331.
Fors, Vaike, Sarah Pink, Martin Berg, and Tom O’Dell. Imagining Personal Data: Experiences of Self-Tracking. Routledge, 2020.
Kelders, Saskia M., Robin N. Kok, Hans C. Ossebaard, and Julia EWC Van Gemert-Pijnen. “Persuasive System Design Does Matter: A Systematic Review of Adherence to Web-Based Interventions.” Journal of Medical Internet Research 14, no. 6 (2012): e152.
Lister, Cameron, Joshua H. West, Ben Cannon, Tyler Sax, and David Brodegard. “Just a Fad? Gamification in Health and Fitness Apps.” JMIR Serious Games 2, no. 2 (2014): e3413.
Ruckenstein, Minna. “Charting the Unknown: Tracking the Self, Experimenting with the Digital: Reflection.” In The Palgrave Handbook of the Anthropology of Technology, pp. 253-271. Singapore: Springer Singapore, 2022.
Ruckenstein, Minna, and Natasha Dow Schüll. “The Datafication of Health.” Annual Review of Anthropology 46 (2017): 261-278.
Smith, Gavin JD, and Ben Vonthethoff. “Health By Numbers? Exploring the Practice and Experience of Datafied Health.” Health Sociology Review 26, no. 1 (2017): 6-21.
Thaler, Richard H., and Cass R. Sunstein. Nudge: Improving Decisions About Health, Wealth, and Happiness. Penguin, 2009.
