Are you healthy enough? Assumptions of the Healthism cult

I read Deborah Lupton’s paper Quantifying the body: monitoring and measuring health in the age of mHealth technologies [1]. This week’s paper really appealed to me because of its critical stance on a common cultural fad prevalent today: healthism. Healthism is the notion that positions the achievement and maintenance of good health above many other aspects of life and features of one’s identity, so that an individual’s everyday activities and thoughts are continually directed towards this goal. mHealth technologies such as headbands, wristbands, sports shoes, fitness clothing etc. have made it easy to collect data on one’s bodily functions and everyday activities like blood glucose, body temperature, body weight, heart rate etc.

In an age where being disease-free is not good enough, pursuing healthy lifestyles is seen as a virtue and shunning anything not contributing to that discourse is seen as a vice. In the words of Bryan Appleyard writing for The Independent [2], “Doctors have become the priests of this new cult of endless aspiration. They screen, check and warn the healthy, upbraid the sick and lecture us all on the multiple error of our ways.”. Lupton says that Healthist discourses value those who take responsibility for their own health and represent them as ideal citizens, while people who are viewed as lacking self-responsibility or who are ill are positioned as inferior and morally deficient.

Lupton takes a critical perspective on the mHealth movement within the Quantifying Self field. She highlights the techno-utopian assumptions and the image of the perfect(ible) body embraced by mHealth practitioners. She argues that problems related to tech-uptake or the digital divide are often ignored in mHealth discourses. Another point raised by the author is that while metrics generated by body monitoring devices etc. are hailed as liberating and promoting self-knowledge, there is still a politics of measurement: numbers are not neutral. The way in which phenomenon are quantified and interpreted are always implicated in power dynamics and ways of seeing.

In writing this paper, the author has taken a viewpoint that acknowledges the good brought about by empowering individuals to monitor their health and other related metrics. However, the purpose of this paper has been to raise the unspoken assumptions and the ‘healthist’ agenda present within such an enterprise. This has implications for researchers, who seek to implement public interventions, especially in the arena of health and education. One must recognise the techno-utopian assumptions that one inevitably brings to the table in such discourses.

An example of personal informatics that I want to discuss is Diabeto (diabeto.io), a Bluetooth-powered device aimed at diabetics, which transfers glucose readings from a glucometer to a mobile application. The readings can then be viewed and visualized within the app or online, and even shared with endocrinologists with a few clicks, to enable conversations about the issue. The creators of this solution aim to remove the tedious process of manually scribing glucometer readings in a diary and taking it to the doctor. The application is available on Android as well, making it accessible on the cheapest smartphones on the market. This will appeal to diabetics in India, called the world’s diabetes capital, and potentially can be used in rural contexts too.

References

1. D. Lupton, “Quantifying the body : monitoring and measuring health in the age of mHealth technologies,” vol. 1596, no. November 2015.
2. http://www.independent.co.uk/voices/healthism-is-a-vile-habit-it-is-no-longer-enough-simply-to-be-well-we-are-exhorted-to-pursue-an-1450141.html