Self-tracking as health promotion Paper for the conference ”Metric Culture: the Quantified Self and Beyond”. Aarhus, 7-9 June 2017 Erling Jelsøe Research Center for Health Promotion, Roskilde University, Denmark

Self-tracking Self-tracking by means of digital and other devices is a way to obtain information about one’s own body through measurement. There may be different incentives for self-tracking, but generally they are aiming at self-improvement and self-reflection (Lupton, 2016). One important incentive is to improve healthy living. As such self-tracking can be understood as a particular approach to practicing health promotion.

Two different contexts for self-monitoring and self-tracking The self-initiated application, typically among healthy people, with no direct relation to the healthcare sector. The institutionalised application within the healthcare sector (surveillance, diagnosis, treatment). This paper primarily deals with the first category (but there is an interaction, some self-trackers, for instance within the quantified self movement, are sceptical against the medical establishment).

Health promotion and self-tracking with a focus on the individual Self-tracking as an individual activity seems to go well together with the aims of health promotion as it is understood by health authorities and health professionals in most countries internationally. Thus, health promotion is very often , if not predominantly, seen as aiming at encouraging citizens to have a healthy lifestyle, through health campaigns and information etc. based on an understanding and identification of risk factors. In this conception of health promotion health is understood as the responsibility of the individual, reflecting a rationale of neoliberalism.

A social conception of health promotion Health promotion, however, is not necessarily associated with a focus on individual lifestyles. A more critical social conception of health promotion is outlined in the WHO Ottawa Charter from 1986. The Charter stipulates the following actions as central to health promotion: Build healthy public policy Create supportive environments Strengthen community actions Develop personal skills Reorient health services Ottawa Charter for Health promotion, First International Conference on Health promotion, Ottawa, 21 November 1986 – WHO/HPR/HEP/95.1

Some key elements of health promotion policies following the Ottawa Charter A focus on social determinants of health. Tackling health inequalities. Emphasizing community health. Health promotion initiatives in social settings. Resource mobilisation and empowerment. and “health is…seen as a resource for everyday life, not the objective of living”.

The social aspects of self-tracking? Self-tracking is concerned with the self and with the individual person’s own data. Does that mean that there is no room for social efforts among self-trackers, i.e. is self-tracking a purely individual undertaking? The answer is of course no since sharing of data and communication about them on social platforms – social media, chat rooms etc. – is a prominent feature of self-tracking activities as pointed out by several scholars (Sharon, 2016; Barta and Neff, 2015). But what are the implications of this in relation to a perspective of social health promotion activities?

Some significant features of data sharing Gamification Self-presentation

The virtual community Howard Rheingold in his famous and now classical book on “the virtual community” emphasized three “collective goods” associated with virtual communities: Social network capital Knowledge capital Communion Such values are basically in agreement with those of social health promotion. However, the book has been criticised for idealising internet communities and for technological determinism. This criticism is also relevant in relation to a discussion about the potentials of self-tracking communities

Sharing of data versus community formation Sharing of data does not necessarily imply formation of communities of mutually supportive participants for reasons already mentioned. A further and connected issue is whether virtual communities of self-trackers will be inclusive to socially vulnerable groups, who may lack the capability of participating in such communities? This question also highlights the problem of technological determinism, i.e. technology in itself does not ensure community formation that can be socially supportive, that also depends on the social context in which the technology is embedded.

The obsession with quantified data… How can communities focused on quantitative data give social support and empowerment to other members of the community? Common interpretation of data of and translation of data into narratives that can make the basis for social support? The large majority of self-trackers are not like the frontrunners in the QS movement, who meet regularly and exchange experience. To what extent can communities that are ´social´ beyond exchange of data develop? The availability of technologies is not enough. Indeed, most of the technologies that are available for self-tracking are designed to meet the individual’s quest for self-tracking, and in turn shape the individual.

The smart city as a framework for community health? The smart city may be associated with surveillance and control, but it may also offer opportunities for self-tracking, for instance in relation to traffic and air pollution, resource utilization, etc. Smart city networks might also become a medium for social support. If groups of citizens get access to data generation as well as decisions about how to use the data.

Technology and data in context Community orientation is an element in self-tracking activities. But often in an individualizing context (e.g. gamification, self-presentation). Developing virtual communities that can engage in social health promotion will be dependent on citizens, who set new agendas for use and development of data and technologies.