Wearables are too expensive for groups underrepresented in medical research

Most people who use smartwatches and other wearable devices that can track health are white, well-educated, and wealthy. That’s not because other groups aren’t interested in using the devices to track their fitness, heart rate or other metrics, according to a new study. Only the costs of these devices are too high. That leaves out lower income groups and racial minority groups from research studies using portable data.

The study was conducted by researchers at the All of Us Research Program, an initiative of the National Institutes of Health with the goal of building a health database representative of the United States. The team is purposefully trying to include groups that are historically underrepresented in medical research. As part of the program, the researchers wanted program participants to send health data directly from Fitbit devices. However, they found that the demographics of the people who decided to send data were whiter and richer than the racial and socioeconomic diversity of the project as a whole.

To find out why, the team surveyed more than 1,000 patients at six federally qualified health centers that provide medical care to underserved communities. About 40 percent of the people who responded identified as Hispanic, 36 percent as non-Hispanic black or African American, and 15 percent as non-Hispanic white. Two-thirds of the surveys were conducted in English and one-third in Spanish. Most had a high school education or lower.

More than half of the people who responded to the survey said they’d be interested in a fitness tracker and said they’d be interested in things like tracking their steps or heart rate. Of the group that was interested, 49 percent said they: do not have a tracker because they are too expensive. Nearly 20 percent said they don’t know how to use them, and 15 percent said they don’t know how a tracker could help, but they would like to learn.

The research team also found that language barriers can prevent people from using a smartwatch: Many Spanish-speaking participants were concerned about using “tracker” to describe the devices and thought their movements would be monitored.

As more and more health features are built into wearable devices, they are becoming an important tool used for both individual people’s health and medical research. But if groups like those served by Federally Qualified Health Centers are excluded from the products, smartwatches will ultimately amplify existing equality gaps in healthcare and health research. When groups are not represented in studies, the results cannot be generalized to those groups and they miss out on the benefits of new findings.

But the study results show that intentional work to close those gaps could help members of the All of us team wrote in an editorial in status† “Clearly, the willingness of participants to use wearable technologies is there,” they said. “Targeted efforts to build access, opportunities and infrastructure will enable all communities to benefit from the scientific knowledge gained through wearable technology data.”

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