In truth, I didn’t pay a tremendous amount of attention to iOS8 until a post scrolled by on my Tumblr feed, which disturbed me a good deal: The new iteration of Apple’s OS included “Health”, an app that – among many other things – contains a weight tracker and a calorie counter.
And can’t be deleted.
Okay, so why is this a big deal? Pretty much all “health” apps include those features. I have one (third-party). A lot of people have one. They can be very useful. Apple sticking non-removable apps into its OS is annoying, but why would it be something worth getting up in arms over? This is where it becomes a bit difficult to explain, and where you’re likely to encounter two kinds of people (somewhat oversimplified, but go with me here). One group will react with mild bafflement. The other will immediately understand what’s at stake.
The Health app is literally dangerous, specifically to people dealing with/in recovery from eating disorders and related obsessive-compulsive behaviors. Obsessive weight tracking and calorie counting are classic symptoms. These disorders literally kill people. A lot of people. Apple’s Health app is an enabler of this behavior, a temptation to fall back into self-destructive habits. The fact that it can’t be deleted makes it worse by orders of magnitude.
So why can’t people just not use it? Why not just hide it? That’s not how obsessive-compulsive behavior works. One of the nastiest things about OCD symptoms – and one of the most difficult to understand for people who haven’t experienced them – is the fact that a brain with this kind of chemical imbalance can and will make you do things you don’t want to do. That’s what “compulsive” means. Things you know you shouldn’t do, that will hurt you. When it’s at its worst it’s almost impossible to fight, and it’s painful and frightening. I don’t deal with disordered eating, but my messed-up neurochemistry has forced me to do things I desperately didn’t want to do, things that damaged me. The very presence of this app on a device is a very real threat (from post linked above):
Whilst of course the app cannot force you to use it, it cannot be deleted, so will be present within your apps and can be a source of feelings of temptation to record numbers and of guilt and judgement for not using the app.
Apple doesn’t hate people with eating disorders. They probably weren’t thinking about people with eating disorders at all. That’s the problem.
Then this weekend another post caught my attention: The Health app doesn’t include the ability to track menstrual cycles, something that’s actually kind of important for the health of people who menstruate. Again: so? Apple thinks a number of other forms of incredibly specific tracking were important enough to include:
In case you’re wondering whether Health is only concerned with a few basics: Apple has predicted the need to input data about blood oxygen saturation, your daily molybdenum or pathogenic acid intake, cycling distance, number of times fallen and your electrodermal activity, but nothing to do with recording information about your menstrual cycle.
Again: Apple almost certainly doesn’t actively hate cisgender women, or anyone else who menstruates. They didn’t consider including a cycle tracker and then went “PFFT SCREW WOMEN.” They probably weren’t thinking about women at all.
During the design phase of this OS, half the world’s population was probably invisible. The specific needs of this half of the population were folded into an unspecified default. Which doesn’t – generally – menstruate.
I should note that – of course – third-party menstrual cycle tracking apps exist. But people have problems with these (problems I share), and it would have been nice if Apple had provided an escape from them:
There are already many apps designed for tracking periods, although many of my survey respondents mentioned that they’re too gendered (there were many complaints about colour schemes, needless ornamentation and twee language), difficult to use, too focused on conceiving, or not taking into account things that the respondents wanted to track.
Both of these problems are part of a larger design issue, and it’s one we’ve talked about before, more than once. The design of things – pretty much all things – reflects assumptions about what kind of people are going to be using the things, and how those people are going to use them. That means that design isn’t neutral. Design is a picture of inequality, of systems of power and domination both subtle and not. Apple didn’t consider what people with eating disorders might be dealing with; that’s ableism. Apple didn’t consider what menstruating women might need to do with a health app; that’s sexism.
The fact that the app cannot be removed is a further problem. For all intents and purposes, updating to a new OS is almost mandatory for users of Apple devices, at least eventually. Apple already has a kind of control over a device that’s a bit worrying, blurring the line between owner and user and threatening to replace one with the other. The Health app is a glimpse of a kind of well-meaning but ultimately harmful paternalist approach to design: We know what you need, what you want; we know what’s best. We don’t need to give you control over this. We know what we’re doing.
This isn’t just about failure of the imagination. This is about social power. And it’s troubling.
Sarah Wanenchak is a PhD student at the University of Maryland, College Park. Her current research focuses on contentious politics and communications technology in a global context, particularly the role of emotion mediated by technology as a mobilizing force. She blogs at Cyborgology, where this post originally appeared, and you can follow her at @dynamicsymmetry.
Comments 78
Bill R — October 20, 2014
I could be wrong but I believe these kinds of apps have been here from the beginning, including free ones. If you're OCD you've got one.
Such apps, assuming some base of users want them, are here to stay, period. No study or written complaints of how they might be used by some people to hurt themselves is going to stop it. (About 40% of the households in this country own guns!)
I appreciate your concern but it would be better directed toward helping people cope with this additional fact of life.
Sara — October 20, 2014
Android user here, i think the health app sounds like a nice idea, but it should be removable which i think is part of a bigger problem. My old phone only had 2 gigs of space and there were so many apps that weren't necessary for my phone to be working, that i was not allowed to remove. I could only have a handful of apps on my phone at a time, which was incredibly annoying. My new phone has 32 gigs, so it's much less of a problem, but i would still like the option to delete the bloatware.
As to the other matter, I use a menstrual tracker called OvuView. It allows you to change to many different color schemes. Is not twee at all, and allows you to chose between different modes (avoiding pregnancy, trying to get pregnant and simple menstruation tracking). You can also customize what symptoms you track, there is a huge list and you can add your own as well. I don't think it's available for iphones unfortunately.
fuzzy — October 20, 2014
Just went and looked at the app---calories are tracked as a daily number you enter, not the happy tap the food you ate kind of tracker. So if you're trying to track food, you already have a far more sophisticated app on there anyway
Theresa — October 21, 2014
But it's a slippery slope. Any function on a phone can be used to "trigger" and enable an addiction or mental disorder, that doesn't mean there is any active sexism or ableism going on or that certain people are being deliberately slighted. The features on the Health app are very general. Whoever you are, your health relies in some way on energy input and output. Every one burns calories, but not everyone has periods. If you're going to have a fixed app, it makes sense to make it general, and yes, neutral.
SlipperySlope — October 21, 2014
Not to nitpick, but one could always choose to buy a different phone. Or an older iPhone and not update to iOS 8. Or if one can't make that choice because of a compulsion, what is stopping them (already) from compulsively downloading a free health-tracking app, or purchasing a similar app, on whatever phone they have?
This argument creates its own slippery slope. If you have a compulsion as discussed, you will have a health-tracking app, period. Unless you are unable to figure out how to download an app, or unless you choose not to own a smartphone. Whether or not Apple loads apps like this on all their iOS 8 products doesn't really change that situation at all.
I think the question of forced apps that can't be deleted is valid. As is the fact that a health tracker ought to allow tracking menstruation. But that's not the main thrust of the article, which I think overstretches slightly.
Ruby — October 21, 2014
Apple not letting you remove their apps is a major annoyance (does anyone use Stocks?). They should let you delete apps you don't want. I see the temptation for people with OCD or eating disorders, but there were always similar third-party apps to tempt them. As someone with a chronic illness, I like the 'Medical ID' feature of the iPhone Health app. Seems like that could be helpful in an emergency & could alert first responders to medications & interactions, blood type, etc. I don't like the calorie, fitness, sleep, and weight tracker in the app, and I refuse to fill out that information if for no other reason than I'm not sure how private & secure that data is. I think the addition of this app shows how much the "cult of fitness" has permeated our culture.
honoringmyfather — October 22, 2014
*golf-clap* bravo dr. contentious politics. this article clearly illustrates many failures, most of which are the credentials to obtain a PhD. "weren’t thinking about women at all"; right. Apple doesn't employ women, "pfft screw women" was actually the first choice before settling on "Think Different". Your vivid imagination should be directed tward theatre, but since you actually belive this to be true, i'd just like to say fuck you very much for using your social power to shit on folks, many of whom are emotionally and selflessly driven to produce this product.
Paul Harrison — October 22, 2014
There is a reason Google called their OS Android, it's like a human shaped mold.
As someone who grew up with computers, there is something claustrophobic about iOS and Android. You hardly have to think to use these machines, in fact you are not allowed to, you just poke at the thing you want. They organize you, you don't get to decide how you want to be organized. I don't want to stay human shaped, computers for me have always been about infinite potential.
Cory Doctorow talks about knowing and choosing what applications run on your devices as a fundamental freedom.
The mold in these devices has always been there, but you suddenly notice part of the mold digging into you uncomfortably.
Sunday links, 10/26/14 | Tutus And Tiny Hats — October 26, 2014
[…] only go so far in making HAES more inclusive. -Fatphobia: 5 facts and a guide for the disbeliever. -Apple’s health app: where’s the power? -When is weight a symptom? -Australian dance company Force Majeure has put out a call for fat […]
Links am Sonntag – 26. Oktober 14 | .- — October 26, 2014
[…] Apple’s Health App: Where’s the Power? – “The Health app is literally dangerous, specifically to people dealing with/in recovery from eating disorders and related obsessive-compulsive behaviors. Obsessive weight tracking and calorie counting are classic symptoms. These disorders literally kill people. A lot of people.” […]
The New Health App on Apple’s iOS 8 Is Literally Dangerous - Axis News — October 29, 2014
[…] post originally appeared on Sociological Images, a Pacific Standard partner site, as “Apple’s Health […]
Oscar Olim — October 29, 2014
Maybe they shouldn't bundle the messaging app, since so many people die driving while texting...
Annoyed — October 29, 2014
I'm addicted to porn. A web browsing app is on my phone? With private browsing mode?! Oh no, Apple. Shame on you.
This is ridiculous. Find something worthwhile to write about.
Chris R — October 29, 2014
Like people who comment on articles without reading them, I'm afraid this author has written an article without even remotely understanding the app. The iOS 8 Health "app" is a front-end (window) into a back-end database that essentially aggregates data from other apps like Map My Fitness and My Fitness Pal along with the data from the onboard motion sensor. In other words, it's not an app that one uses in service of their obsessions and/or compulsions.
mittendrin — October 29, 2014
I agree they shouldn't require you keep an app if you don't want or don't use it. But even if this was removable, you could still just download it and add it back again. People do have to do some work themselves to overcome these challenges, be they OCD or eating disorders or whatever else.
As for not including a tool for tracking menstruation, it does seem strange if this is touted as a general "Health" app, rather than one that is geared for something more specific, like weight loss. Given the level of detail they're offering about other things, and how simple it is to track menstruation, it seems like a big oversight. But given how male-centric tech companies are, it's very likely they just didn't consider women's needs. I shudder to think of the meetings they'd have to discuss building such features...
The Tech Daddy — October 29, 2014
Sarah, you may be a PhD student, but you're not doing well in grammar. You have misused (and over-used) the word "literally" in each instance in your article. And you're not alone. Just Google "literally" and the 1st 6 hits are all columns about this very topic. Anyway, just to be clear, an APP cannot "literally" be dangerous OR kill anyone. The effects of USING the app may do so. Please learn the difference between literally and figuratively. Other than that? Thanks for shining a light on this!
Guest — October 31, 2014
On the one hand complaining that Apple INCLUDED a feature that can possibly, hypothetically hurt hurt less than .1% of population (the person would have to be uniquely affected by this specific app rather than the million other that exists) while encouraging healthy physical activity in 100% of users.. on the other hand complaining that they DIDN'T INCLUDE a feature that would be a potential convenience to 50% of the population. How could they possibly win? strip out all activity monitors (heart rate monitor hearts exercise addicts, calorie counter and weight tracker hearts people with eating disorders) and make it solely a women's app to track menstruation?
pamb — November 3, 2014
Wah, wah, wah. Put the app on it's own screen, like the third screen, and never go there. Out of sight, out of mind. Apple, or any company, simply can't plan for every special snowflake and their issues. It's like all the hipsters complaining that U2 had infiltrated their 'curated' music files. Pssst, just don't download it. Problem solved.
Now no period tracker, which affects half the population, is different. Were no female on that team? If there were, were their suggestions were overruled? that's interesting to me.
Christopher Keele — November 4, 2014
I'm pretty confused by this article. I'm not sure the author has ever used the Health app.
As someone who uses it regularly and follows iPhone development, Apple really released two things:
1. Code libraries and APIs to help other apps put data into the Health app.
2. The Health app to help you visualize any data provided.
Clearly the concept behind the Health app is to assist the developers of these third-party apps, and thereby their existing users, in visualizing this data. No new temptation is present. The only automatic data source is the pedometer, which is probably not an invitation to too many destructive habits or compulsions.
The rest of the user interface is mostly designed to display data intended to be supplied by other apps; namely the ones that are already widely available, deletable, and not new temptations. The hope is that these apps will embrace the centralized display and opt in to funneling their information into a dashboard users or their doctors can refer to for a holistic glimpse into their health.
While manual data entry into the Health app is possible, it's not the intent of the application, nor is it encouraged. The article correctly asserts that "design isn't neutral". Briefly examining the design of the app shows this manual data entry to be cumbersome.
Graphs for each metric are easily accessible, and the ability to add data is only quietly tucked underneath each one deep in the interface. The forms for data entry are unwieldly. If a metric lacks data, it prompts you to install an application that will track the metric rather then ask you to enter your own into the tracker. No conveniences for data entry that make existing apps appealing are present, such as reminders, notifications, alarms, geofencing, or alerts. Indeed, supporting these features would require pages and pages of settings for each metric, let alone them all. And nearly all of the metrics provided in the application would require either external hardware or regular manual data entry.
In short, the ability to add your own data is clearly designed to supplement existing apps in case you missed a measurement, rather than enable you to use the Health app as your mainstay of gathering data.
All in all Health is designed to provide less temptation to fret over your health than installing a more robust application tailored to the metrics you care about. And if these apps that already exist choose to integrate with it, it'll display it prettily. And maybe send it to your doctor, if you install an application for that too.
Best case scenario, the author is concerned about what the app could evolve to be if Apple decided to compete with themselves in their own lucrative health and lifestyle application market, and chose to accept the onus of developing what is rightly a thriving, complicated ecosystem of apps and peripheral hardware upon themselves. But the language of the article doesn't suggest that.
Worst case scenario the author either ignored or never even inspected the design of application itself, and chose to write an uninformed or unresearched article in a fear-mongering tone about a sensitive and oft-mishandled topic to score some page views.
I don't think either of these hypotheticals constitutes good journalistic coverage or fosters positive discussion of these disorders or how technology affects them.
On the other hand, support for menstruation data just makes sense. That's literally the second application of this technology that came to my mind when I heard about the application's pending release watching the live stream of the developer conference.
Sayin — December 28, 2014
Hmm. I definitely see this as unfortunate for groups who have this issue, but it would be virtually impossible to design a computer with no features that could potentially harm someone with obsessive-compulsive disorder. Even a call-log can trigger someone with severe social anxiety.
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