Obesity is a major concern for Americans of all age groups. According to Gallup, the obesity rate among Americans rose to 27.7% in 2014 — up another 2.2% from the rate in 2008. Young adults are no exception. Although much has been made of the Millennial generation's health-consciousness and willingness to use disruptive healthcare innovation to effect change, impactful results have not been as forthcoming as many of us thought they would be.
In the 2008 Gallup study, 17.4% of American adults aged 18 to 29 were obese; in the 2014 follow-up, 17.7% were obese. Although the rate of change was flatter among Millennials, the trend was nonetheless positive. The obesity rate among younger adults is still climbing.
Are healthcare engagement apps showing real returns?
They may not be. A study recently published in the journal Obesity found that a weight, calorie and exercise-tracking smartphone application had no discernible effect on Millennial patients' weight loss efforts.
In the study, participants aged 18 to 35 were divided into three groups. One group was given a gamified, interactive Android-based app that could be used to track caloric intake, log exercise and monitor the user's weight. Another group received the same app, plus six weeks of personal weight loss coaching sessions, followed up thereafter by monthly phone calls. A control group was given printed information about exercise and healthy eating, but no app and no coaching.
The app-only group showed little change in weight loss rate relative to the control group at a six-month follow-up and again at the one-year or two-year marks. The group that received personal coaching showed significant improvements in weight loss over the first six months, relative to the other groups, but no significant change at one year or two years post-study. Without personal coaching, the researchers found, they resorted to old lifestyle habits, regardless of the continuing availability of the app.
“Given the seeming power of cell phone apps and frankly the popularity of these health and fitness apps in the commercial world,” Dr. Laura Svetkey, the study's primary investigator, told Kaiser Health News, “we thought this might be a really good strategy to provide effective intervention very broadly and potentially at low cost.”
Unfortunately, the researchers concluded, the app amounted to little more than a money and time sink for its developers. It was not the magic bullet promised by many healthcare tech experts and futurists. People, it seems, are people. Real-world, social engagement still seems to be the most effective driver of health behavioral changes.
Moreover, the 2015 c2b Consumer Diagnostic, a national study of consumers’ attitudes and behaviors across channels of healthcare delivery, only 27% of Millennials indicate they have downloaded and actively use health & fitness apps. Moreover, no single health & fitness app seems to enjoy a commanding market share; after looking at 67 health & fitness apps, the leading apps among Millennials – 7 Minute Workout and Calorie Counter & Diet Tracker – were only used by 6% of this generation.
What's at stake?
Plenty. The lifetime financial impact on the Millennial generation of obesity alone is stark: several studies have found that obesity is correlated with lower wage-earning capacity and depressed economic prosperity.
A 2010 study published in the Journal of Business and Psychology found that the expected lifetime expenditure to treat obesity may be as much as $29,460 (in 2010 dollars, as much as a mid-range SUV or sedan) for a Millennial American.
Millennial women, the researchers found, will suffer disproportionately from obesity-associated decreases in lifetime earning capacity relative to Millennial men. Under the study's predictive model, Millennial men stand to earn (in the aggregate) $43 billion less due to obesity, whereas obese Millennial women stand to earn a staggering $956 billion less than they otherwise would have earned.
Such findings have unconscionable implications for our nation's economic future. And for Millennials who are already in low to low-middle income strata, the situation is even more dire: Gallup found that the obesity rate for Americans earning less than $36,000 per year stood at 32.3%. For 1 in 3 poorer Americans, obesity ranks as a significant barrier to upward mobility.
Are apps the end-all-be-all solution for disruptive innovation in healthcare? Probably not, given the results reported in Kaiser Health News. Are there other IT avenues and other channels that we could harness to bring about positive health and socioeconomic outcomes? Probably so. What those innovations look like, for now, remains to be seen.