Digital Care: Agency and Temporality in Young People’s Use of Health Apps

Abstract

This paper draws from interviews with 21 young New Zealanders, ages 16-24, to examine how health apps shape young people's experiences of themselves as agentive subjects in relation to their physical and mental wellbeing. Focusing on the intended and unintended effects of health apps, I examine how digital care technologies recast the spatiality and temporality of healthcare, enabling new ways of constituting and tracking health, expanding possibilities of interactive exchanges with others, and redistributing a sense of agency and control. In many ways, the forms of self-governance that health apps engender are no different from other moves to promote increased self-responsibility that are cultivated as part of advanced liberalism. However, I argue that by collapsing the spatial and temporal relations of technology use, health apps not only heighten opportunities for adopting self-responsibility, but also, as many young people attest, promote the feeling that there is no escaping from them. The result is that for many young people having a sense of control and responsibility over their health comes to be calibrated against not only the inherent inter-sociality of care (i.e. young people's desires to both give and receive care to and from others), but also the health and fitness "demands" seemingly made upon them by technology itself.

Understanding the Role of Healthy Eating and Fitness Mobile Apps in the Formation of Maladaptive Eating and Exercise Behaviors in Young People

“…Healthy eating and fitness apps offer the opportunity to enhance the social life of the user by giving access to group memberships and opportunities to find like-minded people or friends on the internet (sharing and comparing data through the app) and offline (engaging in physical activities with groups of preexisting friends or new ones through the app) [78]. Many apps provide the opportunity for users to rank themselves among other users, thus encouraging competition.…”

“…Our app review indicates that the majority of apps facilitated social features, that is, data sharing with other app users (n=32) or through social media (n=59). However, although healthy eating and fitness apps are seen as socially mediated experiences to connect people with common interests and goals for healthy eating and physical activity [78], our qualitative data suggested that individual app engagement can result in antisocial behavior (eg, not attending social functions) that can lead into loneliness and impact the psycho-social development of a young person, for whom the development of social relationships is an important and psychologically salient developmental task [79]. Reflecting on these points, it is important that future healthy eating and fitness apps not only facilitate creation of a digital connection and communities but also provide tools to encourage social connectivity.…”

Temporalities of mental distress: digital immediacy and the meaning of ‘crisis’ in online support

“…specialist online forums, conversational chat bots, health information, access to clinical services, 'therapeutic' mobile apps) (Bauman andRivers 2015, Lupton 2018). The unpredictable nature of living with mental health problems means that support is often required outside of the availability of professional services (Tucker and Smith 2014), which can make the availability of digital support appealing (Trnka 2016). Coupled with funding pressures causing reduced provision of mental health services, people may find themselves seeking help online (Naslund et al 2016, Tucker andGoodings 2017).…”

New Kinds of (Ab)normal?: Public Pedagogies, Affect, and Youth Mental Health in the Digital Age

“…These sites in turn mediate how young people articulate their experiences of distress via categories of depression, anxiety, disordered eating etc. (Hendry et al 2017;Trnka 2016). Hence, the digital literacy and learning relations about mental health that young people are engaged through need to be understood as thoroughly entangled with diagnostic cultures, clinical expertise, activist movements, Big Pharma research and products, as well as formal education and public promotion campaigns.…”