The social grounds of self-tracking in insurance: A mixed-method approach to adoption and use

Digit Health. 2023 Jun 7:9:20552076231180731. doi: 10.1177/20552076231180731. eCollection 2023 Jan-Dec.

Abstract

Scholars have explored the role of self-tracking in mediating people's values, perceptions, and practices. But little is known about its institutionalised forms, although it is becoming a routine component of health policies and insurance programs. Furthermore, the role of structural elements such as sociodemographic variables, socialisations, and trajectories has been neglected. Using both quantitative (n = 818) and qualitative (n = 44) data gathered from users and non-users of an insurance program's self-tracking intervention, and drawing from Bourdieu's theoretical framework, we highlight the impact of users' social background on the adoption and use of the technology. We show that older, poorer, and less educated individual are less likely to adopt the technology, and describe four prototypical categories of users, the meritocrats, the litigants, the scrutinisers and the good-intentioned. Each category displays different reasons and ways to use the technology that are grounded in users' socialisations and life trajectories. Results suggest that too much emphasis may have been put on self-tracking's transformative powers and not enough on its reproductive inertia, with important consequences for both scholars, designers, and public health stakeholders.

Keywords: Bourdieu; digital divide; disease; exercise; health inequalities; insurance; lifestyle; mHealth; public health; self-tracking; sociology.