Can your iPhone measure health?

Ethan Berke M.D., associate professor at Dartmouth Medical School, is using a new weapon to fight chronic disease: The iPhone. Trained as a spatial epidemiologist, Dr. Berke studies the influence of habitat on health, how a person’s physical surroundings impacts their wellbeing. This includes factors such as the built environment, for example does your neighborhood encourage walking and socializing. He is also a practicing family doctor, and it is this direct interaction with patients that has informed much of his research.

While working in a low resource area, he observed how people’s environment seemed to have a larger impact on their health than the typical bio-medical causes of disease. If you don’t feel safe walking in your neighborhood, for example, no amount of coaxing by your doctor will make you take an evening stroll. “I realized that my counseling to patients was not as effective as it could have been because my words weren’t achievable in the context of their environment,” Dr. Berke says, “So what I do as a physician is incredibly dependent on what the patient is able to do within their environment.”

So awareness of a person’s environment, and how it may limit or encourage their health behavior is obviously important. Traditionally researchers have relied on survey questionnaires to find out exactly what people do in specific situations. The problem is that these aren’t always accurate: People forget, their impressions may be inaccurate, and they may try to give the "right" answer.

That’s where the iPhone comes in. Working with software engineers, Dr. Berke’s team has reprogrammed the device to collect data. The capabilities that this ubiquitous smart phone brings to health research is impressive. Thanks to features like GPS and audio recognition, the phone can gather such information as how far a person travels during the day, how fast they were walking, where they tend to slow down and speed up, and how long they stood still for. It can measure how many social interactions they have, and whether they are talking to one person, two people, or a larger group. All the subject has to do is carry the phone. Eventually researchers may be able to remotely retrieve data, without even seeing, meeting, or bothering the subject. The ability to accurately and reliably gather such detailed data about individual behaviors, and to measure it repeatedly and efficiently in many people can greatly increase our understanding of how people interact with each other and their environment. This type of knowledge can inform healthy urban design, and realistic and meaningful preventive health and treatment counseling.

More broadly, this innovative use of everyday tools for health research is both inspiring and important. What other technology could we be using to increase our knowledge of health behaviors, or our understanding of how to better promote them?