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This study delves into the micropolitics of digital health technologies through a materialist lens, investigating their capacities, impacts, and potential for change in specific contexts. It explores digital capitalism, societal perspectives on technology, and the assemblages of digital health technologies like tracking devices and coaching apps. By analyzing these technological systems, potential for resistance, activism, and re-engineering are identified to shape a more positive future.
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The material micropolitics of digital health technologies Nick J Fox University of Sheffield @socnewmat
Introduction • A materialist approach to digital health. • What can a digital technology do? • The micropolitics of digital capitalism. • Re-engineering digital technologies. • The digital generation, activism and citizen health. @socnewmat
The transparency of technology? • Sociological perspectives on technology: • Technological determinism • Social shaping of technology • Technology as affordance • I explore technology instead from a materialist perspective.
Beyond sociological dualism • Avoid both social essentialism and technological essentialism. • Look at the material capacities of digital technologies in specific contexts. • Do we really know what digital technologies can actually do? • What might digital technologies do? @socnewmat
A (new) materialist ontology • Not pre-existing entities but relations that assemble. • Not attributes, but entirely contextual capacities. • Not agency but a capacity to affect or be affected. • Not systems of structures but fluctuating assemblages. • Not a politics of social forces but a micropolitics of affecting. • Not texts or discourses but materialities. @socnewmat
Applying materialist ontology • Look at digital technologies in their assemblages. • What capacities do they produce? • What is the micropolitical impact of a technology in terms of power, resistance, social order, continuity, change etc? • How might these micropolitics be changed by altering the contexts or other forces? @socnewmat
Digital health technologies (DHTs) • For use by an individual outside formal healthcare. • Self-tracking or monitoring of body functions or performance. • May have capacities for therapeutic intervention. • May use communication or networked functionality. Fox, N.J. (2017) Personal health technologies, micropolitics and resistance: a new materialist analysis. Health. 21(2): 136-153.
What can a digital health technology do? • I will reverse engineer DHTs, to ask: • What relations does each comprise? • What affect economies make each work? • What is the defining micropolitics of each? • What capacities does the assemblage produce, including bodies’ capacities to do, feel and think? @socnewmat
Tracking devices (Fitbit, Apple Watch etc.) • What do they do? - use sensors to provide quantified data; encourage action. • The Fitbit/Watch assemblage: body performance and movement – terrain – device – wearer – manufacturer – other users • Micropolitics - quantifies body performance; encourages behaviours; responsibilises user; creates routines; commercialises fitness. @socnewmat
FetalBeatshttps://www.fetalbeats.com/ • What does it do? – links a foetal heart rate monitor to a smartphone/watch, revealing effects of environment on foetus, and enabling sharing of foetal data. • The FetalBeats assemblage: foetal environment - foetal heart – doppler sensor – smartphone – parent – parent’s environment – friends/doctor • Micropolitics: foetus can be monitored by parents in real-time; mother responsible for sustaining positive and healthy foetal environment (e.g. reducing stress levels, eating healthily); data can be shared with doctor, friends etc. @socnewmat
Vida: virtual coachingwww.vida.com • What does it do? –coaching app that shares self-tracking data with online health and fitness coaches. • Coaching styles : cheerleader; drill sergeant; innovator; listener; challenger; analyser. • The Vida-assemblage: body – app – device – coach – health programme – company – shareholders – profit • Micropolitics - turns health and fitness into ways to make money; outsources traditional tasks of healthcare to sustain health and fitness.
The micropolitics of digital health technologies • Unit of sociological analysis needs to be the assemblage, not the technology. • The micropolitics of these digital assemblages are emergent. • These micropolitics produce the features of ‘digital capitalism’. @socnewmat
Digital capitalism (DC) and health • Efficiencies. • Health knowledge as commercial resource. • Monetising services. • Marketisation of health. • Consumerisation. • Opportunities for privatising/out-sourcing. @socnewmat
Vida as exemplar of DC • Reduces costs of providing coaching. • Brings coaches and consumers/clients together online. • Establishes a global market that still feels local. • Creates virtual versions of existing businesses and business models. • Reduces margins and increases volume of sales. @socnewmat
What else can the digital do? • If we can reverse engineer technology, we can also forward engineer it to produce different micropolitical outcomes. • Less pessimistic analysis of digital health. • Possibilities for action and resistance, including digital activism and ‘citizen health’. @socnewmat
An activist perspective • Digital technologies can be engineered to: • Reject biomedical model. • Enable collective responses • Challenge health policy. • Organise against health corporations, fast food outlets, environmental polluters etc. • Encourage environmental sustainability. @socnewmat
Citizen Health • Subvert biomedical or corporate interests. • Reject individualised approach to health. • Reject monetisation of health and fitness. • Connect people and social formations to each other. @socnewmat
Conclusions • A materialist and micropolitical approach allows us to ask: • What can a digital health technology do? • How do DHTs contribute to digital capitalism? • How can we re-engineer DHTs?
The material micropolitics of digital health technologies Nick J Fox University of Sheffield @socnewmat