My new book: The Quantified Self

My new book The Quantified Self: A Sociology of Self-Tracking is due out with Polity Press this April. The publishers are offering a 20% discount for six months (from 18 January 2016 to 31 July 2016) if it is ordered via their website. Please use the code PY703 when you order to receive the discount.

Here is a PDF of the Introduction: Lupton 2016 Introduction to The Quantified Self.

Table of Contents

Acknowledgements

Introduction

1          ‘Know Thyself’: Self-tracking Practices and Technologies

2          ‘New Hybrid Beings’: Theoretical Perspectives

3          ‘An Optimal Human Being’: the Body and Self in Self-Tracking Cultures

4          ‘You are Your Data’: Personal Data Meanings, Practices and Materialisations

5          ‘Data’s Capacity for Betrayal’: Personal Data Politics

Conclusion

References

Index

 

POLITY-Lupton-Quantified Self Visuals-AUG24-3 (1)

 

My 2015 publications

Here are my publications that came out in 2015.

Book

  • Lupton, D. (2015) Digital Sociology. London: Routledge.

Book chapters

  • Lupton, D. (2015) Digital sociology. In Germov, J. and Poole, M. (eds), Public Sociology: An Introduction to Australian Society, 3rd St Leonards: Allen & Unwin.
  • Lupton, D. (2015) Donna Haraway: the digital cyborg assemblage and the new digital health technologies. In Collyer, F. (ed), The Palgrave Handbook of Social Theory in Health, Illness and Medicine. Houndmills: Palgrave Macmillan.

Peer-reviewed journal articles

Report

  • Lupton, D. and Pedersen, S. (2015) ‘What is Happening with Your Body and Your Baby’: Australian Women’s Use of Pregnancy and Parenting Apps. Available here.

Critical social research on self-tracking: a reading list

Self-tracking has recently become a new area of fascination for critical social researchers. A body of literature has now been established of research that has sought to investigate the social, cultural and political dimensions of self-tracking, nearly all of which has come out in the last few years. This literature complements an established literature in human-computer interaction research (HCI), first into lifelogging and then into self-tracking (or personal informatics/analytics, as HCI researchers often call it).

I am currently working on an article that is a comprehensive review of both literatures, in the attempt to outline what each can contribute to understanding self-tracking as an ethos and a practice, and its wider sociocultural implications. Here is a reading list of the work from critical social researchers that I am aware of. I will publish a similar list of interesting HCI research in a forthcoming post.

Albrechtslund, A, and P Lauritsen, (2013) Spaces of everyday surveillance: Unfolding an analytical concept of participation, Geoforum, 49: 310-16.

Allen, AL, (2008) Dredging up the past: Lifelogging, memory, and surveillance, The University of Chicago Law Review, 75 (1): 47-74.

Barta, K, and G Neff, (2015) Technologies for sharing: lessons from Quantified Self about the political economy of platforms, Information, Communication & Society, online first.

Bode, M, and DB Kristensen,  (2016) The digital doppelgänger within. In Assembling Consumption: Researching actors, networks and markets, edited by R. Canniford and D. Badje. London: Routledge, pp.

Bossewitch, J, and A Sinnreich, (2013) The end of forgetting: Strategic agency beyond the panopticon, New Media & Society, 15 (2): 224-42.

Copelton, D, (2010) Output that counts: pedometers, sociability and the contested terrain of older adult fitness walking, Sociology of Health & Illness, 32 (2): 304-18.

Crawford, K, J Lingel, and T Karppi, (2015) Our metrics, ourselves: A hundred years of self-tracking from the weight scale to the wrist wearable device, European Journal of Cultural Studies, 18 (4-5): 479-96.

Daly, A, (2015) The law and ethics of ‘self quantified’ health information: an Australian perspective, International Data Privacy Law, online first.

Dodge, M, and R Kitchin, (2007) ‘Outlines of a world coming into existence’: pervasive computing and the ethics of forgetting, Environment and Planning B: Planning & Design, 34 (3): 431-45.

Drew, DL, and JM Gore, (2014) Measuring up? The discursive construction of student subjectivities in the Global Children’s Challenge™, Sport, Education and Society, online first.

Fiore-Gartland, B, and G Neff, (2015) Communication, mediation, and the expectations of data: data valences across health and wellness communities, International Journal of Communication, 9: 1466-84.

Fox, NJ, (2015) Personal health technologies, micropolitics and resistance: a new materialist analysis, Health:, online first.

Gardner, P, and B Jenkins, (2015) Bodily intra-actions with biometric devices, Body & Society, online first.

Gerlitz, C, and C Lury, (2014) Social media and self-evaluating assemblages: on numbers, orderings and values, Distinktion: Scandinavian Journal of Social Theory, 15 (2): 174-88.

Gilmore, JN, (2015) Everywear: The quantified self and wearable fitness technologies, New Media & Society, online first.

Jethani, S, (2015) Mediating the body: Technology, politics and epistemologies of self, Communication, Politics & Culture, 47 (3): 34-43.

Klauser, FR, and A Albrechtslund, (2014) From self-tracking to smart urban infrastructures: towards an interdisciplinary research agenda on Big Data, Surveillance & Society, 12 (2): 273-86.

Lomborg, S, and K Frandsen, (2015) Self-tracking as communication, Information, Communication & Society: 1-13.

Lupton, D, (2012) M-health and health promotion: the digital cyborg and surveillance society, Social Theory & Health, 10 (3): 229-44.

Lupton, D, (2013a) The digitally engaged patient: self-monitoring and self-care in the digital health era, Social Theory & Health, 11 (3): 256-70.

Lupton, D, (2013b) Quantifying the body: monitoring and measuring health in the age of mHealth technologies, Critical Public Health, 23 (4): 393-403.

Lupton, D, (2013c) Understanding the human machine, IEEE Technology & Society Magazine, 32 (4): 25-30.

Lupton, D, (2014a) The commodification of patient opinion: the digital patient experience economy in the age of big data, Sociology of Health & Illness, 36 (6): 856-69.

Lupton, D, (2014b) Self-tracking cultures: towards a sociology of personal informatics. In Proceedings of the 26th Australian Computer-Human Interaction Conference (OzCHI ’14). Sydney: ACM Press.

Lupton, D. (2014c) Self-tracking modes: reflexive self-monitoring and data practices. Social Science Research Networkhttp://ssrn.com/abstract=2483549  (accessed 27 August 2014).

Lupton, D. (2014d) You are your data: self-tracking practices and concepts of data. Social Science Research Networkhttp://papers.ssrn.com/sol3/papers.cfm?abstract_id=2534211  (accessed 12 December 2015).

Lupton, D, (2015a) Data assemblages, sentient schools and digitised health and physical education (response to Gard), Sport, Education and Society, 20 (1): 122-32.

Lupton, D. (2015b) Lively data, social fitness and biovalue: the intersections of health self-tracking and social media. Social Science Research Networkhttp://papers.ssrn.com/sol3/papers.cfm?abstract_id=2666324  (accessed 13 November 2015).

Lupton, D. (2015c) Personal data practices in the age of lively data. Social Science Research Networkhttp://papers.ssrn.com/sol3/papers.cfm?abstract_id=2636709  (accessed 15 August 2015).

Lupton, D, (2015d) Quantified sex: a critical analysis of sexual and reproductive self-tracking using apps, Culture, Health & Sexuality, 17 (4): 440-53.

Lupton, D, (2016a) The diverse domains of quantified selves: self-tracking modes and dataveillance, Economy and Society, in press.

Lupton, D, (2016b) The Quantified Self: A Sociology of Self-Tracking Cultures. Cambridge: Polity Press.

Lynch, R, and S Cohn, (2015) In the loop: Practices of self-monitoring from accounts by trial participants, Health:, online first.

Millington, B, (2015) ‘Quantify the Invisible’: notes toward a future of posture, Critical Public Health, online first.

Moore, P, and A Robinson, (2015) The quantified self: What counts in the neoliberal workplace, New Media & Society, online first.

Nafus, D, (2013) The data economy of biosensors. In Sensor Technologies:  Healthcare, Wellness and Environmental Applications, edited by M. McGrath and C. N. Scanaill: Springer.

Nafus, D, (2014) Stuck data, dead data, and disloyal data: the stops and starts in making numbers into social practices, Distinktion: Scandinavian Journal of Social Theory, 15 (2): 208-22.

Nafus, D, and J Sherman, (2014) This one does not go up to 11: the Quantified Self movement as an alternative big data practice, International Journal of Communication, 8: 1785-94.

Neff, G, and D Nafus, (2016) Self-Tracking. Cambridge, MA: The MIT Press.

Niva, M, (2015) Online weight-loss services and a calculative practice of slimming, Health:, online first.

Pantzar, M, and M Ruckenstein, (2015) The heart of everyday analytics: emotional, material and practical extensions in self-tracking market, Consumption Markets & Culture, 18 (1): 92-109.

Reigeluth, TB, (2014) Why data is not enough: digital traces as control of self and self-control, Surveillance & Society, 12 (2): 243-54.

Rettberg, JW, (2014) Seeing Ourselves Through Technology: How We Use Selfies, Blogs and Wearable Devices to See and Shape Ourselves. Basingstoke: Palgrave Macmillan.

Ruckenstein, M, (2014) Visualized and interacted life: personal analytics and engagements with data doubles, Societies, 4 (1): 68-84.

Ruckenstein, M,  (2015) Uncovering everyday rhythms and patterns: food tracking and new forms of visibility and temporality in health care. In Techno-Anthropology in Health Informatics, edited by L. Botin, C. Nohr and P. Bertelsen. Amsterdam: IOS Press, pp. 28-40.

Ruckenstein, M, and M Pantzar, (2015a) Beyond the Quantified Self: thematic exploration of a dataistic paradigm, New Media & Society, online first.

Ruckenstein, M, and M Pantzar, (2015b) Datafied life: techno-anthropology as a site for exploration and experimentation, Techne, 19 (2): 191-210.

Sellen, AJ, and S Whittaker, (2010) Beyond total capture: a constructive critique of lifelogging, Communications of the ACM, 53 (5): 70-77.

Smith, WR, (2015) Communication, sportsmanship, and negotiating ethical conduct on the digital playing field, Communication & Sport, earlyview online.

Stragier, J, T Evens, and P Mechant, (2015) Broadcast yourself: an exploratory study of sharing physical activity on social networking sites, Media International Australia, 155 (1): 120-29.

Thomas, GM, and D Lupton, (2015) Threats and thrills: pregnancy apps, risk and consumption, Health, Risk & Society, online first.

Till, C, (2014) Exercise as labour: Quantified Self and the transformation of exercise into labour, Societies, 4 (3): 446-62.

Van Den Eede, Y,  (2015) Tracing the tracker: a postphenomenological inquiry into self-tracking technologies. In Postphenomenological Investigations: Essays on Human–Technology Relations, edited by R. Rosenberger and P.-P. Verbeek. Lanham, Maryland: Lexington Books, pp. 143-58.

Whitson, J, (2013) Gaming the quantified self, Surveillance & Society, 11 (1/2): 163-76.

Wilkinson, J, C Roberts, and M Mort, (2015) Ovulation monitoring and reproductive heterosex: living the conceptive imperative?, Culture, Health & Sexuality, 17 (4): 454-69.

Williamson, B, (2015) Algorithmic skin: health-tracking technologies, personal analytics and the biopedagogies of digitized health and physical education, Sport, Education and Society, 20 (1): 133-51.

Yang, Y, (2014) Saving the Quantified Self: How we come to know ourselves now, Boom: A Journal of California, 4 (4): 80-87.

 

 

 

 

Towards a new mode of self-tracking

In a conference paper and my forthcoming book The Quantified Self: A Sociology of Self-Tracking Cultures, I identify five modes of self-tracking. What I call ‘private self-tracking’ is undertaken for voluntary and personal reasons that are self-initiated. ‘Pushed self-tracking’ involves encouragement for people to monitor themselves from other agencies, while the mode of ‘communal self-tracking’ relies on people sharing their personal information with others. ‘Imposed self-tracking’ involves moving from encouragement to requiring people to collect or engage with data about themselves, so that they may have little choice in doing so. The ‘exploited self-tracking’ mode represents the ways in which personal data may be used by other actors and agencies for their own purposes, either overtly or covertly.

Since writing the initial conference paper, developing these ideas in my book and also for a journal article based on the paper, I have added some thoughts about the possibilities for forms of self-tracking that go beyond these modes. As I argue, self-tracking conforms to a conservative political agenda that represents citizens as automated/autonomous subjects, ideally engaging in self-responsibilised practices of monitoring and life optimisation and emitting valuable ‘data exhausts’ for repurposing by other actors and agencies.

As yet, there has been little discussion of the ways in which self-tracking may be used for resistant or strategic political interventions – as means to challenge accepted norms and assumptions about selves and bodies rather than conforming to these norms and assumptions. Few commentators have drawn attention to how self-tracking highlights certain forms of information about specific kinds of individuals or social groups while it neglects or ignores others, and how idealised citizen subjects are configured via dominant self-tracking cultures while those who fail to meet these ideals are stigmatised or disciplined.

Nascent moves towards a more political use of self-tracking are evident in some citizen sensing initiatives, when they are used to expose or challenge assumptions about geographical areas, the social determinants of ill-health, the environment and living conditions in the effort to draw attention towards social inequalities, government neglect or environmental mismanagement.

There is ample further scope for alternative approaches to self-tracking as a form of knowledge production that seek to identify, record and highlight details of socioeconomic disadvantage or social stigma rather than simply perpetuating them, or to generate knowledge of others rather than being directed at serving the solipsism of self-knowledge. Resistant self-tracking efforts may serve to make visible forms of power relations, injustice and inequalities that are currently hidden from view. It is here that a new mode of self-tracking may develop. The possibilities for a new form of data politics that takes up these more critical and challenging practices are intriguing.

Digitising female fertility and reproduction

Over the past few months, I have been working on writing about the findings of several research projects addressing the topic of digital technologies directed at female fertility and reproduction. These projects involve:

1) a critical content analysis of fertility and reproduction-related software and devices (especially apps);

2) an online survey of 410 Australian women’s use of pregnancy and parenting apps; and

3) focus groups and interviews with Australian and British women about their use of these technologies (these are still in progress).

Several outcomes have now been published drawing on these findings. They include a report (with Sarah Pedersen from Robert Gordon University, Aberdeen) outlining the findings of the online survey (this can be accessed here), an article on the gamification and ludification of pregnancy in apps (with Gareth Thomas from Cardiff University, available here) and a book chapter on the concept of the reproductive citizen and the range of digital technologies that are directed at helping women to monitor and regulate their fertility and reproduction (available here). Edit: two other articles have now been published: one based on the survey findings (here), and another on the pregnancy app study (here).

Some of the key findings are:

  • The survey showed that pregnancy and parenting apps were very popular among the survey respondents – three-quarters of the respondents (who were either pregnant or who had a baby in the past three years at the time of the survey) said that they had used at least one pregnancy app, while almost half had used at least one parenting app.
  • Googling information about pregnancy is very common among pregnant women, for whom too much information about pregnancy appears never to be enough (this finding emerged in the focus groups). They tend to invest their trust in the first few search findings that come up on their search engine, reasoning that because this is evidence of popularity, then these websites must be credible.
  • Despite the popularity of pregnancy and parenting apps, few women are contemplating the validity of the information presented in them, or demonstrated concern about the data security and privacy of the personal information that the apps may collect (this was evident in both the survey and the focus groups).
  • This genre of software is intensifying an already fervid atmosphere of self-surveillance, attempts at management and control and self-responsibility in which female fertility and reproduction are experienced and performed.
  • Stereotypical concepts of idealised female fertile and pregnant bodies are reproduced in apps and other software. They use highly aestheticised images and the promise of rational calculation and monitoring to seek to contain and control women’s fertility and reproduction.
  • Women in their fertile years – and particularly those contemplating pregnancy or already pregnant – are part of a highly commodified demographic. The information that they generate from their online practices possess a new form of value, biovalue, as part of the bioeconomy of personal health and medical data.

Self-tracking, social fitness and biovalue

I have just completed a chapter for the forthcoming volume The Sage Handbook of Social Media. The chapter addresses the intersections of self-tracking for health and medical purposes with social media platforms and rationales. As I argue in the chapter, the expanded array of digitised devices that are available for self-tracking and the capacity of many of these technologies to interact with social media platforms have encouraged self-trackers to share the details that they collect about themselves with others. I begin with a description of self-tracking and the sociomaterial theoretical foundations on which the chapter rests. This is followed with an overview of the technologies that are available for health and medical self-tracking and for self-trackers to share their data. The discussion section of the chapter presents an analysis of the new forms of value that personal health and medical data have attracted in the digital data economy, and the moral and political repercussions of encouraging people to participate as socially fit citizens. The chapter ends with outlining key questions for further research.

The full pre-print of the chapter is available here.

Who owns your personal health and medical data?

09/01/15 -- A moment during day 1 of the 2-day international Healthcare and Social Media Summit in Brisbane, Australia on September 1, 2015. Mayo Clinic partnered with the Australian Private Hospitals Association (APHA), a Mayo Clinic Social Media Health Network member to bring this first of it's kind summit to Queensland's Brisbane Convention & Exhibition Centre. (Photo by Jason Pratt / Mayo Clinic)

Presenting my talk at the Mayo Clinic Social Media and Healthcare Summit (Photo by Jason Pratt / Mayo Clinic)

Tomorrow I am speaking on a panel at the Mayo Clinic Healthcare and Social Media Summit on the topic of ‘Who owns your big data?’. I am the only academic among the panel members, who comprise of a former president of the Australian Medical Association, the CEO of the Consumers Health Forum, the Executive Director of a private hospital organisation and the Chief Executive of the Medical Technology Association of Australia. The Summit itself is directed at healthcare providers, seeking to demonstrate how they may use social media to publicise their organisations and promote health among their clients.

As a sociologist, my perspective on the use of social media in healthcare is inevitably directed at troubling the taken-for-granted assumptions that underpin the jargon of ‘disruption’, ‘catalysing’, ‘leveraging’ and ‘acceleration’ that tend to recur in digital health discourses and practices. When I discuss the big data phenomenon, I evoke the ‘13 Ps of big data‘ which recognise their social and cultural assumptions and uses.

When I speak at the Summit, I will note that the first issue to consider is for whom and by whom personal health and medical data are collected. Who decides whether personal digital data should be generated and collected? Who has control over these decisions? What are the power relations and differentials that are involved? This often very intimate information is generated in many different ways – via routine online transactions (e.g. Googling medical symptoms, purchasing products on websites) or more deliberately as part of people’s contributions to social media platforms (such as PatientsLikeMe or Facebook patient support pages) or as part of self-tracking or patient self-care endeavours or workplace wellness programs. The extent to which the generation of such information is voluntary, pushed, coerced or exploited, or indeed, even covert, conducted without the individual’s knowledge or consent, varies in each case. Many self-trackers collect biometric data on themselves for their private purposes. In contrast, patients who are sent home with self-care regimes may do so reluctantly. In some situations, very little choice is offered people: such as school students who are told to wearing self-tracking devices during physical education lessons or employees who work in a culture in which monitoring their health and fitness is expected of them or who may be confronted with financial penalties if they refuse.

Then we need to think about what happens to personal digital data once they are generated. Jotting down details of one’s health in a paper journal or sharing information with a doctor that is maintained in a folder in a filing cabinet in the doctor’s surgery can be kept private and secure. In this era of using digital tools to generate and archive such information, this privacy and security can no longer be guaranteed. Once any kind of personal data are collected and transmitted to the computing cloud, the person who generated the data loses control of it. These details become big data, part of the digital data economy and available to any number of second or third parties for repurposing: data mining companies, marketers, health insurance, healthcare and medical device companies, hackers, researchers, the internet empires themselves and even national security agencies, as Edward Snowden’s revelations demonstrated.

Even the large institutions that are trusted by patients for offering reliable and credible health and medical information online (such as the Mayo Clinic itself, which ranks among the top most popular health websites with 30 million unique estimated monthly visitors) may inadvertently supply personal details of those who use their websites to third parties. One recent study found that nine out of ten visits to health or medical websites result in data being leaked to third parties, including companies such as Google and Facebook, online advertisers and data brokers because the websites use third party analytic tools that automatically send information to the developers about what pages people are visiting. This information can then be used to construct risk profiles on users that may shut them out of insurance, credit or job opportunities. Data security breaches are common in healthcare organisations, and cyber criminals are very interested in stealing personal medical details from such organisations’ archives. This information is valuable as it can be sold for profit or used to create fake IDs to purchase medical equipment or drugs or fraudulent health insurance claims.

In short, the answer to the question ‘Who owns your personal health and medical data?’ is generally no longer individuals themselves.

My research and that of others who are investigating people’s responses to big data and the scandals that have erupted around data security and privacy are finding that concepts of privacy and notions of data ownership are beginning to change in response. People are becoming aware of how their personal data may be accessed, legally or illegally, by a plethora of actors and agencies and exploited for commercial profit. Major digital entrepreneurs, such as Apple CEO Tim Cook, are in turn responding to the public’s concern about the privacy and security of their personal information. Healthcare organisations and medical providers need to recognise these concerns and manage their data collection initiatives ethically, openly and responsibly.

Edited book ‘Beyond Techno-Utopia: Critical Approaches to Digital Health Technologies’ now out

Last year I guest-edited a special issue of the open-access sociology journal Societies that focused on critical perspectives on digital health technologies. The collection includes my editorial and another article I contributed (on the topic of apps as sociocultural artefacts), as well as eight other articles from scholars based in the UK, Australia, Finland, the USA and Sweden. Individual contributions may be accessed on the journal’s website here, and now the whole collection is available as an open access book PDF (or can be purchased as a hard copy), both available here.

The following outline of the special issue/book’s contents, an edited excerpt taken from my editorial, provides an overview of its contents.

The articles in this special issue build on a well-established literature in sociology, science and technology studies and media and cultural studies that has addressed the use of digital technologies in health and medicine… Several of these topics are taken up in the articles published in this special issue. All the authors use social and cultural theory to provide insights into the tacit assumptions, cultural meanings and experiences of digital health technologies. The articles cover a range of digital health technologies: devices used for the self-tracking of body metrics (Ruckenstein; Till; Rich and Miah; Lupton); social media platforms for discussing patients’ experiences of chronic disease (Sosnowy) and experiences of pregnancy and early motherhood (Johnson); health and medical apps (Till; Johnson; Christie and Verran; Lupton); telehealthcare systems (Hendy, Chrysanthaki and Barlow); and a digital public health surveillance system (Cakici and Sanches). While some articles focus on globalised digital media (Cakici and Sanches; Rich and Miah; Till; Lupton), others engage more specifically with a range of sociocultural groups, contexts and locations. These include Aboriginal people living in a remote region of Australia (Christie and Verran) and Australian mothers in urban Sydney (Johnson) as well as research participants in Helsinki, Finland (Ruckenstein), the United States (Sosnowy) and England (Hendy, Chrysanthaki and Barlow).

Understandings and experiences of selfhood and embodiment as they are generated and experienced via digital health devices are central preoccupations in the articles by Ruckenstein, Rich and Miah, Till, Lupton, Sosnowy and Johnson. Ruckenstein’s study of self-trackers found that they often conceptualised their bodies and their physical activities in different ways when these were being monitored and rendered into digital data. The data that were generated by these devices proved to be motivational and to give value to some activities (like housework) that otherwise lacked value or new meaning to functions such as sleep (which when digitised and quantified became viewed as a competence). Ruckenstein found that the digital data tended to be invested with greater validity than were other indicators of bodily wellbeing or activity, such as the individual’s physical sensations.

All of the above authors comment on the ways in which digital health devices such as wearable self-tracking devices, social media platforms, apps and patient support websites work as disciplinary tools. They invite users to conform to the ideals of healthism (privileging good health above other priorities) and the responsible self-management and self-monitoring of one’s health and body, including avoiding exposure to risk. Rich and Miah use the concept of “public pedagogy” to describe the socio-political dimensions of digital health technologies as they are employed to educate people about their bodies and promote self-management. As Johnson notes, for women who are pregnant or have the care of young children, this sphere of responsibility is extended to the bodies of others: the foetus or child. And as Till’s article emphasises, when employees are “encouraged” to engage in self-tracking, the ethos of responsibility extends from personal objectives to those of employers.

Ruckenstein, Till and Sosnowy also highlight the digital labour involved for people who engage with social media or self-tracking apps as part of their personal health or fitness practices. Sosnowy’s interviews with women with multiple sclerosis who blog about their condition emphasise the work involved in such engagement as an “active patient”. Till’s analysis of digital exercise self-tracking points to the appropriations of people’s labour by other actors for commercial reasons.

The article by Hendy, Chrysanthaki and Barlow moves in a somewhat different direction. Using ethnographic cases studies, they look at the managerial issues involved with implementing telehealthcare in English social and health care organisations. Their focus, therefore, is not on the recipients or targets of digital health technologies but rather those who are attempting to institute programs as part of their work as managers. These authors’ contribution highlights the messiness of introducing new systems and practices into large organisations, and the resistances that may emerge on the part of both workers and the targets of telehealthcare programs. Cakici and Sanches’ article also takes an organisational perspective in addressing a European Commission co-funded project directed at syndromic surveillance, or the use of secondary sources to detect outbreaks and patterns in diseases and medical conditions. Digital data are increasingly being use as part of syndromic surveillance: Google Flu Trends is one such example. Cakici and Sanches’ analysis highlights the role played by human decision-making and the affordances of digital technologies in structuring what kinds of data are retrieved for syndromic surveillance and how they are interpreted.

While there are as yet few detailed ethnographic accounts of how people are implementing, adopting or resisting contemporary digital health technologies, there are even fewer that investigate the use of these technologies by members of cultural groups outside the global North. The article by Christie and Verran takes a much-needed diversion from perspectives on white, privileged groups to Aboriginal people living in a remote part of Australia. As they argue, the concepts on health, illness and the body that are held by this cultural group differ radically from the tacit assumptions that are invested in mainstream health and medical apps. Any app that is developed to assist in health literacy that is targeted at this group must incorporate culturally-appropriate modes of communication: positioning people within their cultural and kinship networks of sociality, for example, rather than representing them as atomised actors.

The articles collected here in this special issue have gone some way in offering a critical response to digital health technologies, but they represent only a beginning. Many more compelling topics remain to be investigated. These include research into the ways in which lay people and healthcare professionals are using (or resisting the use) of social media, apps and self-monitoring devices for medicine and health-related purposes; the implications for medical power and the doctor-patient relationship; how citizen science and citizen sensing are operating in the public health domain; the development of new digital health technologies; the implications of big data and data harvesting in medicine and healthcare; the spreading out of health-related self-tracking practices into many social domains; the unintended consequences and ethical aspects of digital technology use and their implications for social justice; and data security and privacy issues.

Digitised children’s bodies

This is an excerpt from the pre-print version of a chapter I have written on the topic of ‘digital bodies’. The full pre-print can be accessed here.

The sociomaterialist perspective has been taken up by several scholars writing about children’s bodies, particularly within cultural geography, but also by some sociologists and anthropologists (Prout, 1996; Horton and Kraftl, 2006a, 2006b; Lee, 2008; Woodyer, 2008). Researchers using a sociomaterialist approach have conducted studies on, for example, children’s use of asthma medication (Prout, 1996), the surveillant technologies that have developed around controlling children’s body weight in schools (Rich et al., 2011), children’s sleep and the objects with which they interact (Lee, 2008), the interrelationship of objects with pedagogy and classroom management of students’ bodies (Mulcahy, 2012) and sociomaterial practices in classrooms that lead to the inclusion or exclusion of children with disabilities (Söderström, 2014). Outside sociomaterialist studies, young children’s interactions with digital technologies have attracted extensive attention from social researchers, particularly in relation to topics such as the potential for cyber-bullying, online paedophilia and for children to become unfit and overweight due to spending too much time in front of screens (Holloway et al., 2013). However few researchers thus far have directed their attention to the types of digital technologies that visually represent children’s bodies or render their body functions, activities and behaviours into digital data; or, in other words, how children’s bodies become digital data assemblages.

From the embryonic stage of development onwards, children’s bodies are now routinely monitored and portrayed using digital technologies. A plethora of websites provide images of every stage of embryonic and foetal development, from fertilisation to birth, using a combination of digital images taken from embryo and foetus specimens and digital imaging software  (Lupton, 2013). 3/4D ultrasounds have become commodified, used for ‘social’ or ‘bonding’ purposes. Many companies offering 3/D ultrasounds now come to people’s homes, allowing expectant parents to invite family and friends and turn a viewing of the foetus into a party event. This sometimes involves a ‘gender reveal’ moment, in which the sonographer demonstrates to all participants, including the parents, the sex of the foetus . Some companies offer the service of using 3D ultrasound scan files to create life-sized printed foetus replica models for parents.

The posting to social media sites such as Facebook, Twitter, Instagram and YouTube of the foetus ultrasound image has become a rite of passage for many new parents and often a way of announcing the pregnancy. Using widgets such as ‘Baby Gaga’, expectant parents can upload regular status updates to their social media feeds automatically that provide news on the foetus’s development. While a woman is pregnant, she can use a range of digital devices to monitor her foetus. Hundreds of pregnancy apps are currently on the market, including not only those that provide information but others that invite users to upload personal information about their bodies and the development of their foetus. Some apps offer a personalised foetal development overview or provide the opportunity for the woman to record the size of her pregnant abdomen week by week, eventually creating a time-lapse video. Other apps involve women tracking foetal movements or heart beat. Bella Beat, for example, is a smartphone attachment and app that allows the pregnant women to hear and record the foetal heart beat whenever she likes and to upload the audio file to her social media accounts.

YouTube has become a predominant medium for the representation of the unborn entity in the form of ultrasound images and of the moment of birth. Almost 100,000 videos showing live childbirth, including both vaginal and Caesarean births, are available for viewing on that site, allowing the entry into the world of these infants to be viewed by thousands and, in the case of some popular videos, even millions of viewers. Some women even choose to live-stream the birth so that audiences can watch the delivery in real time. Following the birth, there are similar opportunities for proud parents to share images of their infant online on social media platforms. In addition to these are the growing number of devices on the market for parents to monitor the health, development and wellbeing of their infants and young children. Apps are available to monitor such aspects as infants’ feeding and sleeping patterns, their weight and height and their development and achievements towards milestones. Sensor-embedded baby clothing, wrist or ankle bands and toys can be purchased that monitor infants’ heart rate, body temperature and breathing, producing data that are transmitted to the parents’ devices. Smartphones can be turned into baby monitors with the use of apps that record the sound levels of the infant.

As children grow, their geolocation, educational progress and physical fitness can be tracked by their parents using apps, other software and wearable devices. As children themselves begin to use digital technologies for their own purposes, they start to configure their own digital assemblages that represent and track their bodies. With the advent of touchscreen mobile devices such as smartphones and tablet computers, even very young children are now able to use social media sites and the thousands of apps that have been designed especially for their use (Holloway et al., 2013). Some such technologies encourage young children to learn about the anatomy of human bodies or about nutrition, exercise and physical fitness, calculate their body mass index, collect information about their bodies or represent their bodies in certain ways (such as manipulating photographic images of themselves). These technologies typically employ gamification strategies to provide interest and motivation for use. Some involve combining competition or games with self-tracking using wearable devices. One example is the Leapfrog Leapband, a digital wristband connected to an app which encourages children to be physically active in return for providing them with the opportunity to care for virtual pets. Another is the Sqord interactive online platform with associated digital wristband and app. Children who sign up can make an avatar of themselves and use the wristband to track their physical activity. Users compete with other users by gaining points for moving their bodies as often and as fast as possible.

In the formal educational system there are still more opportunities for children’s bodies to be monitored measured and evaluated and rendered into digitised assemblages. Programmable ‘smart schools’ are becoming viewed as part of the ‘smart city’, an urban environment in which sensors that can watch and collect digital data on citizens are ubiquitous (Williamson, 2014). The monitoring of children’s educational progress and outcomes using software is now routinely undertaken in many schools, as are their movements around the school. In countries such as the USA and the UK, the majority of schools have CCTV cameras that track students, and many use biometric tracking technologies such as RFID chips in badges or school uniforms and fingerprints to identify children and monitor their movements and their purchases at school canteens (Taylor, 2013; Selwyn, 2014). A growing number of schools are beginning to use wearable devices, apps and other software for health and physical education lessons, such as coaching apps that record children’s sporting performances and digital heart rate monitors that track their physical exertions (Lupton, 2015).

We can see in the use of digital technologies to monitor and represent the bodies of children a range of forms of embodiment. Digitised data assemblages of children’s bodies are generated from before birth via a combination of devices that seek to achieve medical- or health-related or social and affective objectives. These assemblages may move between different domains: when, for example, a digitised ultrasound image that was generated for medical purposes becomes repurposed by expectant parents as a social media artefact, a way of announcing the pregnancy, establishing their foetus as new person and establishing its social relationships. Parents’ digital devices, and later those of educational institutions and those of children themselves when they begin to use digital devices, potentially become personalised repositories for a vast amount of unique digital assemblages on the individual child, from images of them to descriptions of their growth, development, mental and physical health and wellbeing, movements in space, achievements and learning outcomes. These data assemblages, containing as they do granular details about children, offer unprecedented potential to configure knowledges about individual children and also large groups of children (as represented in aggregated big data sets).

References

Holloway D, Green L and Livingstone S. (2013) Zero to Eight: Young Children and Their Internet Use. London: LSE London, EU Kids Online.

Horton J and Kraftl P. (2006a) Not just growing up, but going on: Materials, spacings, bodies, situations. Children’s Geographies 4(3): 259-276.

Horton J and Kraftl P. (2006b) What else? some more ways of thinking and doing ‘Children’s Geographies’. Children’s Geographies 4(1): 69-95.

Lee N. (2008) Awake, asleep, adult, child: An a-humanist account of persons. Body & Society 14(4): 57-74.

Lupton D. (2013) The Social Worlds of the Unborn, Houndmills: Palgrave Macmillan.

Lupton D. (2015) Data assemblages, sentient schools and digitised health and physical education (response to Gard). Sport, Education and Society 20(1): 122-132.

Mulcahy D. (2012) Affective assemblages: body matters in the pedagogic practices of contemporary school classrooms. Pedagogy, culture and society 20(1): 9-27.

Prout A. (1996) Actor-network theory, technology and medical sociology: an illustrative analysis of the metered dose inhaler. Sociology of Health and Illness 18(2): 198-219.

Rich E, Evans J and De Pian L. (2011) Children’s bodies, surveillance and the obesity crisis. In: Rich E, Monaghan LF and Aphramor L (eds) Debating Obesity: Critical Perspectives. Houndsmills: Palgrave Macmillan, 139-163.

Selwyn N. (2014) Data entry: towards the critical study of digital data and education. Learning, Media and Technology: 1-19.

Söderström S. (2014) Socio-material practices in classrooms that lead to the social participation or social isolation of disabled pupils. Scandinavian Journal of Disability Research online first.

Taylor E. (2013) Surveillance Schools: Security, Discipline and Control in Contemporary Education, Houndmills: Palgrave Macmillan.

Williamson B. (2014) Smart schools in sentient cities. dmlcentral.

Woodyer T. (2008) The body as research tool: embodied practice and children’s geographies. Children’s Geographies 6(4): 349-362.

‘Eating’ digital data

Update: I have now published a journal article that brings this blog with the previous one and expands the argument – it can be found here.

My previous post drew on Donna Haraway’s concept of companion species to theorise the ways in which we engage with our personal digital data assemblages. The work of Annemarie Mol offers an additional conceptual framework within which to understand digital data practices at a more detailed level, while still retaining the companion species perspective.

Mol has developed a framework that incorporates elements of enquiry that can be mapped onto the topic of digital data practices. These include the following: understanding language/discourse and its context and effects; tracing the development and use of objects of knowledge as they become objects-in-practice; acknowledging the dynamic nature of processes and the ‘endless tinkering’ that is involved in processes; incorporating awareness of the topologies or sites and spaces in which phenomena are generated and used; and finally, directing attention at the lived experiences or engagements in which practices and objects are understood and employed (see also Mol, 2002, 2008; Mol and Law, 2004).

If this approach is applied to digital data practices and their configurations, then focusing attention on the language that is employed to describe digital data, viewing digital data as objects that have both discursive and material effects and that constantly changing, recognising the process of tinkering (experimenting, adapting) that occur in relation to digital data and the spaces in which these processes take place are all important to developing an understanding of the ontology of digital data and our relationship with them.

Mol’s (2002) concept of ‘the body multiple’ in medicine has resonances with the Haraway’s cyborg ontology. This concept recognises that the human body is comprised of many different practices, sites and knowledges. While the body itself is not fragmented or multiple, the phenomena that make sense of it and represent it do so in many different ways so that the body is lived and experienced in different modes. So too the digital data assemblages that are configured by human users’ interactions with digital technologies are different versions of people’s identities and bodies that have material effects on their ways of living and conceptualising themselves. Part of the work of people’s data practices is negotiating the multiple bodies and selves that these digital data assemblages represent and configure.

Mol’s writings on human subjectivity also have implications for understanding data practices and interpretations. In her essay entitled ‘I eat an apple’, Mol points out that once a foodstuff has been swallowed, the human subject loses control over what happens to the content of the food in her body as the processes of digestion take place. As she notes, the body is busily responding to the food, but the individual herself has no control over this: ‘Her actorship is distributed and her boundaries are neither firm nor fixed’ (Mol, 2008: 40). The eating subject is able to choose what food she decides to eat, but after this point, her body decides how to deal with the components of the food, selecting certain elements and discarding others.

This raises questions about human agency and subjectivity. In the statement ‘I eat an apple’ is the agency in the ‘I’ or in the apple? Humans may grow, harvest and eat apples, but without foodstuffs such as apples, humans would not exist. Furthermore, once the apple is chewed and swallowed, it then becomes part of and absorbed into the eater’s body. It is impossible to determine what is human and what is apple (Mol, 2008: 30) The eating subject, therefore, is semi-permeable, neither completely closed off nor completely open to the world.

Mol then goes on to query at what stage the apple becomes part of her, and whether the category of the human subject might recognise the apple as ‘yet another me, a subject in its own right’ (Mol, 2008: 40). Apples themselves have been shaped by years of cultivation by humans into the forms in which they now exist. In fact they may be viewed as a form of Haraway’s companion species. How then do we draw boundaries around the body/self and the apple? How is the human subject to be defined?

To extend Mol’s analogy, the human subject may be conceptualised as both data-ingesting and data-emitting in an endless cycle of generating data, bringing the data into the self, generating yet more data. Data are absorbed into the body/self and then become new data that flow out of the body/self into the digital data economy. The data-eating/emitting subject, therefore, is not closed off but is open to taking in and letting out digital data. These data become part of the human subject but, as data assemblages also represent the individual in multiple ways that have different meanings based on their contexts and uses. Just as eating an apple has many meanings, depending on the social, cultural, political, historical and geographical contexts in which this act takes place, generating and responding to digital data about oneself are highly contingent acts. If digital data are never ‘raw’ but rather are always ‘cooked’ (that is, always understood and experienced via social and cultural processes), and may indeed be ‘rotted’ or spoilt in some way (Boellstorff, 2013), can we also understand them as ‘eaten’ and ‘digested’?

Haraway and Mol both emphasise the politics of technocultures. Haraway’s cyborg theorising was developed to explain her socialist feminist principles. In all of her work she emphasises the importance of paying attention as critical scholars to the exacerbation of socioeconomic disadvantage and inequalities that may be outcomes of these relationships. Mol similarly notes the political nature of technologies. In her ‘I eat an apple’ essay, for example, she comments about her distaste for Granny Smith apples, once imported from Chile and therefore associated in her mind with repressive political regimes. As she notes, while she may eat this type of apple and while it may nourish her body as other apples do, she is unable to gain sensory pleasure from it.

Data science writings on big data often fail to acknowledge the political dimensions of digital data. They do not see how data are always already ‘cooked’, or how their flavour or digestibility are influenced by their context. Just as ‘eating apples is variously situated’ (Mol, 2008: 29) in history, geography, culture, social relations and politics, resulting in different flavours and pleasures, so too eating data is contextual. Like Haraway’s cyborg figuration (see her interview with Gane, 2006), the digital data assemblage may be viewed both as a product of global enterprise and capitalism and as representing possibilities for radical creative and political possibilities.

Using Mol’s concepts of the eating subject, we might wonder: What happens when we ingest/absorb digital data about ourselves? Do we recognise some data as ‘food’ (appropriate for such ingestion) and others as ‘non-food’ (not appropriate in some way for our use)? Are some data simply indigestible (our bodies/selves do not recognise them as us and cannot incorporate them)? How are the flavours and tastes of digital data experienced, and what differentiates these flavours and tastes?

References

Boellstorff, T. (2013) Making big data, in theory. First Monday, 18 (10). <http://firstmonday.org/ojs/index.php/fm/article/view/4869/3750&gt;, accessed 8 October 2013.

Gane, N. (2006) When we have never been human, what is to be done?: Interview with Donna Haraway. Theory, Culture & Society, 23, 135-58.

Mol, A. (2002) The Body Multiple: Ontology in Medical Practice. Durham, NC: Duke University Press.

Mol, A. (2008) I eat an apple. On theorizing subjectivities. Subjectivity, 22, 28-37.

Mol, A. & Law, J. (2004) Embodied action, enacted bodies: the example of hypoglycaemia. Body & Society, 10, 43-62.