How the Fitness Tech Boom Is Exacerbating Health Inequalities
The latest Apple Watch costs $429 . A basic Peloton Bike costs $1,395 , plus a monthly subscription of $49.99 . Add to that a WHOOP membership for $149 per year , and perhaps an Oura Ring for another $349 , and suddenly it seems like participating in what has become the standard approach to health for many Americans can cost thousands of dollars. For some, that price is too high. For others, it’s simply unrealistic.
I’m no stranger to the allure of the latest, most cutting-edge wearables and smart medical devices. But what does this mean for those who don’t wear smartwatches as these health technologies become the norm? If comprehensive health data and the analytics it provides become a luxury item, the existing digital divide in healthcare will only worsen.
The digital divide in healthcare
The problem arises long before anyone even considers buying a fitness tracker. Digital equity in healthcare has already become a fundamental issue of accessibility. “In many ways, access to healthcare means access to technology,” says Amy Gonzalez , assistant professor of communications at the University of California, Santa Barbara. “Especially since [the COVID-19 pandemic], the healthcare industry has been heavily leveraging technology in its services. SMS appointment reminders, QR code scanning for registration, the requirement to have an eHealth account to view test results, some providers only available through telemedicine, and so on.”
The basic infrastructure of modern healthcare—patient portals, appointment apps, prescription management systems—requires a level of digital literacy and access that isn’t universally available. Older adults may struggle to navigate smartphone interfaces. Low-income families may rely on limited mobile internet or shared devices. People with certain disabilities may find it difficult or impossible to use standard medical apps. And the problem is compounded: Gonzalez notes that the populations most likely to face barriers to technology use are often the same ones that need healthcare the most.
Fitness trackers are becoming the norm – for some
Against this backdrop of inherent digital inequality, fitness trackers and wearables are becoming increasingly popular . They aren’t essential medical devices in the traditional sense—no one relies on a Fitbit for their life support—but they have become cultural markers of health optimization. Even more alarming, they are increasingly becoming tools that provide truly useful health information that is simply inaccessible to those without the means to acquire it. Heart rate, blood oxygen saturation, sleep patterns, stress levels, and much more: we live in an era of unprecedented understanding of what our bodies are doing, if you can afford it.
In some circles, these devices have become a simple way for health-conscious individuals to take charge of their well-being. Research has shown that wearables can help detect heart rhythm disturbances , encourage increased physical activity , and provide early warning of signs of illness . Some insurance companies offer discounts to users who share their physical activity data. Employers are incorporating wearables into their health programs.
While this is promising for those who can afford it, others are being left behind. “The digital divide is further exacerbated by ‘bonus devices’ or health ‘accessories’, such as smart wearables,” says Gonzalez. If populations at risk for health are already at risk of accessing digital technologies, this means the gap is only widening.
The Problem with Ubiquitous Fitness Technologies
The creation of a two-tiered information system is perhaps the most insidious aspect of inequality in fitness technology. Apple Watch owners receive detailed daily reports on their cardiovascular health, activity level, and sleep quality. They receive notifications about irregular heartbeats and can share detailed data with their doctors, providing insight into symptoms and conditions. And who doesn’t have such a device? All that’s left is subjective assessments and data collected during regular doctor visits.
“If you don’t have the same resources to track your blood pressure, blood pressure, or physical activity,” says Gonzalez, “you’re definitely falling behind on helpful health care.” Imagine two people with identical cardiovascular risk factors. The one with a wearable device might receive a notification and seek immediate medical attention, potentially preventing a stroke. The other might not notice symptoms until a serious cardiac event occurs. Both deserved this potentially life-saving alert, but only one could afford the device that provided it.
As more and more people with higher incomes adopt these technologies and share data with healthcare providers, the understanding of health data may shift toward populations that can afford comprehensive self-monitoring. If studies increasingly include data from wearable devices, but this data is primarily collected from affluent and educated users, the findings may not be equally applicable to all demographics.
Another perspective
Access isn’t the only approach to this fitness technology. “There’s an unspoken assumption that wearables are inherently good,” says Gonzalez. “But what about the privacy risks?” After all, if you think you own all your health data, think again .
Consider the history of healthcare’s relationship with marginalized communities. The Tuskegee syphilis study , forced sterilization , and persistent disparities in pain management and maternal mortality have generated, to put it mildly, understandable skepticism about data sharing. “Given the history of experimentation and exploitation of some low-income populations, there’s a natural distrust of these subgroups,” says Gonzalez. “Perhaps these demographics are intentionally avoiding having their data collected by third parties.”
Thus, the same communities that could benefit most from health monitoring technologies may also have legitimate reasons to be wary of them. As I’ve written previously , data privacy protections remain inconsistent, and the long-term consequences of providing detailed biometric data to corporations are still unclear. For populations that have historically been subject to surveillance, exploitation, or discrimination, opting out of constant data collection may be a rational decision, not simply a matter of access. It’s worth emphasizing approaches to healthcare that don’t involve third-party corporations collecting detailed data about your bodily functions.
Search for solutions
Of course, there are budget-friendly options for fitness technology, and they can help some people gain access to it. But even “affordable” options still cost money, which many families simply don’t have to spend on what’s technically left over for additional equipment. When you’re choosing between a $50 fitness tracker and groceries, the choice isn’t really a choice.
All of this suggests that the problem of inequality in fitness technology can’t be solved by individual purchasing decisions or corporate discount programs. It’s rooted in broader questions about access to healthcare, digital equality, and what we consider essential to maintaining health. Glucometers, fertility trackers, or blood pressure cuffs might be more likely to be classified as medical devices, while the Oura ring remains a luxury item. Closing this gap requires rethinking what constitutes essential medical technology. Otherwise, we risk heading toward a future in which your ability to identify health issues early, monitor chronic conditions, and optimize your fitness depends on your ability to afford a monthly subscription.
Bottom line
Healthcare has gone digital, creating new opportunities for monitoring and intervention, but also new mechanisms of inequality. As fitness technologies evolve, offering more sophisticated monitoring and more useful analytics, this fundamental inequality will only worsen. After all, at the intersection of healthcare and technology, “people who struggle with one are often the same people who need the other,” says Gonzalez.
An Apple Watch on your wrist may seem like a personal choice, a small investment in your well-being. But when scaled to millions of people and billions of data points, individual choice becomes a structural inequality. Technologies that were supposed to make health information universally accessible instead create a new hierarchy of knowledge about one’s body. And those who need this knowledge most may find themselves the least accessible.