Why more data won’t make us healthier

We are living through the greatest expansion of health data in history. A phone and a wearable now generate millions of data points a year per person - steps, sleep, heart rate, glucose, mood, recovery. The promise was simple and seductive: give people the data, and they will change.

Except they don’t. Not at scale, and not for long. The gym fills in January and empties by March. The glucose monitor fascinates for a fortnight and becomes background noise. We have more information about our own bodies than any generation in history, and the population is getting sicker, not healthier.

I have spent a long time trying to understand why, and the answer has shaped everything I now believe about building in health.

What Dsions taught me

Years ago I worked on a concept called Dsions - a medically-led, AI-driven idea for personalised prevention, built on exactly the assumption above: that if we could converge all of someone’s health data, personal preferences (budget, faith, family set-up, retail), environment (weather, location, activities) and hand it back to them intelligently, they would make better choices. It never became a company. But it left me with insight that has shaped everything since.

Behaviour changes for the better only when the environment is taken into account. The same person, with the same data, behaves differently depending on the room they are in, the defaults around them, and which choices are made easy and which are made hard. Information alone does not move people. The environment they sit in does.

Once you see that, you cannot unsee it. It explains why the diabetes poster above the hospital vending machine changes nobody’s snack. Why the wellbeing app on a phone loses to the biscuits in the kitchen. Why telling people to move more, in cities built for cars and jobs built for sitting, was never going to work.

Why prevention keeps failing

This is the real reason prevention keeps failing despite better science and more data. We keep pushing information at individuals and ignoring the architecture around them. We tell people to eat well and surround them with cheap, engineered, ultra-processed food. We track everything and change nothing, because the environment still rewards the old behaviour and taxes the new one.

I saw it first-hand building a health-food business into workplaces. The companies where healthy eating took hold were never the ones with the best posters or the most data. They were the ones that changed the environment - what was in the vending machine, what sat at eye level, what was free and what cost extra, what the default was in the canteen at 3pm.

Why this is a commercial problem, not only a behavioural one

This matters for anyone building in health. Your product is not the intervention. The environment you place it into is.

A brilliant prevention tool dropped into an environment that pays for treatment, defaults to convenience, and rewards the wrong pocket will not scale, however good the science inside it. The data it generates will be beautiful and change nothing. And the founder will spend two years wondering why a clinically superior product cannot find a market.

The real work is designing the architecture around the product. Who is the buyer that benefits when the behaviour changes? What is the default that makes the healthy choice the easy one? What is the incentive that aligns the pocket that pays with the pocket that gains? Build those, and the product finally does what the data always promised it would.

Well Purposed's VITAL Framework is, in the end, a method for building the environment a product needs to succeed commercially: the right buyer, the right proof, the right route, priced so the maths works for the person signing.

What to build instead

When your prevention product is not landing, the instinct is to add more - more data, more features, more evidence. Almost always, the answer is the opposite. Look at the environment around it. Who has to change their behaviour for your product to work, and what is currently rewarding the old one? Which single default would you change to make your product the path of least resistance? Whose budget captures the benefit when the behaviour changes, and are you selling to them, or to someone else?

More data is coming, whether we design for it or not. The winners will not be the ones with the most of it. They will be the ones who build the environment that turns data into changed behaviour, and changed behaviour into a business.

If you are building in prevention, personalised health or healthy ageing and the environment around your product is working against you, reply to this email or drop me a line. That is exactly the problem I like most.

With purpose,

Sara