Apple watch has been inching toward that messaging from the very beginning. At the first launch in 2014, Tim Cook called the Apple Watch a health device.
In 2018, when Apple introduced the feature that could detect irregular heart rates, Cook named the watch lifesaving. So now, instead of pitching the watch as something that could save a life, it’s framed as something people can’t live without.
The anecdotes used to back that messaging up in the videos — the people whose watches alerted them to heart problems or helped get them out of trouble — are worth paying attention to. Real people get help from Apple Watches during emergencies. But Apple is grouping active safety features — like crash detection or the ability to make emergency calls from the wrist — with passive health monitoring features. And there still isn’t clear evidence that the health features on Apple watches can keep people healthier overall.
Take the heart rhythm feature, for example. It flags when people have abnormal heart rhythms that could indicate atrial fibrillation, a condition that increases the risk of stroke or heart failure. So it’s pretty good at doing that. But catching atrial fibrillation or another abnormal heart rhythm isn’t the same as preventing a stroke.
Most people who get a cardiac alert from their Apple Watch don’t end up getting diagnosed with a cardiac condition, according to one study from 2020. But screening the signals can take up time and resources in the healthcare system, and the process can be anxiety-provoking for patients. And even if people have a natural, abnormal heart rhythm, there often isn’t many doctors can do about it, according to a different study from this past March.
Apple also can’t say if any other health-related features on the Apple Watch can actively improve someone’s health. For example, the watch has a feature that can detect blood oxygen levels, but the Food and Drug Administration doesn’t clear that monitor as a medical device. So apple can’t make any claims that it can keep people safer. That doesn’t mean someone who wears a watch can’t use it to try and keep track of their oxygen levels if they contract COVID-19, for example.
The newest health sensor on the Apple Watch Series 8 is a temperature monitor that will initially be used to estimate when someone ovulates. It could also help establish a wearer’s temperature baseline — everyone’s temperature is “normal” in a different range, says Jennifer Radin, an epidemiologist with the digital medicine division at Scripps Research Translational Institute.
But like the blood oxygen monitor, this isn’t an FDA-cleared medical device, so Apple can’t make any claims about its ability to detect or diagnose a medical condition. Also, like the blood oxygen monitor, it might struggle with accuracy, Radin says. The wrist is a tricky spot to take a temperature, as Fitbit users have seen. (Certain Fitbit models, like the Fitbit Sense and Fitbit Charge 4, have temperature sensors). Radin, for example, says that Fitbit read a colder body temperature when she was in colder rooms — even though the outside temperature doesn’t significantly impact body temperature.
Then there’s the fact that the benefits of this tech may be unequally distributed. For example, health features on wearables are typically less accurate for people with darker skin. For example, research shows that the light sensors used to track heart rate on the Apple Watch don’t work as well on darker skin tones. Likewise, Fingertip blood oxygen monitors are less accurate on darker skin, and oxygen monitors built into smartwatches work similarly. So even if these features save lives, white people would be more likely to benefit from them than people of color.
It may be a good marketing tactic to make people think they must spend hundreds of dollars on an Apple Watch to keep themselves safe. The fear-mongering presentation made it seem like the Apple Watch was the only thing between people and disaster. It’s no longer being presented as a fitness device, a curiosity, or a way to learn more about yourself. No, now, it’s a necessary thing to have. That’s a high bar — and it’s not one it’s met yet.