While we make personal decisions about diet and exercise, government policies influence our ability to make healthy choices by affecting healthcare access, service quality and basic needs like housing, education and income. Smoking, poor diet, physical inactivity and harmful alcohol use, along with most chronic diseases, all follow a socioeconomic trajectory. The less money you have, the worse your health outcomes.

Beyond the polished ads featuring toned models flaunting Insta-friendly gadgets, Professor Amitava Banerjee’s experiences are quite different. As a cardiologist at University College London and a professor of clinical data science, he treats the NHS’s sickest heart patients – often from the poorest backgrounds, where health monitoring isn’t a lifestyle choice but a medical necessity. Health professionals like Banerjee might put a probe on your finger to check your oxygen levels; or use an ECG to check your heart rhythm; or they may monitor your fluid intake. This careful monitoring takes place in medicalised healthcare settings and may be the result of years of research. Can we have the same confidence when we strap on a wearable device after listening to an enthusiastic influencer?

“Healthy, wealthy people could build an entire intensive care unit at home if they wanted to”, Banerjee says, “but that doesn’t mean they should.” He’s critical of the narrative driven by some influencers and industry leaders that achieving optimal health demands relentless body monitoring. True health, he contends, isn’t about tracking every detail of your physical state. “Frankly, I’d rather go river rafting,” one US doctor quipped in The Atlantic when asked about tracking metrics. Others I’ve spoken to take a different view. They’ve told me this approach is old-fashioned and they place great faith in the role of measurements and data.

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