Facebook's 'Preventative Health' tool has a flaw that's impossible to ignore

Facebook has created a tool that reminds users to get cancer screenings, routine checkups and flu vaccines. It also lets users keep track of doctor appointments within the Facebook app, and share their status with friends.

Unveiled in October 2019, Preventative Health is Facebook’s second venture into the world of digital healthcare. The first foray was a feature that tipped users to blood drives in their area. Preventative Health takes a more personal approach to individuals’ health, nudging Facebook app users to take better care of themselves.

The tool has some serious backers: The American Cancer Society, American College of Cardiology, the American Heart Association and the US Centers for Disease Control and Prevention (CDC) were all involved in the development of Preventative Health. The tool’s purpose is to give people the “tools they need to be proactive about their health” according to Richard Kovacs, M.D., President of the American College of Cardiology, who is quoted in a statement on Preventative Health’s homepage.

But is Facebook able to motivate people to head to a clinic? Experts tell Inverse that Preventative Health has promise. But Facebook has a glaring flaw that’s impossible to ignore. The social network has essentially been a sieve for the privacy of its 1.63 billion daily active users on various matters for several years. “Is your health data actually private on Facebook?,” one might wonder. The company’s reputation is not going to help it as it looks to expand into health.

A helpful reminder?

Many health apps don’t have data to back up their claims, according to a review published earlier this year. But there could be utility in a tool that simply reminds users to make health appointments, and which uses social media to drive that message home.

Sherry Pagoto, Ph.D., is the director of the University of Connecticut’s Center for mHealth & Social Media (mHealth stands for mobile Health). Pagoto tells Inverse that digital reminders could drive people to change their behavior when delivered in the right way, and in the right context.

A digital reminder could be useful for “one-off” appointments that happen once a year or less, like a physical, or screening for sexually transmitted diseases.

“If it’s not something you have to do everyday, but something you do infrequently, reminding can be useful. I think there’s a good evidence base around that from a behavior-change perspective,” says Pagoto. “The thing is that the reminders don’t end up becoming intrusive and bothering people. That’s what I would be curious to see with this tool.”

Preventative Health is opt-in, so Facebook users don’t need to worry about an inundation of push notifications — unless they sign up. It’s also possible to set a personal reminder that will result in a notification within the Facebook app.

"That’s where I think Facebook doing it could be more powerful than just a mobile app doing it."

The ability to schedule checkups, track progress, and receive accurate health information isn’t unique to Preventative Health. Other mobile health apps (some run by clinicians) offer the same functionality. The defining feature of Facebook’s tool, says Pagoto, comes down to the fact that they’re a social media platform, which means you can share your status with others.

Social networking for health

If you opt-in, Preventative Health won’t automatically share the fact that you got a mammogram or had an eye exam with your friends and family. Instead, you can share the fact that you’re tracking your health with Preventative Health through a status update. That could create peer pressure, inspiring your contacts to do the same — or so Facebook hopes. The question is whether this kind of activity will inspire others to both use the tool and actually go to their health checkups.

“That’s where I think Facebook doing it could be more powerful than just a mobile app doing it, because it does have that social piece,” Pagoto says.

Facebook is adept at leveraging peer pressure. A 2016 study found that Facebook status updates substantially increased voter turnout — but only when people specifically tagged their friends and offered messages of encouragement. The authors found that digital communication was more effective in increasing voter turnout than face-to-face communication.

Nitesh Chawla, Ph.D., is a professor of computer science and engineering at Notre Dame who studies social networks and behavior change in a health context. He explains that the data on voting behavior is a good sign, but there are hurdles that might hamper spreading healthy behaviors via social networks. Two factors that might hold people back from seeking care are lack of access and high costs — which have nothing to do with simple forgetfulness.

"It’s not just a single post on Facebook that will have an impact on health."

Chawla’s research suggests that heath and wellness behaviors do travel throughout social networks, but they require consistent, close ties to make significant headway within a network. That means it could take far more than just one reminder or a status update from a long-forgotten Facebook friend to change habits.

“The question becomes, does that connection on Facebook become a sustained effort in engaging together to result in health and wellbeing outcomes?” Chawla says.

Ultimately, it comes down to whether the right five, ten, or 15 people engage in the behavior — with that kind of tight social network, says Chawla, it might be possible to get a habit to stick.

The messenger matters

The biggest problem facing Preventative Health may not come from the difficult business of changing human behavior. Facebook may have the potential to leverage social dynamics for public health good, but whether the company is the right medium for the message isn’t clear.

In 2018, Facebook exposed 87 million user profiles to the firm Cambridge Analytica, which infamously used that data for political advertising purposes. This week, two days after Facebook announced the rollout of Preventative Health, the company paid the maximum fine possible for their role in the ensuing scandal — about $643,000.

This incident and others have raised concerns over Facebook’s suitability as a steward of private data, never mind a person’s health data. Freddy Abnousi, M.D., who heads up health care research for Facebook, said in a statement that Facebook won’t share health data with third parties, or show ads based on the information that users put into the tool.

Mandy Sugrue, a Facebook spokesperson, tells Inverse that the company went to additional lengths to protect user privacy. She did not answer Inverse’s questions about how Facebook plans to keep users’ data private and secure.

Public trust in Facebook has eroded: 60 percent of respondents to a Wall Street Journal and NBC poll said they don’t trust the company at all to protect their private data. That lack of public trust could undercut the power of the social connections the website fosters. Still, Pagoto hopes that we may be able to find more transparent, trustworthy ways to use social media for public health:

“We can use our social connections to help improve health other’s health. That’s the thing I hope people can get excited about,” says Pagoto. “We still need to figure out how to do that in the best way.”