Inc42 View: Apple Misses A Beat By Leaving India Out Of Apple Watch Health Studies

Alongside shiny new iPhones and Apple Watch Series 5 models, Apple also announced that it’s doubling down on healthcare and unveiled three new studies which are linked to its Apple Watch product. But for those who have a close eye on healthcare technology, these health studies are not quite the democratic innovation that can be used to address the urgent concerns of health in developing economies such as India.

The new Apple health studies, which will be limited to the US when they launch, will look to address issues of hearing and sound pollution, heart health, and women’s health in relation to menstruation and reproduction. And while this signals Apple’s sharpened focus on healthcare, for now, its benefits will be limited to its US audience.

For the studies, Apple is teaming up with research partners such as global and American healthcare associations and major healthcare institutions to study the data collected through Apple Watch devices and associate them with health outcomes.

The new studies have been announced thanks to the success of the Apple Heart Study, which it had been conducting over the past year. Apple says the study has positively impacted medical research and will benefit future generations as the data from the study is used for health outcomes.

While laudable there are the two major concerns around Apple’s new healthcare studies: Will Apple ever bring this to emerging markets which are more in need of healthcare innovation? And secondly, does the premium pricing of the Apple Watch risk making the studies limited in their scope due to the niche crowd that will be able to afford them?

Apple’s Health Studies Ignore Developing Markets

Let’s focus on the first question — due to high saturation in the US and parts of Europe, Apple desperately needs to focus on emerging markets, which have the highest potential for growth, as evidenced by India’s double-digit growth for smartphones in the previous quarter.

Apple has had its eye on the India market for a while now, having setup an assembly plant for its iPhones in the country, and is also looking to start its own retail stores. But by restricting its healthcare study to the US market, Apple is limiting its own potential in such emerging markets, which are also some of the most underserved in terms of new-age healthcare solutions.

For the three new studies, users will be able to download the Apple Research app which will be available in the US later this year, Apple CEO Tim Cook said. Apple’s official press release does not mention if the study will be widened to developing countries right now.

So even if Apple sells more Apple Watches and iPhones in India this year, its users will not be able to participate in these studies immediately, for the company to claim to have a meaningful impact on healthcare.

Take for example the women’s health study, in which researchers will use the Apple Research app to collect data on menstrual cycles and other gynaecological health points. This data is intended to be used for disease screening, recommendations and risk assessments for major illnesses such as polycystic ovary syndrome (PCOS), infertility, osteoporosis, breast cancer, pregnancy complications, and menopausal transition, aspects where the Indian market desperately needs innovation and technology.

Women’s health is a crucial inadequacy in the Indian healthcare system, which already suffers from access and capacity issues. In the 2018 Global Gender Gap report, India was ranked 108 out of 149 countries by the World Economic Forum in terms of gender equality and quality of healthcare and economic services for women. In terms of mortality rate for women, which tracks the probability that a 15-year-old will die before reaching age 60, expressed per 1,000 people, India ranks 120 out of 187 countries surveyed with a mortality rate of 139 for 2014-2016.

If Apple is serious about pushing its devices and their use-cases for the Indian market and other countries which desperately need this innovation, it needs to work more closely to bring such offerings to the Indian market as well. In fact, by leaving out everyone but the users in the USA, Apple has pulled off what many would call a classic US move — forgetting the rest of the world exists.

Even from a branding and marketing point of view, Apple can get a better response in developing markets by treating its customers equally. Especially because Apple’s customers tend to have a higher purchasing power and be more tech-savvy than the average consumer.

Healthcare, But Only For Those Who Can Afford It

The other big issue with such health studies which are based around premium, niche devices is the inherent selection bias, which let’s be honest is ridiculous. Apple’s health studies are limited to the US and to those who actually own a compatible iPhone and Apple Watch, which means it automatically leaves out 59% of the market in the US alone — Apple has a 41% smartphone market share in the US, according to Counterpoint Research, and a paltry 1.2% in the Indian market.

Secondly, the health data is very likely to be skewed as individual health is directly linked to spending capacity, and the group of subjects in Apple’s health studies will have a higher proportion of such users, who some would argue, already have access to the best healthcare.

Some experts are also concerned about the repercussions of continuous monitoring which can raise false alarms in healthy people, sending data to researchers that may not necessarily reflect the actual health and wellbeing of the individual.

No one doubts that Apple has had a profound impact on healthcare with the Apple Watch, which has legitimately intervened in cases to save lives. But perhaps to make a real difference, Apple needs to get out of its US-centric approach and look at the world at large and at markets such as India that really need this innovation.