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Why you can’t boil people down to a single health score

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I’ve spent a couple of decades now working on harnessing technology and data to help improve people’s health. One thing I know for certain is that changing people’s behaviour starts from the top—by changing their minds. If this first, crucial step of engaging and fostering a sense of investment in the journey isn’t executed to perfection, and most importantly, if it isn’t rooted in psychology, then there’s no other way to put it: it’s game over.  In a world that is so all about the numbers these days, the most common misstep (I’m looking at you, insurance companies) is simple. It’s the idea that you can reduce people to a single ‘health score’.

Close your eyes for a moment and think about the person about whom you care most. Your partner? Your child? Your best friend? Now, think about reducing their entire life to a number. Would you? No, you wouldn’t. But, in the eyes of some (particularly insurance companies), they’re not your best friend, your mum, nor a person with a rich, complicated life behind them—they’re a number. Specifically, they’re a 682/1000. How would you expect them to respond when you told them that, based on their whole life—their sense of happiness and purpose, financial situation, level of education, weight, postcode, resting heart rate, hobbies, posture, job title, and so on—they’d been drawn up to simply be… that one number? Without a shadow of a doubt, they certainly won’t be feeling empowered, won’t like you more, nor will they feel more inclined to pay more attention to you after being fed that information.  And yet, this ‘person to a number’ approach is what insurers and some wellness programs are touting. Personally, based on everything I’ve ever seen work (and not work), this is amongst the most psychologically damaging, disempowering, counterproductive thinking. People deserve better than this, especially if we’re to encourage them to better their own health journey.

I suspect that this methodology has come about because insurers use scoring in order to price risk—it’s a part of the actuarial set of tools, and it helps insurers to stay in business. Don’t get me wrong, there’s nothing wrong with that! But, just because it’s going on in the background, doesn’t mean the end customer needs to be exposed to it. Most companies I deal with as a consumer are probably using algorithms to score me. I’d have a credit score, a customer loyalty score, and a propensity to buy score sitting in databases all over the place. Do I need to know them? Not really—just in the same way that a real, living, breathing person doesn’t need to have their life flattened into a ‘single health score’. No one wants an insurer showing them a cold, calculating, inhuman number that couldn’t possibly account for their life lived… without insulting them, at least.

Of course, I’m not suggesting that ignorance is bliss. Quite the opposite, in fact. HeadUp is founded on the idea that everyone should know more about themselves and have a dashboard to help them understand just what’s going right, and what’s needing attention to help them feel in control and navigate what’s ahead. But that’s what it is. A very carefully considered set of gauges and dials to help people manage things better and feel empowered and give them autonomy. Even when the not-so-good elements of an individual’s health are presented, there’s an absolute ton of work behind the scenes that goes into ensuring that they receive it in the right spirit, that it’s delivered constructively and delicately, and that it’s put into the right context.  This dashboard and its delivery can mean the difference between crushing someone’s spirits, and empowering them to make mindful changes to improve their health. Personally, we’re fans of the latter.

Health scoring: a symptom of a deeper issue.

Insurers already struggle deeply with trust—using ‘health scoring’ as one of their key pillars is symptomatic of an industry whose model has forever been reactive and transactional.  Unfortunately, this model extends little in the way of support and ongoing positive engagement with customers. When coupled with the fact that there has traditionally been very few touch-points between insurers and customers, it should be no surprise that the perceived value for insurance is bleak, at best.  Consequently, it has been rare to see insurers  help consumers to manage their risks over time or support them throughout their lives. Instead, it’s been an exercise in simply underwriting them once they are at the point of application, and then minimising future interactions in order to avoid the risk of churn when policyholders are reminded of this ‘reluctant’ purchase. It’s no wonder then, that in a rush to try to ‘engage’ people, they’ve simply brought the actuarial workings above the surface. Ironically, this can push people away even further.

The most alarming aspect in all of this is that these health scores are often wildly inaccurate.  Insurers typically price using fewer than 10 data points, generating minimal and unreliable data for effective risk assessment, let alone any meaningful, precise or personalised insight. This simply instills a sense of learned helplessness amongst many customers, especially those with pre-existing medical conditions, specific bio-markers, or those more prone to certain medical conditions due to family medical history.  I’ve also seen countless instances of where new, brilliant forms of data and modelling for risk assessment—which are well understood and evidenced in the clinical and medical world—are not accommodated by actuarial models. That’s bad for business, and bad for health scoring. And that is bad science.

Most of these ‘wellness’ interventions that give people a single health score or point solution then assume that people are coin-operated—that is, that once seeing their score, the lightning will strike, and that they’ll be unstoppable when it comes to trying to earn a better health score. A great theory? Yes. Does it actually happen though? Not at all. What generally occurs is that a small percentage of already healthy people figure out how to game the system, whilst the vast majority who could actually do with help, understanding, and guidance run for the hills. Okay, maybe that’s a bad phrase to use… these people tend not to be runners, but do you get my point? With an increasing burden of disease—the majority of which is the direct result of lifestyle diseases—preventive health interventions delivered at scale can effect change in the trend, reducing the cost burden on society. Insurers are perfectly positioned for this, and have the capacity to truly change the game. That’s why I love working with insurers who get it. They are the ones who have thrown out the old playbook. They get that a clinically proven, connected experience that leverages psychology, data, reinforcement, and machine learning to continually adapt to an individual’s needs and projected outcomes over time is the only way forward for both the company, and the individual.  It’s more than just the number.

With that, there’s no doubt that insurers have so much to gain from understanding customers better and creating a more intimate, genuine, sincere, long-term relationship. Just like any intimate, genuine, sincere, long term relationship though, it’s not about scoring. And that’s why—unless you want to damage things—you can’t stand someone up and boil them down to a single health score.

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