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Healing or hacking? Examining the hidden cost of health apps

Users are willing to trade their personal data and online privacy for free services.

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We surveyed 12,726 internet users from 13 countries across four continents to better understand the relationship between technology and people’s overall well-being. This study is meant to shed light on how modern technology influences our health, how people use apps to manage and improve their physical and mental health, and how we unknowingly use our privacy as a currency.

Ctrl+Alt+Relax: Using tech to unwind

Curling up in your book nook with the latest page-turner on your lap is a thing of the past — unless it’s on your phone, tablet, or e-book reader. Globally, 96% of people turn to their devices when they want to relax, ranging from 90% in Sweden to 99% in the UK.

In general, TV remains the #1 device for relaxation and easy entertainment (70%). Smartphones are not far behind (69%), but they have already taken over and become the most used device for winding down in Italy (83%), Malaysia (79%), and Spain (74%).

Italians turned out to be the most likely to use technology for relaxing — 69% of them said they do so a few times a day. On the opposite end, we have Switzerland, where less than 50% of respondents reported using a device to unwind more than once throughout the day.

When it comes to activities, watching TV is the most common way to relax in most countries (66%), closely followed by listening to music (63%). Exceptions to this were Spain and Switzerland, where listening to music was slightly more popular; Australia, where streaming was in second place behind TV; and Malaysia, where TV came in fourth behind music, streaming, and scrolling through social media.

infographic popular devices to unwind

The digital prescription: using apps to improve mental health

People love using apps. And if there’s an app that can (even indirectly) improve your health, chances are you’ll want it. A 58% chance to be exact — that’s how many people use at least one app to improve their health.

When it comes to tracking various metrics, 49% of people surveyed used apps to track at least one of the activities listed in the survey. Exceptions were Malaysia, France, Spain, the US, and Switzerland, where more than half of people used tracking apps. Sweden and Italy, however, were the least likely to do that — 38% and 41% respectively.

The most tracked activities globally were working out (25%), sleeping (19%), drinking water (17%), and healthy eating (16%).

No single health app was the clear winner, because people from different countries used many different apps. But various step counters, calorie trackers, and mental health apps were among the most popular:

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    Mental health and meditation apps were more popular in English-speaking countries.

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    Fitness apps and step counters were in the top three of all countries surveyed.

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    Localized health apps were also widely popular: More than 50% of Malaysians use MySejahtera, 19% of Austrians use MeineSV, and 17% of French use Compte Ameli.

Malaysia stood out from the rest, where 8 out of 10 people claimed they use at least one app to support their mental or physical health. In contrast, less than 5 out of 10 Canadians reported regularly using health apps.

infographic most tracked activities

Data mining your mind: Are you using mental health apps safely?

It seems that not many users have realized that when they’re using a “free” service, they’re still paying — just not with money. However, our research showed that when it comes to certain life areas, people think it’s more beneficial to be a paying customer.

Only 7% of users said they exclusively use paid health apps, but when asked about mental health apps specifically, 19% claimed to use only paid ones. So users were more than twice as likely to use a paid app for mental health than general health — an effect that was more pronounced in Malaysia, the UK, Austria, and the Netherlands.

However, the use of free apps for mental health was still at over 75% for all countries except Germany and even higher for general health — up to almost 98% of health app users in Italy used free apps.

Whether free or paid, all apps require users to provide some information about themselves in order to function properly. What did people give up in order to stay healthy?

People gave away their contact information generously: Email and name were provided by over 50%, and phone number by over 31% of people surveyed. This (along with health information which was also given by more than half of users) is often a requirement in order to use an app. Signing up is common and begins the tracking of individual data, with 13% of people also adding a photo to their profile. Over 9% of users also gave access to their contact list, so even if you’re being careful with your data, there’s always a chance that someone else isn’t.

Germany stood out in this regard — people gave over more payment info but less other types of data. This behavior can be linked to a higher rate of paid app usage in Germany and shows a clear tradeoff between paid apps and privacy in users’ choices.

However, only 14% of people don’t give any data to their health apps, which means 86% of users rely on the cybersecurity measures of their apps for the privacy of their data. Unfortunately, this does not really play into their decision-making when choosing a health app.

The top three most important features were ease of use, availability of a free plan, and content. This was true in all countries except Malaysia, where privacy policies were the third most important. The high prioritization of free plans reflects the high percentage of people who prefer free apps.

The two least important features were MFA and the app’s developers across all countries. Overall, encryption of user data was the fourth lowest in importance. Other low-scoring priorities were the app’s popularity, description, and price, further showcasing the dominance of free apps.

Those using paid apps to support their health were about three times as likely to have experienced a cybersecurity-related issue with free health apps in the past. It is likely that this served as a motivation to use paid apps to a significant number of users.

What is worrying, however, is that 82% of people who have experienced cybersecurity-related issues still use free apps. It might suggest that users don’t know how to improve their behavior or lack concern for their data. Perhaps they don’t know how to protect it or are simply unable to pay for apps to support their health.

While an app being free is not necessarily a red flag, it often includes exchanging services for sensitive personal data. When this information sold to advertisers and data brokers includes topics like fertility, mental illness, and sexual orientation, it’s particularly worrying.

Data like this can be used to create detailed user profiles containing sensitive information that could potentially be used for discrimination or exclusion, like denying insurance or job opportunities based on your physical or mental health.

Analysis by country shows a slight trend between making active use of apps for mental health and prioritizing privacy policies when choosing an app. This demonstrates an overall awareness of the sensitivity of mental health data among active users, and the need to look at how this data is protected.

As recent history shows, even well-known paid health service providers have sold their paying users’ data to third parties. It shouldn’t come as a surprise that your free meditation, fitness, or meal-tracking app could do the same. Either way, it’s entirely up to you to take care of your data privacy.

infographic health apps information

How do you stay healthy and safe?

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    Limit how much information you give to companies. You might pay for a service, but the provider could still treat your private information carelessly or suffer a data breach after a cyberattack. Always keep in mind that you’re the one who’s responsible for your data.

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    Use NordVPN and its Threat Protection feature to block third-party trackers and limit your overall digital footprint. Blocking trackers makes it harder for advertisers to build a detailed online profile on you, allowing you to use online services in more privacy and avoid intrusive targeted ads and unfair prices.

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    Stick to known, reputable app developers and be mindful of what information and access permissions you give them. You can also use additional resources to check the apps you want before installing them, like Mozilla’s *Privacy Not Included to check the security standards or the Exodus tracker database to test an app for trackers and permissions.

Methodology

NordVPN commissioned the survey, and Cint carried it out in most countries — only respondents from Sweden were questioned by Norstat. Quotas were placed on age, gender, and place of residence to achieve a nationally representative sample among internet users.

Time of the study

In most countries, the survey took place between May 15 and May 26, 2023. In Malaysia, the survey was conducted between April 4 and April 19, 2023.

Number of respondents

The number of respondents per country was 1,000, with the exception of Spain (800) and Switzerland (900).

Age of the respondents

Respondents from all countries were all 18 years and older. The only country with a set age limit was Malaysia, where only people aged 18-64 were surveyed.

Press materials

Looking for assets to help you report on our research? Look no further.

Want to learn more about our digital life? Check out our other research!

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