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Why Wearables Are Out Of Reach For People Who Need Them Most

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Dr. Roy M. Arnold owns a healthcare practice in the deep south, where physicians can be scarce. To help those who can’t afford time or transportation to see a doctor, he has started using a wearable device system called Mobile Cardiac Outpatient Telemetry, which monitors weight and heart rates and delivers a printout to him. “It’s important in chronic congestive heart failure because a sign of the heart function worsening is gain of weight.”

But, Arnold says he hasn’t seen it being used in poorer communities. Costing a steep $350 per month, it’s not a surprise.

Two thirds of healthcare costs today are for the management of chronic illnesses and one in nine of healthcare expenditure is spent on diabetes care. Apple, Samsung, Fitbit and Google are all among tech giants taking a step into diabetes-related wearables that will supposedly transform the way we manage such diseases. But for sufferers and physicians alike, it’s an industry far from within reach.

From Fitbit’s record-breaking IPO to the much-anticipated Apple Watch, 2015 sales are on the rise and so has interest. Dubbed “the year of the wearable,” 2014 saw explosions in the consumer market and the potential to stay active and track sleep while big pharma used hundreds of wearables for clinical trials.

At the same time, there are impending epidemics among Americans who are also experiencing a complete change in healthcare. The International Diabetes Federation says one of the coming epidemics is diabetes, which will affect one in 10 adults by 2030, an increase of 90%. Rates of diabetes in indigenous people are amongst the highest in the world. And more than 80% of diabetes deaths occur in low and middle-income countries, according to WHO.

A common plea from wearables’ companies is aimed at weight loss, but not at the ones who suffer most. CDC's recent study shows a stark obesity disparity among varying racial groups in the United States—with the highest rates residing in the south. African-Americans had the most cases, followed by Hispanics. It also represents huge implications for future individual health costs because obesity causes significant downstream of health problems like diabetes, heart disease and cancer.

But insurance coverage for wearables like the one Dr. Arnold uses has been extremely limited, largely due to the fact that insurance companies don’t have solid data yet says Rock Health’s Teresa Wang. “By keeping populations healthier, they’ll be able to subsidize these devices to widen access,” she says. “A lot of communities can have access to technology and health resources they didn’t have before but insurance companies need to have ROI."

But, even with expanded health insurance, low-income families are still not guaranteed access to health care services that offer wearables, one study found. Potential beneficiaries are at a loss when living in “double disparity” areas like Maryland where there’s a disproportionate environmental hazards and limited access to health care resources. But for the many who’s insurance doesn’t cover wearables or may not have insurance at all—it’s just another hurdle.

On the patient side, people aren’t used to paying so much for health-related devices, and yet will have to get used to bearing more of a cost burden Wang says. “Many will become more comfortable with the idea of paying for health expenses out of pocket,” she says. Those who can afford it that, is.

But these are communities that can’t necessarily afford a $100 to $300-wearable device, says Autumn Saxton-Ross, program director at the National Collaborative for Health Equity. "When it comes to wearables, if I’m looking at a cellphone versus a wearable, and this is my last 20 bucks for the month, it’s going to go toward a phone,” Saxton-Ross says.

This is the first of a six-part series 'The Leftovers: Why The Communities Who Could Benefit Most from Wearables Are Being Left Behind'.