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TikTok Parents Are Taking Advantage Of Their Kids. It Needs To Stop


TikTok Parents Are Taking Advantage of Their Kids. It Needs to Stop


TikTok Parents Are Taking Advantage of Their Kids. It Needs to Stop

Rachel Barkman's son started accurately identifying different species of mushroom at the age of 2. Together they'd go out into the mossy woods near her home in Vancouver and forage. When it came to occasionally sharing in her TikTok videos her son's enthusiasm and skill for picking mushrooms, she didn't think twice about it -- they captured a few cute moments, and many of her 350,000-plus followers seemed to like it.

That was until last winter, when a female stranger approached them in the forest, bent down and addressed her son, then 3, by name and asked if he could show her some mushrooms. 

"I immediately went cold at the realization that I had equipped complete strangers with knowledge of my son that puts him at risk," Barkman said in an interview this past June. 

This incident, combined with research into the dangers of sharing too much, made her reevaluate her son's presence online. Starting at the beginning of this year, she vowed not to feature his face in future content. 

"My decision was fueled by a desire to protect my son, but also to protect and respect his identity and privacy, because he has a right to choose the way he is shown to the world," she said.

These kinds of dangers have cropped up alongside the rise in child influencers, such as 10-year-old Ryan Kaji of Ryan's World, who has almost 33 million subscribers, with various estimates putting his net worth in the multiple tens of millions of dollars. Increasingly, brands are looking to use smaller, more niche, micro- and nano-influencers, developing popular accounts on Instagram, TikTok and YouTube to reach their audiences. And amid this influencer gold rush there's a strong incentive for parents, many of whom are sharing photos and videos of their kids online anyway, to get in on the action. 

The increase in the number of parents who manage accounts for their kids -- child influencers' parents are often referred to as "sharents" -- opens the door to exploitation or other dangers. With almost no industry guardrails in place, these parents find themselves in an unregulated wild west. They're the only arbiters of how much exposure their children get, how much work their kids do, and what happens to money earned through any content they feature in.

Instagram didn't respond to multiple requests for comment about whether it takes any steps to safeguard child influencers. A representative for TikTok said the company has a zero-tolerance approach to sexual exploitation and pointed to policies to protect accounts of users under the age of 16. But these policies don't apply to parents posting with or on behalf of their children. YouTube didn't immediately respond to a request for comment.

"When parents share about their children online, they act as both the gatekeeper -- the one tasked with protecting a child's personal information -- and as the gate opener," said Stacey Steinberg, a professor of law at the University of Florida and author of the book Growing Up Shared. As the gate opener, "they benefit, gaining both social and possibly financial capital by their online disclosures."

The reality is that some parents neglect the gatekeeping and leave the gate wide open for any internet stranger to walk through unchecked. And walk through they do.

Meet the sharents

Mollie is an aspiring dancer and model with an Instagram following of 122,000 people. Her age is ambiguous but she could be anywhere from 11-13, meaning it's unlikely she's old enough to meet the social media platform's minimum age requirement. Her account is managed by her father, Chris, whose own account is linked in her bio, bringing things in line with Instagram's policy. (Chris didn't respond to a request for comment.)

You don't have to travel far on Instagram to discover accounts such as Mollie's, where grown men openly leer at preteen girls. Public-facing, parent-run accounts dedicated to dancers and gymnasts -- who are under the age of 13 and too young to have accounts of their own -- number in the thousands. (To protect privacy, we've chosen not to identify Mollie, which isn't her real name, or any other minors who haven't already appeared in the media.)

Parents use these accounts, which can have tens of thousands or hundreds of thousands of followers, to raise their daughters' profiles by posting photos of them posing and demonstrating their flexibility in bikinis and leotards. The comment sections are often flooded with sexualized remarks. A single, ugly word appeared under one group shot of several young girls in bikinis: "orgy."

Some parents try to contain the damage by limiting comments on posts that attract too much attention. The parent running one dancer account took a break from regular scheduling to post a pastel-hued graphic reminding other parents to review their followers regularly. "After seeing multiple stories and posts from dance photographers we admire about cleaning up followers, I decided to spend time cleaning," read the caption. "I was shocked at how many creeps got through as followers."

But "cleaning up" means engaging in a never-ending game of whack-a-mole to keep unwanted followers at bay, and it ignores the fact that you don't need to be following a public account to view the posts. Photos of children are regularly reposted on fan or aggregator accounts, over which parents have no control, and they can also be served up through hashtags or through Instagram's discovery algorithms.

The simple truth is that publicly posted content is anyone's for the taking. "Once public engagement happens, it is very hard, if not impossible, to really put meaningful boundaries around it," said Leah Plunkett, author of the book Sharenthood and a member of the faculty at Harvard Law School.

This concern is at the heart of the current drama concerning the TikTok account @wren.eleanor. Wren is an adorable blonde 3-year-old girl, and the account, which has 17.3 million followers, is managed by her mother, Jacquelyn, who posts videos almost exclusively of her child. 

Concerned onlookers have pointed Jacquelyn toward comments that appear to be predatory, and have warned her that videos in which Wren is in a bathing suit, pretending to insert a tampon, or eating various foodstuffs have more watches, likes and saves than other content. They claim her reluctance to stop posting in spite of their warnings demonstrates she's prioritizing the income from her account over Wren's safety. Jacquelyn didn't respond to several requests for comment.

Last year, the FBI ran a campaign in which it estimated that there were 500,000 predators online every day -- and that's just in the US. Right now, across social platforms, we're seeing the growth of digital marketplaces that hinge on child exploitation, said Plunkett. She doesn't want to tell other parents what to do, she added, but she wants them to be aware that there's "a very real, very pressing threat that even innocent content that they put up about their children is very likely to be repurposed and find its way into those marketplaces."

Naivete vs. exploitation

When parent influencers started out in the world of blogging over a decade ago, the industry wasn't exploitative in the same way it is today, said Crystal Abidin, an academic from Curtin University who specializes in internet cultures. When you trace the child influencer industry back to its roots, what you find is parents, usually mothers, reaching out to one another to connect. "It first came from a place of care among these parent influencers," she said.

Over time, the industry shifted, centering on children more and more as advertising dollars flowed in and new marketplaces formed. 

Education about the risks hasn't caught up, which is why people like Sarah Adams, a Vancouver mom who runs the TikTok account @mom.uncharted, have taken it upon themselves to raise the flag on those risks. "My ultimate goal is just have parents pause and reflect on the state of sharenting right now," she said. 

But as Mom Uncharted, Adams is also part of a wider unofficial and informal watchdog group of internet moms and child safety experts shedding light on the often disturbing way in which some parents are, sometimes knowingly, exploiting their children online.

The troubling behavior uncovered by Adams and others suggests there's more than naivete at play -- specifically when parents sign up for and advertise services that let people buy "exclusive" or "VIP" access to content featuring their children.

Some parent-run social media accounts that Adams has found linked out to a site called SelectSets, which lets the parents sell photo sets of their children. One account offered sets with titles such as "2 little princesses." SelectSets has described the service as "a classy and professional" option for influencers to monetize content, allowing them to "avoid the stigma often associated with other platforms."

Over the last few weeks, SelectSets has gone offline and no owner could be traced for comment.

In addition to selling photos, many parent-run dancer accounts, Mollie's included, allow strangers to send the dancers swimwear and underwear from the dancers' Amazon wish lists, or money to "sponsor" them to "realize their dream" or support them on their "journeys."

While there's nothing technically illegal about anything these parents are doing, they're placing their children in a gray area that's not explicitly sexual but that many people would consider to be sexualized. The business model of using an Amazon wish list is one commonly embraced by online sugar babies who accept money and gifts from older men.

"Our Conditions of Use and Sale make clear that users of Amazon Services must be 18 or older or accompanied by a parent or guardian," said an Amazon spokesperson in a statement. "In rare cases where we are made aware that an account has been opened by a minor without permission, we close the account."

Adams says it's unlikely to be other 11-year-olds sending their pocket money to these girls so they attend their next bikini modeling shoot. "Who the fuck do you think is tipping these kids?" she said. "It's predators who are liking the way you exploit your child and giving them all the content they need."

Turning points

Plunkett distinguishes between parents who are casually sharing content that features their kids and parents who are sharing for profit, an activity she describes as "commercial sharenting." 

"You are taking your child, or in some cases, your broader family's private or intimate moments, and sharing them digitally, in the hope of having some kind of current or future financial benefit," she said.

No matter the parent's hopes or intentions, any time children appear in public-facing social media content, that content has the potential to go viral, and when it does, parents have a choice to either lean in and monetize it or try to rein it in.

During Abidin's research -- in which she follows the changing activities of the same influencers over time -- she's found that many influencer parents reach a turning point. It can be triggered by something as simple as other children at school being aware of their child's celebrity or their child not enjoying it anymore, or as serious as being involved in a car chase while trying to escape fans (an occurrence recounted to Abidin by one of her research subjects). 

One influencer, Katy Rose Pritchard, who has almost 92,000 Instagram followers, decided to stop showing her children's faces on social media this year after she discovered they were being used to create role-playing accounts. People had taken photos of her children that she'd posted and used them to create fictional profiles of children for personal gratification, which she said in a post made her feel "violated."

All these examples highlight the different kinds of threats sharents are exposing their children to. Plunkett describes three "buckets" of risk tied to publicly sharing content online. The first and perhaps most obvious are risks involving criminal and/or dangerous behavior, posing a direct threat to the child. 

The second are indirect risks, where content posted featuring children can be taken, reused, analyzed or repurposed by people with nefarious motives. Consequences include anything from bullying to harming future job prospects to millions of people having access to children's medical information -- a common trope on YouTube is a video with a melodramatic title and thumbnail involving a child's trip to the hospital, in which influencer parents with sick kids will document their health journeys in blow-by-blow detail.

The third set of risks are probably the least talked about, but they involve potential harm to a child's sense of self. If you're a child influencer, how you see yourself as a person and your ability to develop into an adult is "going to be shaped and in some instances impeded by the fact that your parents are creating this public performance persona for you," said Plunkett.

Often children won't be aware of what this public persona looks like to the audience and how it's being interpreted. They may not even be aware it exists. But at some point, as happened with Barkman, the private world in which content is created and the public world in which it's consumed will inevitably collide. At that point, the child will be thrust into the position of confronting the persona that's been created for them.

"As kids get older, they naturally want to define themselves on their own terms, and if parents have overshared about them in public spaces, that can be difficult, as many will already have notions about who that child is or what that child may like," said Steinberg. "These notions, of course, may be incorrect. And some children may value privacy and wish their life stories were theirs -- not their parents -- to tell."

Savannah and Cole LaBrant with daughter Everleigh

Savannah and Cole LaBrant have documented nearly everything about their children's lives.

Jim Spellman/WireImage

This aspect of having their real-life stories made public is a key factor distinguishing children working in social media from children working in the professional entertainment industry, who usually play fictional roles. Many children who will become teens and adults in the next couple of decades will have to reckon with the fact that their parents put their most vulnerable moments on the internet for the world to see -- their meltdowns, their humiliation, their most personal moments. 

One influencer family, the LaBrants, were forced to issue a public apology in 2019 after they played an April Fools' Day Joke on their 6-year-old daughter Everleigh. The family pretended they were giving her dog away, eliciting tears throughout the video. As a result, many viewers felt that her parents, Sav and Cole, had inflicted unnecessary distress on her.

In the past few months, parents who film their children during meltdowns to demonstrate how to calm them down have found themselves the subject of ire on parenting Subreddits. Their critics argue that it's unfair to post content of children when they're at their most vulnerable, as it shows a lack of respect for a child's right to privacy.

Privacy-centric parenting

Even the staunchest advocates of child privacy know and understand the parental instinct of wanting to share their children's cuteness and talent with the world. "Our kids are the things usually we're the most proud of, the most excited about," said Adams. "It is normal to want to show them off and be proud of them."

When Adams started her account two years ago, she said her views were seen as more polarizing. But increasingly people seem to relate and share her concerns. Most of these are "average parents," naive to the risks they're exposing their kids to, but some are "commercial sharents" too.

Even though they don't always see eye to eye, the private conversations she's had with parents of children (she doesn't publicly call out anyone) with massive social media presences have been civil and productive. "I hope it opens more parents' eyes to the reality of the situation, because frankly this is all just a large social experiment," she said. "And it's being done on our kids. And that just doesn't seem like a good idea."

For Barkman, it's been "surprisingly easy, and hugely beneficial" to stop sharing content about her son. She's more present, and focuses only on capturing memories she wants to keep for herself.

"When motherhood is all consuming, it sometimes feels like that's all you have to offer, so I completely understand how we have slid into oversharing our children," she said. "It's a huge chunk of our identity and our hearts."

But Barkman recognizes the reality of the situation, which is that she doesn't know who's viewing her content and that she can't rely on tech platforms to protect her son. "We are raising a generation of children who have their entire lives broadcast online, and the newness of social media means we don't have much data on the impacts of that reality on children," she said. "I feel better acting with caution and letting my son have his privacy so that he can decide how he wants to be perceived by the world when he's ready and able."


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What States Can And Can't Do When Banning Abortion


What States Can and Can't Do When Banning Abortion


What States Can and Can't Do When Banning Abortion

For more information about your reproductive health rights and related federal resources, you can visit the US government's

Reproductive Rights

site.

Whether someone can get an abortion or related medical procedure mostly hinges on which state they live in after the Supreme Court overturned Roe v. Wade last month and ended the constitutional right to abortion. But the switch from federal protection to state law isn't straightforward and has led to confusion and misinformation on what pregnant patients and physicians can do.

In this still developing landscape, how confident can people be that their treatment is still legal?

"The answer to all your questions is 'Who the heck knows,'" said Dr. Louise Perkins King, a surgeon and bioethicist at Harvard Medical School. "And that's the problem."

The US Department of Health and Human Services issued guidance on July 11 reminding physicians of their responsibilities under the existing Emergency Medical Treatment and Labor Act, or EMTLA, which supports the need to treat and stabilize patients in an emergency, including pregnant patients who may require an abortion. Days later, Texas sued the Biden administration over the law, which allows for medical assistance to save the life of the mother, because, Texas Attorney General Ken Paxton said, it "seeks to transform every emergency room in the country into a walk-in abortion clinic." 

On Tuesday, a judge in Texas blocked the EMTLA guidance, so physicians in that state may no longer be protected by federal law if they perform an abortion when they deem it medically necessary but it falls outside of Texas' interpretation of a life-endangering pregnancy. Physicians nationwide who are members of the American Association of Pro-Life Gynecologists and Obstetricians or the Christian Medical and Dental Association are also exempt -- a total of about 18,000 health care providers, according to the court document.

Texas' new trigger law -- which will be in effect on Aug. 25 -- bans all abortions except when the pregnancy puts the mother "at risk of death or poses a serious risk of substantial impairment of a major bodily function." Physicians who perform an illegal abortion will be committing a felony. It doesn't make exceptions for rape, incest or fetal abnormalities, and it also doesn't make an exception for when the pregnant person's risk of death would come from a "claim or diagnosis" that they'll be hurt or might die in the future. (This could be interpreted to mean a doctor can't provide an abortion if a woman threatens to die by suicide because she has depression.) All abortions are currently banned in Texas after the state's Supreme Court ruled that a law from the 1920s could stand.

Legal battles within some states will continue to shape post-Roe America, with the landscape changing by the day. And lawsuits like the one in Texas clarify the country's stance on whether state law preempts federal rule on abortion or reproductive health care. Basically, can federal regulations trump state law? 

"There's going to be cases that are going to have to determine this question," I. Glenn Cohen, a professor and bioethicist at Harvard Law School, said. 

The argument over medication abortion access -- which is banned or restricted in many states but still available to people if they order it (not without risk) online -- will likely also be one of the first big court cases post-Roe, Cohen said. Questions of whether federal regulations on medication abortion conflict directly enough with state restrictions will continue to be center stage.

Boxes of mifepristone and a bottle of misoprostol tablets sit on a table

Medication abortion, for use in early pregnancy, accounts for more than half of abortions in the US. Restricting the pills is the new frontier of abortion bans.

Robyn Beck/Getty Images

Other federal guidance issued by the Biden administration includes a reminder to pharmacists that they are required to fill medication and birth control prescriptions for patients. Failing to do so is discrimination based on pregnancy status. This was in response to the many reports of women having treatment delayed or prescriptions denied while health care workers try to  navigate around new state laws.

Here's what we know today.

Can states ban abortion pills? Not completely, but some are trying. 

Any state with a current total ban on abortion -- including Texas, Oklahoma, South Dakota, Alabama, Arkansas, Mississippi, Missouri and Wisconsin -- also bans medication abortion. Heavy restrictions in other states, including Tennessee and South Carolina, which ban abortion after about six weeks, also extend to medication abortion. This means providers can't prescribe the medication in those states and patients can't fill prescriptions at pharmacies.  

"If a state law bans abortion broadly, that includes medication abortions," Elisabeth Smith, director of state policy and advocacy at the Center for Reproductive Rights, told MedPage Today.

But abortion bans and state laws seek to punish abortion providers or people who assist them, not the person seeking the abortion (there's reason to believe this might change in the future). For now, people living in the most restrictive states can still order pills from an overseas pharmacy, including Aid Access. However, the pills could take awhile to arrive and potentially put the person past the point of pregnancy for which the medication is safe and effective (about 10 weeks).

Pill packet on a yellow envelope marked
Peter Dazeley/Getty Images

The fate of medication abortion pills in Republican-leaning states centers on mifepristone, the first pill given in the two-dose regimen of medication abortion. Because the US Food and Drug Administration approved mifepristone as a safe and effective way to end a pregnancy over 20 years ago, states shouldn't be able to restrict it, the US attorney general's office argued the same day Roe was overturned. (Misoprostol, the second pill, is used off-label for abortion and miscarriage treatment. It's also used to treat health conditions such as stomach ulcers.) 

Whether this federal regulation (and the FDA's stamp of approval) supersedes state laws will need to be decided. Cohen said this is likely to be determined by the Supreme Court as "one of the first post-Dobbs cases."

"It's unclear whether that's going to be a winner of an argument, to be perfectly honest," Cohen said.

Last year, the FDA extended a pandemic-era rule that allowed patients to get medication abortion pills through the mail, instead of requiring them to be prescribed in person. This was seen as a victory for the American College of Obstetricians and Gynecologists and other medical groups, which viewed the in-person requirement as unnecessary for a medication that's safe and effective in early pregnancy.   

But states have their own requirements for medication abortion, and providers licensed in Montana can't prescribe pills to patients who travel over from a restrictive state like South Dakota, NPR reported.

Read more: Worries About Post-Roe Data Privacy Put Spotlight on Period Apps  

A woman holds her abdomen in pain

Ectopic pregnancies can't result in a delivery and require medical treatment. Symptoms can start with typical pregnancy signs, including a missed period, but can progress to abdominal or pelvic pain, vaginal bleeding, weakness and more. 

Svetlana Gustova/Getty Images

Can states ban treatment for high risk pregnancies? The HHS says no, but doctors say state laws are restricting care.  

Even though the most restrictive states banning abortions leave room for some degree of medical emergency, practicing physicians need to decide where the medical emergency line is – and risk prosecution if a state sees it differently. 

This month, the story of a 10-year-old girl who was raped and pregnant and who traveled to Indiana from Ohio, where abortion is banned around six weeks without exception for rape or incest, made headlines. Not only was the physician publicly questioned by Indiana's attorney general on whether she followed state law, but Ohio Attorney General Dave Yost said in the aftermath that the girl should've been able to legally get an abortion under the state law's medical emergency exemption. Ohio's OB-GYNs disagreed. 

"It states specifically 'medically diagnosed condition,' and as far as I can tell, adolescent pregnancy is not a medically diagnosed condition that's listed," Dr. Jason Sayat, a Columbus OB-GYN, told the Ohio Capital Journal. 

The Department of Health and Human Services reminded physicians and hospitals that if they want to keep their Medicare agreement and avoid "civil penalties," they must treat pregnant patients and provide abortions if necessary as required under the 1986 Emergency Medical Treatment and Labor Act. The EMTLA, now blocked in Texas, outlines certain life-endangering pregnancies that doctors must treat regardless of state law, including ectopic pregnancies, preeclampsia and complications of pregnancy loss.

But that narrow line of abortion exceptions for medical emergencies given by states like Wisconsin is what's troubling Dr. Jennifer McIntosh, a maternal-fetal medicine physician practicing in the state. While Wisconsin's attorney general said he wouldn't enforce a ban, physicians there stopped performing abortions because the state has a pre-Roe criminal statute that prohibits most abortions. The "save the life of the mother" abortion exception language in that law can leave out health conditions which may not be an immediate emergency but can become one down the line. 

"Some of what we do is to prevent emergencies from happening," McIntosh said. "To have to wait for an emergency to actually appear puts your patient's life at risk."

The treatment for an ectopic pregnancy is termination, because terminating the pregnancy is the only safe outcome when an embryo grows outside of the uterus, typically in a fallopian tube. Without treatment, the fallopian tube is likely to rupture, which can lead to internal bleeding and death. But some laws, like one in Texas, specifically restrict medications including methotrexate, which has led to access problems for people who are pregnant as well as people who are taking methotrexate for another health reason. 

Complicating confusion and risk over how abortion bans will affect treatments for ectopic pregnancies is the fact that more rare types of ectopic pregnancies exist, including ones where the pregnancy is growing inside a C-section scar or other area outside the safety of the main cavity of the uterus -- but still technically in the uterus. These rarer kinds of ectopic pregnancies are also life-threatening, and may be more difficult to diagnose and treat as such in a state that bans abortions with an emphasis on the pregnancy being in the uterus.

Activists on both sides of the abortion issue protest outside the US Supreme Court in 2020
Saul Loeb/AFP/Getty Images

States are not prosecuting people who have abortions (yet)

Current state laws -- both those in effect and those in limbo in court -- prosecute other people involved in an abortion, not the person who's pregnant. 

But the health impact may be already felt when a doctor is hesitant to treat patients, or pharmacists are reluctant to fill a prescription for mifepristone before interviewing a woman to ascertain whether her pregnancy is already ended and her situation is in line with state law.

"Even in these straightforward cases of basic OB/GYN practice, the laws leave providers questioning and afraid," Dr. Carley Zeal, an OB-GYN in Wisconsin, told The New York Times. "These laws are already hurting my patients."

Aside from hesitancy among health care providers, physicians also fear that worries people have about being prosecuted for having an abortion or miscarriage will stop patients experiencing complications from any kind of pregnancy loss from seeking care. 

That's because it was already happening, before Roe was overturned. According to the National Advocates for Pregnant Women, there were over 1,700 arrests or prosecutions of women from 1973 (when Roe became law) to 2020 where their pregnancies were the focus of the case against them. 

So will doctors report you if they suspect you had an abortion? 

"The vast majority of health care professionals will not do that, because that's not caring for their patients," King said. But, she added, "I'm sure there's a very small, but unfortunately detrimental, minority who might." 

An illustration of a woman's body surrounded by medical equipment

Your current access to birth control shouldn't be impacted by the overturn of Roe v. Wade. However, there's reason to believe that could change in the future.

Carol Yepes/Getty Images

Birth control is still protected under the Affordable Care Act

Right now, IUDs, birth control pills and other birth control methods are legal in all 50 states. And they should also be covered at no out-of-pocket cost for those covered under the Affordable Care Act. The right to birth control is protected under two Supreme Court rulings: Griswold v. Connecticut (1965) and Eisenstadt v. Baird. (Another Supreme Court Case, Burwell v. Hobby Lobby Stores, chipped away a little of that protection, however, finding that some corporations are exempt for religious reasons.) 

Plan B or "morning after pill" brands are also not included in abortion bans, because they will not end an existing pregnancy. Most health plans should also cover them. 

Legislators in Missouri last year voted to block taxpayer funding for IUDs and emergency contraception, casting doubt that all birth control devices will be protected indefinitely, at least in some states. The claims of legislators like Paul Wieland, a Republican state senator in Missouri, are that anything that has the potential to disrupt a fertilized egg's implantation into the uterus is an abortifacient. 

The medical community has been clear that IUDs and emergency contraception do not cause abortions and will not end an existing pregnancy. Copper IUDs work mostly by causing a chemical change in the sperm and egg before they meet, according to the World Health Organization. Hormonal IUDs like Mirena work mostly by thickening cervical mucus so sperm can't reach the egg, and can also prevent ovulation. Plan B and similar pills likely won't work if a person has already ovulated, meaning the chances of it stopping implantation are currently understood to be slim.

Nevertheless, unlikely occurrences or instances where a fertilized egg may be prevented from implanting into a uterus could be called into question in future court cases.

Read more: Could a Post Roe v. Wade World Impact Your Access to Birth Control?   

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.


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What The Future Of Health Looks Like For Apple


What the Future of Health Looks Like for Apple


What the Future of Health Looks Like for Apple

Apple's Health app keeps evolving, with aspirations to be a complete combination personal data archive, medical liaison and insight engine. But the goals, while ambitious, aren't fully realized yet. iOS 16 and WatchOS 9 are adding medication management and multistage sleep tracking to a growing list of features. But what comes next, and will it start to become a tool that interfaces with doctors even more than it has?

Apple just published a multipage health report (PDF), which aims to detail where the company sees its health focus heading on the iPhone and the Apple Watch. The report covers the app, research studies and initiatives with medical organizations.

As Google prepares to release a Pixel Watch that will connect to Fitbit's features and services, Apple looks to be strengthening its position by expanding beyond the watch to a larger spectrum of health services. Already, Apple Health and Fitness Plus are evolving into services you don't need an Apple Watch to use.

When will Health start to become an extension of how I connect with my own doctors? Will sleep tracking offer a doorway to other health insights? And why doesn't Apple have its own equivalent of the "readiness score" used by Fitbit and Oura?

Apple's vice president of health, Dr. Sumbul Desai, spoke with CNET about the goals of Apple Health and where goals are being set next. She sees the blend of lifestyle with clinical data, medication data and an increasing number of metrics in one place as helping future insights in other health measurements over time. 

"You have to do it in a really thoughtful and meaningful way," Desai said. "Because there are also correlations you can make that are incorrect. That's where the work is, making sure that when you make those connections that they are correct, grounded in the science and make sense to the user."

Apple's Medication tracker on the iPhone and Apple Watch.

Medication tracking on iOS 16 looks like another step to bring medical histories onto Health.

Apple

Where does Apple Health meet your doctor?

As I've found over the last few months, over several surgeries and doctor visits, my own medical care doesn't often connect with my wearable and phone apps. Apple's been aiming to make strides to connect Apple Health with medical providers, but the framework isn't fully there yet for digital health platforms. A lot of Apple's promised benefits are in identifying long-term data patterns and insights.

"I do think how they interact with each other is really important," said Desai, who points to the new tracking of atrial fibrillation patterns over time in Watch OS 9. "We are actually taking how much time you're in AFib and correlating it to your lifestyle. How much you're sleeping. How much you're moving, you'll see the changes in AFib. If you're using Mindful Minutes, do you see a change."

Apple has tried making data sharing easier with doctors, but right now it still doesn't go far enough. At the medical group where I'm a patient, for instance, there's no obvious way to share the data I'm collecting in Apple Health through the patient portal.

Sleep tracking on the iPhone and Apple Watch

Sleep tracking is gaining sleep stages in WatchOS 9. Will that bring a wave of other health insights down the road?

Apple

Sleep as the next frontier?

Apple's addition of sleep stage-based sleep tracking in the upcoming Watch OS 9 looks to close the gap on other fitness trackers like those from Fitbit, Samsung and Oura. Apple's been pulling new features for the Apple Watch from work in some of the company's ongoing heart research studies, and sleep could end up being a place that evolves next.

"What I'm really excited to learn from a scientific standpoint is, does the amount of sleep that you're getting in certain stages, like core [replenishing sleep], does that actually translate to benefit during the day when you're moving?" Desai said. "Are there certain phenotypes of certain people who have more benefit versus others? There's so much to tackle from a research standpoint there. We would never put anything out until we knew we kind of had some scientific grounding. The whole causation-correlation thing can get very tricky."

Desai suggested future research combining sleep stage data with Apple's ongoing heart and move data from its ongoing study will possibly provide more insights, "but we're still a ways away from that."

Could Apple ever develop its own readiness score?

One thing Apple's evolving and elaborate set of Health insights currently doesn't have is any sort of attempt at a distilled score, or personal health rating. Fitbit, Oura, and a number of other wearables have daily personal scores derived from a variety of individual metrics. I asked Desai whether Apple might pursue a similar idea anytime soon. While it sounds like a direction Apple Health could head in, it also seems like Apple is still trying to lock down the best path to get there.

"It's a really good question. I think the answer is, to be honest, is we don't have a firm POV yet," Desai said. "We want to understand the science behind that, and what can we understand and glean from a scientific standpoint."

Desai suggests that the health measurements, and their meanings, can vary. "HRV [heart rate variability] is a great metric. I'm super fascinated by HRV. But HRV can be changed based on multiple reasons." She suggested that Apple's eventual evolution of its insights will need to come with clear guidance, too.

"I think for us, we want to be able to provide actionable information. So to understand to do that, you actually have to be able to draw it back to, what we think is actually causing that? We are really trying to understand the science behind all of these different metrics and focus on how we provide insights that we know we can back up."

On whether Apple Health could come to other non-Apple devices

Apple's aiming for Health to be a comprehensive, secure system for anyone to use, but it still flows through Apple hardware, which means a portion of the population will always be left out. I asked Desai whether Apple Health might ever be available beyond iPhones.

"We're always looking at ways to support the ecosystem. We just want to make sure we can support that in a private and secure way. That's fundamentally what drives our decision making," Desai said. "We have a ton of things in the App Store ecosystem that are super interesting that people are doing, and we're very supportive of supporting that work.

"Honestly, we make a lot of decisions driven by privacy. And there's a lot of things we choose not to do and choose to do, based upon that."

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.


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What The Future Of Health Looks Like For Apple


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What the Future of Health Looks Like for Apple


What the Future of Health Looks Like for Apple

Apple's Health app keeps evolving, with aspirations to be a complete combination personal data archive, medical liaison and insight engine. But the goals, while ambitious, aren't fully realized yet. iOS 16 and WatchOS 9 are adding medication management and multistage sleep tracking to a growing list of features. But what comes next, and will it start to become a tool that interfaces with doctors even more than it has?

Apple just published a multipage health report (PDF), which aims to detail where the company sees its health focus heading on the iPhone and the Apple Watch. The report covers the app, research studies and initiatives with medical organizations.

As Google prepares to release a Pixel Watch that will connect to Fitbit's features and services, Apple looks to be strengthening its position by expanding beyond the watch to a larger spectrum of health services. Already, Apple Health and Fitness Plus are evolving into services you don't need an Apple Watch to use.

When will Health start to become an extension of how I connect with my own doctors? Will sleep tracking offer a doorway to other health insights? And why doesn't Apple have its own equivalent of the "readiness score" used by Fitbit and Oura?

Apple's vice president of health, Dr. Sumbul Desai, spoke with CNET about the goals of Apple Health and where goals are being set next. She sees the blend of lifestyle with clinical data, medication data and an increasing number of metrics in one place as helping future insights in other health measurements over time. 

"You have to do it in a really thoughtful and meaningful way," Desai said. "Because there are also correlations you can make that are incorrect. That's where the work is, making sure that when you make those connections that they are correct, grounded in the science and make sense to the user."

Apple's Medication tracker on the iPhone and Apple Watch.

Medication tracking on iOS 16 looks like another step to bring medical histories onto Health.

Apple

Where does Apple Health meet your doctor?

As I've found over the last few months, over several surgeries and doctor visits, my own medical care doesn't often connect with my wearable and phone apps. Apple's been aiming to make strides to connect Apple Health with medical providers, but the framework isn't fully there yet for digital health platforms. A lot of Apple's promised benefits are in identifying long-term data patterns and insights.

"I do think how they interact with each other is really important," said Desai, who points to the new tracking of atrial fibrillation patterns over time in Watch OS 9. "We are actually taking how much time you're in AFib and correlating it to your lifestyle. How much you're sleeping. How much you're moving, you'll see the changes in AFib. If you're using Mindful Minutes, do you see a change."

Apple has tried making data sharing easier with doctors, but right now it still doesn't go far enough. At the medical group where I'm a patient, for instance, there's no obvious way to share the data I'm collecting in Apple Health through the patient portal.

Sleep tracking on the iPhone and Apple Watch

Sleep tracking is gaining sleep stages in WatchOS 9. Will that bring a wave of other health insights down the road?

Apple

Sleep as the next frontier?

Apple's addition of sleep stage-based sleep tracking in the upcoming Watch OS 9 looks to close the gap on other fitness trackers like those from Fitbit, Samsung and Oura. Apple's been pulling new features for the Apple Watch from work in some of the company's ongoing heart research studies, and sleep could end up being a place that evolves next.

"What I'm really excited to learn from a scientific standpoint is, does the amount of sleep that you're getting in certain stages, like core [replenishing sleep], does that actually translate to benefit during the day when you're moving?" Desai said. "Are there certain phenotypes of certain people who have more benefit versus others? There's so much to tackle from a research standpoint there. We would never put anything out until we knew we kind of had some scientific grounding. The whole causation-correlation thing can get very tricky."

Desai suggested future research combining sleep stage data with Apple's ongoing heart and move data from its ongoing study will possibly provide more insights, "but we're still a ways away from that."

Could Apple ever develop its own readiness score?

One thing Apple's evolving and elaborate set of Health insights currently doesn't have is any sort of attempt at a distilled score, or personal health rating. Fitbit, Oura, and a number of other wearables have daily personal scores derived from a variety of individual metrics. I asked Desai whether Apple might pursue a similar idea anytime soon. While it sounds like a direction Apple Health could head in, it also seems like Apple is still trying to lock down the best path to get there.

"It's a really good question. I think the answer is, to be honest, is we don't have a firm POV yet," Desai said. "We want to understand the science behind that, and what can we understand and glean from a scientific standpoint."

Desai suggests that the health measurements, and their meanings, can vary. "HRV [heart rate variability] is a great metric. I'm super fascinated by HRV. But HRV can be changed based on multiple reasons." She suggested that Apple's eventual evolution of its insights will need to come with clear guidance, too.

"I think for us, we want to be able to provide actionable information. So to understand to do that, you actually have to be able to draw it back to, what we think is actually causing that? We are really trying to understand the science behind all of these different metrics and focus on how we provide insights that we know we can back up."

On whether Apple Health could come to other non-Apple devices

Apple's aiming for Health to be a comprehensive, secure system for anyone to use, but it still flows through Apple hardware, which means a portion of the population will always be left out. I asked Desai whether Apple Health might ever be available beyond iPhones.

"We're always looking at ways to support the ecosystem. We just want to make sure we can support that in a private and secure way. That's fundamentally what drives our decision making," Desai said. "We have a ton of things in the App Store ecosystem that are super interesting that people are doing, and we're very supportive of supporting that work.

"Honestly, we make a lot of decisions driven by privacy. And there's a lot of things we choose not to do and choose to do, based upon that."

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.


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Why Your Blood Type Matters When It Comes To Heart Health


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Why Your Blood Type Matters When It Comes to Heart Health


Why Your Blood Type Matters When It Comes to Heart Health

What if we told you that your blood type could potentially tip the scale when it comes to how healthy your heart is?

You wouldn't see it on the surface, but coursing through your veins every second of every day are tiny variations that categorize your blood into one of these groups: A+, A-, B+, B-, O+, O-, AB+ and AB-. Unless you've donated blood, were given a transfusion or found out during pregnancy, maybe you've never thought twice about your blood type and what it means for your health.

Knowing your blood type not only can be crucial in an emergency, but it can also offer some important insight into your health. Ongoing research into blood type suggests it may matter more than we give it credit for -- at least when assessing risk for certain health conditions, especially heart disease. These invisible differences in the blood may give some people an edge at staving off cardiovascular problems, and may leave others more susceptible.

What does blood type mean, and how are they different?

The letters A, B and O represent various forms of the ABO gene, which program our blood cells differently to form the different blood groups. If you have type AB blood, for example, your body is programmed to produce A and B antigens on red blood cells. A person with type O blood doesn't produce any antigens.  

Blood is said to be "positive" or "negative" based on whether there are proteins on the red blood cells. If your blood has proteins, you're Rhesus, or Rh, positive. 

Photo illustration of a doctor sitting in front of a large blood droplet with the blood types surrounding it

The ABO system is the best known way of classifying blood types.

Ekachai Lohacamonchai/EyeEm/Getty Images

People with type O- blood are considered "universal donors" because their blood doesn't have any antigens or proteins, meaning anybody's body will be able to accept it in an emergency.

But why are there different blood types? Researchers don't fully know, but factors such as where someone's ancestors are from and past infections which spurred protective mutations in the blood may have contributed to the diversity, according to Dr. Douglas Guggenheim, a hematologist with Penn Medicine. People with type O blood may get sicker with cholera, for example, while people with type A or B blood may be more likely to experience blood clotting issues. While our blood can't keep up with the different biological or viral threats going around in real time, it may reflect what's happened in the past.

"In short, it's almost like the body has evolved around its environment in order to protect it as best as possible," Guggenheim said.

Monitors used during cardiac surgery

People with type O blood may have a lower risk of cardiovascular events.

Arctic-Images/Getty Images

The blood types most at risk for heart disease 

People with type A, type B or type AB blood are more likely than people with type O to have a heart attack or experience heart failure, according to the American Heart Association. 

While the increased risk is small (types A or B had a combined 8% higher risk of heart attack and 10% increased risk of heart failure, according to one large study) the difference in blood clotting rates is much higher, per the AHA. People in the same study with type A and B blood were 51% more likely to develop deep vein thrombosis and 47% more likely to develop a pulmonary embolism, which are severe blood clotting disorders which can also increase the risk of heart failure.

A reason for this increased risk, according to Guggenheim, might have to do with inflammation that happens in the bodies of people with type A, type B or type AB blood. The proteins present in type A and type B blood may cause more "blockage" or "thickening" in the veins and arteries, leading to an increased risk of clotting and heart disease. 

Guggenheim also thinks this may describe the anecdotal (but currently inconclusive) decrease in risk of severe COVID-19 disease in people with type O blood, which has inspired research. Severe COVID-19 disease often causes heart problems, blood clotting and other cardiovascular issues.

Blood bag for transfusions

There are four main blood groups (types of blood): A, B, AB and O. 

Peter Dazeley/Getty Images

Other consequences of blood type

People with type O blood enjoy a slightly lower risk of heart disease and blood clotting, but they may be more susceptible to hemorrhaging or bleeding disorders. This may be especially true after childbirth, according to a study on postpartum blood loss, which found an increased risk in women with type O blood.

People with type O blood may also fare worse after a traumatic injury due to increased blood loss, according to a study published in Critical Care.

Other research has found people with type AB blood might be at an increased risk for cognitive impairment when compared to people with type O. Cognitive impairment includes things like trouble remembering, focusing or making decisions. 

Should I change my lifestyle based on my blood type? 

While research available now shows that blood type can tip the scale in terms of someone's risk of developing heart disease, big factors such as diet, exercise or even the level of pollution you're exposed to in your community are the major players in determining heart health. 

Guggenheim says that for patients trying to keep their heart healthy, there's no special recommendation that he'd make other than a good heart-healthy diet that lowers inflammation, regardless of someone's blood type. 

healthy foods arranged in the shape of a cartoon heart

Lean proteins, healthy fats, fruits, vegetables and whole grains are all part of a heart-healthy diet.

Lina Darjan/500px/Getty Images

But, he notes, future research could offer more definitive ways doctors treat patients based on their blood type. All factors considered equally, a patient with healthy cholesterol levels and type A blood may benefit from taking aspirin each day whereas it might not be necessary for a person in the same boat with type O blood. 

"A well-balanced, heart-healthy diet in general is going to be what any physician is going to recommend, and I would say that ABO doesn't change that," Guggenheim said. 

"I don't think there's a protective benefit from just having type O blood that contributes to being scot-free," he added.

More for your wellness

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.


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Buying An IPhone 11 In 2022 Might Make Sense For You


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Buying an iPhone 11 in 2022 Might Make Sense for You


Buying an iPhone 11 in 2022 Might Make Sense for You

Since the debut of the iPhone 11 in 2019, we've since seen the debut of the iPhone 13 and iPhone 12. And in a few days, we're likely to see the debut of the iPhone 14 at Apple's next event on Sept. 7. The iPhone 11 may be over two years old, but it might still be a good choice, especially since Apple discounted it to $499 last year. While we recommend that you wait for the next Apple event before buying any iPhone at all, especially since prices for current iPhone models will likely decrease afterward, the iPhone 11 does have a lot to like as a phone that's under $500.

For instance, do you mind using an iPhone that feels a bit dated? Or do you think saving several hundred dollars is more important than carrying the latest phone? What about 5G -- how important is that to you? If you're shopping on a budget, the iPhone 11 is still a great choice. Although you'll be missing out on some newer features, the iPhone 11 gives you all the basics you'd want from an iPhone, including battery life that's on par with the iPhone 12, a great dual-lens camera that includes night mode and a processor that's still fast enough for everyday tasks. 

Read more: Here's how the iPhone 11 compares to the iPhone 12 and how the iPhone 13 compares to the iPhone 12.

But if you have some wiggle room in your budget, here are some questions to ask yourself. (For the purposes of this article, I'm going to assume that you are currently using an iPhone.) And if you're still mulling over your decision after that, here's how the iPhone 13 compares to the last five years of iPhones as well as our list of the best iPhones. Plus, check out all the differences between the iPhone 11, 11 Pro and 11 Pro Max.

5G connectivity: iPhone 11 doesn't have 5G. But do you really need it right now?

One of the iPhone 11's biggest missing features compared to the iPhone 13 and iPhone 12 is 5G connectivity. The iPhone 11 is an LTE-only device, and if you don't care for the next-gen wireless tech just yet (service is patchy in the US after all), then the iPhone 11 should suit you just fine. Remember that 5G debuted on the iPhone 12 lineup and getting access to faster bands of 5G depends on where you live, so going for the iPhone 12 makes your purchase more future-proof

iphone-11-iphone-12-pro-max-product-promo-hoyle-2021
Angela Lang/CNET

Display quality: You won't get a 120Hz refresh rate on an iPhone 11 (or iPhone 12)

The iPhone 11 uses a crisp LCD screen that refreshes at 60 frames per second, or 60Hz. Apple traded up in the iPhone 12, equipping it with an OLED screen, though it kept the display at 60Hz just like most phones. OLEDs are typically more vibrant than their LCD counterparts, with richer contrast and inkier blacks. If you watch a lot of videos on your iPhone and want a superior viewing experience, an OLED screen might make more sense for you. The iPhone 13 also boasts an OLED panel too, though Apple bumped up the refresh rate for the Pro models to 120Hz. The faster refresh rate will translate to smoother, snappier scrolling through apps and websites. 

apple-wallet-license-ios-15

Apple's Wallet app will be able to store driver's licenses in iOS 15. 

Screenshot by CNET

Software support: How long will the iPhone 11 get iOS software updates? 

Apple's latest operating system, iOS 15, is supported on many older iPhones, and the oldest is the 2015 iPhone 6S (Here's how to download the new OS, but you may want to wait.) Based on that and some quick mental math, we can deduce that Apple plans to provide iPhone support for up to six years from launch. As a result, with the iPhone 11, unveiled in 2019, you can rest comfortably knowing that you can expect updates through 2025. 

Read more: iOS 15's biggest new features: FaceTime, Apple Wallet and Notifications get new tricks

Durability and water resistance: How durable do you want your iPhone to be?

If you do opt for the iPhone 11, you will miss out on a few durability features that are available on the newer iPhone models. One of the iPhone 12's big improvements is the material of its display. Apple calls it "ceramic shield" glass. Made by Corning, the ceramic shield glass covering the phone's display is apparently harder than most metals. Indeed, we can confirm that the iPhone 12's ceramic shield is tough. Our iPhone 12 drop tests show it protected the hardware from drops as high as 9 feet. (CNET's iPhone 12 Mini drop tests yielded similar results.) The iPhone 13 also has the same ceramic shield glass on its display.

So if you're a big klutz and are prone to slips and drops, springing for the iPhone 13 or iPhone 12 is a wise move (or just get a really nice iPhone case). Keep in mind, the iPhone 11 isn't a delicate darling, either. It also survived CNET's drop and water tests and earned a CNET Editors' Choice Award. You can read our iPhone 11 review for more details. 

Read more: Farewell iPhone case: The case for the caseless phone

Price and budget: How much do you want to spend on an iPhone?

As I said earlier, Apple is selling the nearly two-year-old iPhone 11 for $300 less now than when it first launched, making it a great choice for those shopping on a budget. But, as also mentioned previously, the iPhone 11 could become even cheaper once Apple debuts its 2022 line of iPhone models. Also of note, the current iPhone 12 and 12 Mini might come down in price and hit that $499 level, as typically Apple lowers the price of existing iPhone models once the newest model goes on sale.

It's also worth considering carrier deals from Verizon, T-Mobile and AT&T, all of which may subsidize the price of an iPhone in exchange for committing to a cellular service plan. Last year the three companies offered hundreds of dollars off with those contracts, and possibly pay off the phone entirely with a device trade-in. Just keep in mind that there are plenty of caveats to those deals, like commitments ranging from 24 to 36 months.

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Apple's getting ready for a Sept. 7 event , which is very likely to be the moment we learn about the company's next iPhone line. 

The newest version, expected to be called the iPhone 14, is rumored to include an always-on display similar to what's on the Apple Watch now, allowing for constant glanceable information without ruining battery life.

Apple hasn't really said what it plans to announce at its event, only sending out a cryptic invitation to the press, with an Apple logo seemingly set in a night sky, suggesting potential camera improvements or last year's rumored satellite emergency calling. The image looks like something we might see from the James Webb Space Telescope, whose stunning photos have already begun changing how we view the cosmos since first being released earlier this summer. In its announcement, Apple included the teaser words "Far out." 

Read more: Apple Makes 'Far Out' iPhone Launch Event Official For Sept. 7

The iPhone 14 launch will also mark the 15th year since the original iPhone's debut, in June of 2007. Back then, the device wasn't the sure hit it is today. Many tech industry watchers were enthusiastic about Apple's prospects of course, but it hadn't proven it can build reliable phone technology before then. It was also up against massive competitors such as Microsoft, Palm and Research in Motion, whose Blackberry devices ruled the business world at the time. Within a decade though, Apple -- as well as Google's popular Android software -- had bested all three companies.

While the iPhone will be a key product we see at Apple's event this year, and likely what most people focus their attention on, the company's expected to hold other events later this year with other devices to show off. Those include new Mac computers with upgraded chips and new iPads.

Read moreEverything We Know So Far About the iPhone 14

When is the Apple event?

Apple's online-only event will be Sept. 7 at 10 a.m. PT, which is 1 p.m. ET, 6 p.m. BST and 3 a.m. AEST. (Sorry, Australia.) Here's a handy time zone converter to help find what time it'll be where you are.

Where can I watch Apple's livestream?

You'll be able to stream Apple's event straight from the company's website. Meanwhile, we'll be reporting on the event live here at CNET.

What can we expect, besides the iPhone 14 launch?

Apple's digital events are fast paced and slickly produced. And even though Apple's now trying its hand at in-person events again as coronavirus pandemic-era health concerns slowly recede, the company still seems to be applying what it's learned about how to make its events more compelling. During its last event, the Worldwide Developers Conference (WWDC) in June, Apple held a livestream but then offered in-person demos for the press afterward


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