Smartwatches are ‘less effective at tracking the health of people with dark skin’

Joggers and other fitness fans are increasingly turning to smartwatches to measure their heart rate during exercise and for overall health monitoring. 

But a new study by the University of Alberta in Canada suggests that the trendy gadgets are less effective at tracking the health of people with darker skin tones. 

The study suggests this may be because the signalling process, which uses beams of light to detect heart rate and rhythm, might not work as well on darker skin that contains more melanin, as it absorbs more light.

However, the algorithms that power these devices are often developed by and tested on homogeneous white populations, which may mean the problems are not being identified prior to launch. 

The latest study is based on a systematic review of 10 previously published studies involving more than 460 participants. 

It is the first to pool figures from multiple studies to specifically examine how skin tone may affect the accuracy of heart data in wearables.

‘People need to be aware that there are some limitations for people with darker skin tones when using these devices, and the results should be taken with a grain of salt,’ said study co-leader Doctor Daniel Koerber, resident physician at the University of Alberta in Edmonton, Canada.

‘Algorithms are often developed in homogeneous white populations, which may lead to results that are not as generalisable as we would like.

‘Ongoing research and development of these devices should emphasise the inclusion of populations of all skin tones so that the developed algorithms can best accommodate for variations in innate skin light absorption.’

The research team identified 10 studies, from 622 scientific papers, that reported heart rate and rhythm data for consumer wearable technology according to a participant’s race or skin tone.

Of those studies, four found that heart rate measurements were ‘significantly less accurate’ in darker-skinned people compared with either lighter-skinned individuals or measurements from validated devices, such as chest strap monitors or electrocardiograms.

One study reported that although there was no difference in heart rate accuracy, wearable devices recorded ‘significantly fewer’ data points for people with darker skin.

Dr Koerber explained that most wearables detect heart rate and rhythm by aiming a beam of light at the wrist and then detecting how much light is absorbed.

Greater light absorption indicates a greater volume of blood flowing through the veins under the skin.

He said the study results suggest that the signalling process might not work as well on darker skin that contains more melanin, which absorbs light.

The study results suggest that the signalling process might not work as well in darker skin that contains more melanin, which absorbs light

In addition to the rising use of wearables to monitor physical activity and sleep patterns, interest in the use of consumer wearables for medical research and even early detection of heart problems has increased in recent years.

Dr Koerber said: ‘There are a lot of claims that these devices can detect heart rhythm issues like tachycardia, bradycardia and even atrial fibrillation.

‘We want to be able to inform health care providers about whether these are reliable sources for collecting data in all patients, regardless of skin tone.’

Dr Koerber says the study underscores the importance of ensuring technology meets the needs of diverse populations, especially when it is intended to improve health.

He said recent studies have reported that other devices – such as pulse oximeters used to measure the amount of oxygen in the blood – also don’t perform as well for people with darker skin tones, which can lead to serious health consequences if problems go undetected.

‘It is important to explore alternative options to make sure we can create a more equitable solution in health care and not just in the consumer industry,’ Dr Koerber added.

‘For example, there is some evidence to suggest that certain wavelengths of light, particularly green light, are more accurate in people across all skin tones.’

He is due to present the findings at the American College of Cardiology’s annual conference in Washington DC next month.