There is a strong connection between money and health, even when adjusted for sociodemographic variables, as reported in Lancet Digital Health. From a mental health perspective, a toxic cycle exists whereby worrying about money can worsen mental health and mental health problems can make managing money harder.
For example, Citizens Advice Bureau in the UK found that 60% of their service users had received a mental health diagnosis within the past 6 months, with debt advisors reporting that 56% of users showed negative mental states that impaired their financial judgments.
Furthermore, 59% of surveyed people experiencing poor mental health took out credit at a vulnerable time when they wouldn’t have otherwise done so. From a social and economic policy perspective, central bank interest rate decisions might also impact health, as evidence suggests that with each percentage point increase in interest rates there could be approximately 20,000 additional cases of psychiatric-morbidity in the UK, as measured using the General Health Questionnaire (GHQ-12).
From a data science perspective, there is a dearth of evidence-based research investigating the relationship between finance and health. For example, the science search engine, PubMed, identified 95,772 citations for ‘suicide’ but only 72 citations when combined with ‘debt’. Similar disparities exist for other health terms combined with money-related terms, for example, ‘cancer’ (4,126,850) versus ‘cancer and debt’ (104).
Where are we now? The serendipitous intersection of health and financial sector priorities
We are at a point in time where financial services providers are transitioning away from product-led propositions toward customer needs-based propositions. Some Fintechs are leveraging technological advances to offer differentiated services and build features (with customer focus groups) that may have potential benefits to customer health (e.g., enabling self-blocking of gambling transactions).
New technologies have enabled Fintechs to rapidly gather data to build highly granular financial footprints. Concurrently, the rise of digital healthcare may allow researchers to evaluate electronic health records at scale to advance investigations of health-related issues.
These two digital ‘revolutions’ represent a timely opportunity to further innovate and responsibly combine methods of scientific investigation with real-world real-time mechanisms by which to intervene. Given this serendipitous intersection of health and financial sector priorities, the critical question is how one actually carries out research and acts on generated insights?
Mapping the future landscape for ‘FinHealthTech’ innovation
Given the demands for services that intersect financial health and well-being, and that people are increasingly operationalizing their digital footprints, co-evolution of healthcare practices and financial technology makes sense as a way forward to benefit the consumer.
Innovation bridged across finance, health and technology (i.e., ‘FinHealthTech’) could inform new practice/operating models, while fostering environments that value and prioritize health, financial stability and individual privacy.
FinHealthTech innovation could open up new concepts of integrated ‘health and wealth hubs’ targeting multiple issues simultaneously in order to break the cycle between health problems and financial difficulties. It could allow for deeper insights into personal circumstances, new operating models, funding sources that incentivise long-term growth and value creation for individuals and societies.
How can we build interactive and interpersonal experiences into FinHealthTech?
The impact of financial burdens can reach far beyond an individual. For example, care givers can be confronted with costs following a loved one’s diagnosis and financial stress is a major reason for relationship breakdowns with ramifications for children.
Fintech has started to explore interpersonal financial support systems. For example, SupportPay is helping to make child support easier by promoting transparent banking between divorced/separated parents. SalaryFinance is helping employees access their pay as it is earned and reduce the burden of expensive debt for affordable loans.
These support systems may (indirectly) promote wellbeing/prevent harm (e.g., reducing parental arguments witnessed by a child).
How can we create new financial systems that can identify potential health concerns, offering safe interventions?
For many people, independent financial advisors are unaffordable, which argues a case for creating chatbots that could offer easily accessible, interactive support to promote positive habits, build self-efficacy, and offer support beyond primary care settings.
Financial AI-assistants already exist (e.g., Cleo, Plum, Kakao), but with the sector still in its infancy capabilities remain limited. Health AI is on a parallel path of development, with chatbots arguably more advanced (e.g. Babylon, Woebot, Wysa).
Any future direction will require careful ethical planning and co-design (e.g., to avoid triggering perceptions of being mocked for spending habits). Given that chatbots require large amounts of labelled data to be accurate and that privacy is a major challenge, future approaches should explore solutions whereby data is hosted and owned by the individual, rather than a company.
The dynamics for community lending are changing. For example, peer-to-peer social banking and lending platforms are emerging and Facebook plans to enable payments through their platform. FinHealthTech social networks could create meaningful niche community-building opportunities through closed patient/banking communities or anonymous public social networks (e.g., resembling one-way cryptographic platforms like FindSisterhood).
With consent, data from existing and purpose-built communities could offer important insights into understanding connections between money and health, which could inform future policy and practices.
Evaluating the effectiveness and acceptability of ‘FinHealthTech’ interventions
The use of monetary incentives schemes to modify health behaviours is controversial and divides public opinion. Randomised controlled trials are already examining the potential benefits of such schemes (e.g., psychiatric medication adherence; breastfeeding support) and while preliminary findings are encouraging, they are by no means conclusive (e.g., require further testing for individual suitability), are time-consuming and costly.
Prior to testing, procedures must be in place to address potential health harms, stigmatisation, discrimination, inappropriateness of objectives (e.g., dwell time, click-through rates), and data misuse (e.g., abusing insights to target individuals for commercial ends through product sales, increasing insurance premiums).
Creating privacy preserving technologies to inform practice in clinical settings
Aligning FinHealthTech with emerging technologies, such as blockchain and other privacy preserving technologies (e.g. differential privacy, homomorphic encryption, zero-knowledge proofs etc.), presents an opportunity to reinvent models for personal data ownership.
Sovrin is just one example of tools utilizing methods that allow individuals to regain full control over their data and make choices on how and with whom they share it. Blockchain technology is starting to be used to meet social goals (e.g., Alice), which is likely to inspire future directions for FinHealthTech.
We expect that privacy will be one of the key challenges to any potential knowledge transfer from FinTech to clinical practice. Notably, the financial sector is already deploying artificial intelligence/machine-learning-based platforms to detect deviations in patterns of financial data to identify risk and investigate transactions (e.g., MindBridge Analytics). Assuming consent is obtained, these financial summaries could be shared with patients and practitioners to help them reflect more holistically on the individual’s circumstances, enhance offerings of support, and inform treatment choices.
Call for action & FinHealthTech Consortium
In July 2019, colleagues and I raised a call to action published in Lancet Digital Health for financial technology providers, healthcare professionals and research scientists to work together to better understand how financial data could help healthcare professionals improve care, and how linkage to information about mental and physical health could create more holistic financial support systems.
The FinHealthTech Consortium (FHTC) was then launched in December 2019 and brings together a community of people from across finance, health, technology, experts by experience, policy, and data science in order to explore innovative convergences across finance, health and technology, which always with the user’s needs, preferences and best interests at heart. The FHTC aims to promote visibility of work being done in this space, to act as a hub of resources and information & to facilitate partnerships that can help us build an evidence-base and improve standards.
COVID-19 Digital Mental Health Data Insights Group & Digital Innovation in Mental Health Summer Conference
An international team that included over 50 digital services providers have started to track the scale and nature of the global mental health crisis online. This includes providers from the financial sector. Our ‘snapshot’ study produced data insights from a user base possibly upwards of 50 million people. We will expand and follow-up our work in the months and year to come and will be seeking to include even more data insights from more financial services providers. Our next data insights follow-up will coincide with the Digital Innovation in Mental Health conference taking place virtually 5-6th August 2020. Please contact [email protected] for more details.
About the author
Dr. Becky Inkster is a neuroscientist, seeking innovative ways to improve our understanding and treatment of mental health in the digital age. She applies measured optimism when working across artificial intelligence-enhanced mental healthcare, neuroscience, ethics and governance, as well as digital-, clinical-, and music-based interventions, social media, and public engagement. Dr. Inkster is interested in developing safe and effective digital mental health support using nuanced approaches that consider neuroscience, culture, music & financial health. She provides cross-sectorial guidance and leadership on mental health innovation to numerous institutions and companies that span academia, technology, human rights, mental healthcare, and government.