4S Toronto: Knowing Frail and At-Risk Bodies

Nicola will be presenting at the Society for Social Studies of Science (4S) 50th Anniversary Conference in Toronto as part of the panel session 'Data & the Body (3: Aging, Longevity, and Optimization). Full title and abstract:

Knowing frail and at-risk bodies: data work between clinical reasoning, patient experience, and service provision

‘Ageing well’ is a priority in Scottish public policy and service delivery that aims to support older citizens to continue living in their own homes (rather than care homes) and to take pressure off GP surgeries and hospitals by proactively tailoring support to mitigate declining health and risks to wellbeing. The possibilities of digital and data-driven health and care in relation to this imperative are being explored in a number of national and local innovation projects seeking to streamline health and care via new data practices oriented towards knowing and assessing the body. 

This paper draws from an ethnographic investigation of one of these projects: the development and validation of an online self-assessment tool for frailty and risk of falling. It traces attempts to render knowledge of older citizens' bodies into data in order to categorise, codify, stratify, and make commensurable the outcomes of self-assessment with standardised clinical assessments. These processes of datafication are troubled both by the tacit expertise employed by physiotherapists in clinical practice and by the nuances of citizens’ lived experience and their interactions with the digital tool. The disjunctures between the categories of frailty and risk, and the bodies that are considered frail or at-risk, open up questions about the limits of knowing the body through data and imposing identities via data. This paper shows that these categories and identities are contested on statistical, pragmatic, and affective grounds, and co-evolve with the design of the tool.