program areas Digital Health
Program Areas
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General Comment submission Children’s rights in relation to the digital environment • Professor Amandine Garde, Law & Non-Communicable Research Unit, School of Law and Social Justice, University of Liverpool • Dr Mimi Tatlow-Golden, Senior Lecturer, Developmental Psychology and Childhood, The Open University • Dr Emma Boyland, Senior Lecturer, Psychology, University of Liverpool • Professor Emerita Kathryn C. Montgomery, School of Communication, American University; Senior Strategist, Center for Digital Democracy • Jeff Chester, Center for Digital Democracy • Josh Golin, Campaign for a Commercial Free Childhood • Kaja Lund-Iversen and Ailo Krogh Ravna, Norwegian Consumer Council • Pedro Hartung and Marina Reina, Alana Institute • Dr Marine Friant-Perrot, University of Nantes • Professor Emerita Wenche Barth Eide, University of Oslo; Coordinator, FoHRC • Professor Liv Elin Torheim, Oslo Metropolitan University • Professor Alberto Alemanno, HEC Paris Business School and The Good Lobby • Marianne Hammer, Norwegian Cancer Society • Nikolai Pushkarev, European Public Health Alliance 13 November 2020 Dear Members of the Committee on the Rights of the Child, We very much welcome the Committee’s Draft General Comment No25 on children’s rights in relation to the digital environment (the Draft) and are grateful for the opportunity to comment. We are a group of leading scholars and NGO experts on youth, digital media, child rights and public health who work to raise awareness and promote regulation of marketing (particularly of harmful goods, services and brands) to which children are exposed. We argue this infringes many of the rights enshrined in the UN Convention on the Rights of the Child (CRC) and other international instruments and should be strictly regulated. Based on our collective expertise, we call on the Committee to recognise more explicitly the fundamentally transformed nature of marketing in new digital environments, the harms stemming therefrom, and the corresponding need to protect children from targeting and exposure. Without such recognition, children will not be able to fully enjoy the many opportunities for learning, civic participation, creativity and communication that the digital environment offers for their development and fulfilment of their rights. Facilitating children’s participation in this environment should not come at the price of violations of any children's rights. Before making specific comments, we wish to highlight our support for much of this Draft. In particular, we strongly support the provisions in the following paragraphs of the General Comment: 11, 13, 14, 52, 54, 62, 63, 64, 67, 72, 74, 75, 88, 112, and 119. We also note concerns regarding provisions that will require mandatory age verification: e.g., paragraphs 56, 70, 120, 122. We call on the Committee to consider provisions that this be applied proportionately, as this will certainly have the effect of increasing the processing of children’s personal data - which should not happen to the detriment of the best interests of the child. The rest of this contribution, following the structure of the Draft, proposes specific additions / modifications (underlined, in italics), with brief explanations (in boxes). Numbers refer to original paragraphs in the Draft; XX indicates a new proposed paragraph. Hoping these comments are useful to finalise the General Comment, we remain at your disposal for further information. Yours faithfully, Amandine Garde and Mimi Tatlow-Golden On behalf of those listed above [See full comments in attached document]
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Reports
Does Buying Groceries Online Put SNAP Participants At Risk?
How to Protect Health, Privacy, and Equity
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Press Release
USDA Online Buying Program for SNAP Participants Threatens Their Privacy and Can Exacerbate Racial and Health Inequities, Says New Report
Digital Rights, Civil Rights and Public Health Groups Call for Reforms from USDA, Amazon, Walmart, Safeway/Albertson’s and Other Grocery Retailers - Need for Safeguards Urgent During Covid-19 Crisis
Contact: Jeff Chester jeff@democraticmedia.org (link sends e-mail) 202-494-7100 Katharina Kopp kkopp@democraticmedia.org (link sends e-mail) https://www.democraticmedia.org/ USDA Online Buying Program for SNAP Participants Threatens Their Privacy and Can Exacerbate Racial and Health Inequities, Says New Report Digital Rights, Civil Rights and Public Health Groups Call for Reforms from USDA, Amazon, Walmart, Safeway/Albertson’s and Other Grocery Retailers Need for Safeguards Urgent During Covid-19 Crisis Washington, DC, July 16, 2020—A pilot program designed to enable the tens of millions of Americans who participate in the USDA’s Supplemental Nutrition Assistance Program (SNAP) to buy groceries online is exposing them to a loss of their privacy through “increased data collection and surveillance,” as well as risks involving “intrusive and manipulative online marketing techniques,” according to a report from the Center for Digital Democracy (CDD). The report reveals how online grocers and retailers use an orchestrated array of digital techniques—including granular data profiling, predictive analytics, geolocation tracking, personalized online coupons, AI and machine learning —to promote unhealthy products, trigger impulsive purchases, and increase overall spending at check-out. While these practices affect all consumers engaged in online shopping, the report explains, “they pose greater threats to individuals and families already facing hardship.” E-commerce data practices “are likely to have a disproportionate impact on SNAP participants, which include low-income communities, communities of color, the disabled, and families living in rural areas. The increased reliance on these services for daily food and other household purchases could expose these consumers to extensive data collection, as well as unfair and predatory techniques, exacerbating existing disparities in racial and health equity.” The report was funded by the Robert Wood Johnson Foundation, as part of a collaboration among four civil rights, digital rights, and health organizations: Color of Change, UnidosUS, Center for Digital Democracy, and Berkeley Media Studies Group. The groups issued a letter today to Secretary of Agriculture Sonny Perdue, urging the USDA to take immediate action to strengthen online protections for SNAP participants. USDA launched (link is external) its e-commerce pilot last year in a handful of states, with an initial set of eight retailers approved for participation: Amazon, Dash’s Market, FreshDirect, Hy-Vee, Safeway, ShopRite, Walmart and Wright’s Market. The program has rapidly expanded (link is external) to a majority of states, in part as a result of the current Covid-19 health crisis, in order to enable SNAP participants to shop more safely from home by following “shelter-in-place” rules. Through an analysis of the digital marketing and grocery ecommerce practices of the eight companies, as well as an assessment of their privacy policies, CDD found that SNAP participants and other online shoppers confront an often manipulative and nontransparent online grocery marketplace, which is structured to leverage the tremendous amounts of data gathered on consumers via their mobile devices, loyalty cards, and shopping transactions. E-commerce grocers deliberately foreground the brands and products that partner with them (which include some of the most heavily advertised, processed foods and beverages), making them highly visible on store home pages and on “digital shelves,” as well as through online coupons and well-placed reminders at the point of sale. Grocers working with the SNAP pilot have developed an arsenal of “adtech” (advertising technology) techniques, including those that use machine learning and behavioral science to foster “frictionless shopping” and impulsive purchasing of specific foods and beverages. The AI and Big Data operations documented in the report may also lead to unfair and discriminatory data practices, such as targeting low-income communities and people of color with aggressive promotions for unhealthy food. Data collected and profiles created during online shopping may be applied in other contexts as well, leading to increased exposure to additional forms of predatory marketing, or to denial of opportunities in housing, education, employment, and financial services. “The SNAP program is one of our nation’s greatest success stories because it puts food on the table of hungry families and money in the communities where they live,” explained Dr. Lori Dorfman, Director of the Berkeley Media Studies Group. “Shopping for groceries should not put these families in danger of being hounded by marketers intent on selling products that harm health. Especially in the time of coronavirus when everyone has to stay home to keep themselves and their communities safe, the USDA should put digital safeguards in place so SNAP recipients can grocery shop without being manipulated by unfair marketing practices.” CDD’s research also found that the USDA relied on the flawed and misleading privacy policies of the participating companies, which fail to provide sufficient data protections. According to the pilot’s requirement for participating retailers, privacy policies should clearly explain how a consumer’s data is gathered and used, and provide “optimal” protections. A review of these long, densely worded documents, however, reveals the failure of the companies to identify the extent and impact of their actual data operations, or the risks to consumers. The pilot’s requirements also do not adequately limit the use of SNAP participant’s data for marketing. In addition, CDD tested the companies’ data practices for tracking customers’ behavior online, and compared them to the USDA’s requirements. The research found widespread use of so-called “third party” tracking software (such as “cookies”), which can expose an individual’s personal data to others. “In the absence of strong baseline privacy and ecommerce regulations in the US, the USDA’s weak safeguards are placing SNAP recipients at substantial risk,” explained Dr. Katharina Kopp, one of the report’s authors. “The kinds of e-commerce and Big Data practices we have identified through our research could pose even greater threats to communities of color, including increased commercial surveillance and further discrimination.” “Being on SNAP, or any other assistance program, should not give corporations free rein to use intrusive and manipulative online marketing techniques on Black communities,” said Jade Magnus Ogunnaike, Senior Campaign Director at Color of Change. “Especially in the era of COVID, where online grocery shopping is a necessity, Black people should not be further exposed to a corporate surveillance system with unfair and predatory practices that exacerbate disparities in racial and health equity just because they use SNAP. The USDA should act aggressively to protect SNAP users from unfair, predatory, and discriminatory data practices.” “The SNAP program helps millions of Latinos keep food on the table when times are tough and our nation’s public health and economic crises have highlighted that critical role,” said Steven Lopez, Director of Health Policy at UnidosUS. “Providing enhanced access to healthy and nutritious foods at the expense of the privacy and health of communities of color is too high of a price. Predatory marketing practices have been linked to increased health disparities for communities of color. The USDA must not ignore that fact and should take strong and meaningful steps to treat all participants fairly, without discriminatory practices based on the color of their skin.” The report calls on the USDA to “take an aggressive role in developing meaningful and effective safeguards” before moving the SNAP online purchasing system beyond its initial trial. The agency needs to ensure that contemporary e-commerce, retail and digital marketing applications treat SNAP participants fairly, with strong privacy protections and safeguards against manipulative and discriminatory practices. The USDA should work with SNAP participants, civil rights, consumer and privacy groups, as well as retailers like Amazon and Walmart, to restructure its program to ensure the safety and well-being of the millions of people enrolled in the program. ### -
Press Release
Groups Say White House Must Show Efficacy, Protect Privacy, and Ensure Equity When Deploying Technology to Fight Virus
Fifteen leading consumer, privacy, civil and digital rights organizations called on the federal government to set guidelines to protect individuals’ privacy, ensure equity in the treatment of individuals and communities, and communicate clearly about public health objectives in responding to the COVID-19 pandemic. There must be consensus among all relevant stakeholders on the most efficacious solution before relying on a technological fix to respond to the pandemic.
FOR IMMEDIATE RELEASE Contacts: Susan Grant (link sends e-mail), CFA, 202-939-1003 May 5, 2020 Katharina Kopp (link sends e-mail), CDD, 202-836 4621 White House Must Act To protect privacy and ensure equity in responding to COVID-19 pandemic Groups Tell Pence to Set Standards to Guide Government and Public-Private Partnership Data Practices and Technology Use Washington, D.C. – Today, 15 leading consumer, privacy, civil and digital rights organizations called on the federal government (link is external) to set guidelines to protect individuals’ privacy, ensure equity in the treatment of individuals and communities, and communicate clearly about public health objectives in responding to the COVID-19 pandemic. In a letter to Vice President Michael R. Pence, who leads the Coronavirus Task Force, the groups said that the proper use of technology and data have the potential to provide important public health benefits, but must incorporate privacy and security, as well as safeguards against discrimination and violations of civil and other rights. Developing a process to assess how effective technology and other tools will be to achieve the desired public health objectives is also vitally important, the groups said. The letter (link is external) was signed by the Campaign for a Commercial Free Childhood, Center for Democracy & Technology, Center for Digital Democracy, Constitutional Alliance, Consumer Action, Consumer Federation of America, Electronic Privacy Information Center (EPIC), Media Alliance, MediaJustice, Oakland Privacy, Parent Coalition for Student Privacy, Privacy Rights Clearinghouse, Public Citizen, Public Knowledge, and Rights x Tech. “A headlong rush into technological solutions without carefully considering how well they work and whether they could undermine fundamental American values such as privacy, equity, and fairness would be a mistake,” said Susan Grant, Director of Consumer Protection and Privacy at the Consumer Federation of America. “Fostering public trust and confidence in the programs that are implemented to combat COVID-19 is crucial to their overall success.” “Measures to contain the deadly spread of COVID-19 must be effective and protect those most exposed. History has taught us that the deployment of technologies is often driven by forces that tend to risk privacy, undermine fairness and equity, and place our civil rights in peril. The White House Task Force must work with privacy, consumer and civil rights groups, and other experts, to ensure that the efforts to limit the spread of the virus truly protect our interests,” said Katharina Kopp, Director of Policy, Center for Digital Democracy. In addition to concerns about government plans that are being developed to address the pandemic, such as using technology for contact tracing, the groups noted the need to ensure that private-sector partnerships incorporate comprehensive privacy and security standards. The letter outlines 11 principles that should form the basis for standards that government agencies and the private sector can follow: Set science-based, public health objectives to address the pandemic. Then design the programs and consider what tools, including technology, might be most efficacious and helpful to meet those objectives. Assess how technology and other tools meet key criteria. This should be done before deployment when possible and consistent with public health demands, and on an ongoing basis. Questions should include: Can they be shown to be effective for their intended purposes? Can they be used without infringing on privacy? Can they be used without unfairly disadvantaging individuals or communities? Are there other alternatives that would help meet the objectives well without potentially negative consequences? Use of technologies and tools that are ineffective or raise privacy or other societal concerns should be discontinued promptly. Protect against bias and address inequities in technology access. In many cases, communities already disproportionately impacted by COVID-19 may lack access to technology, or not be fairly represented in data sets. Any use of digital tools must ensure that nobody is left behind. Set clear guidelines for how technology and other tools will be used. These should be aimed at ensuring that they will serve the public health objective while safeguarding privacy and other societal values. Public and private partners should be required to adhere to those guidelines, and the guidelines should be readily available to the public. Ensure that programs such as technology-assisted contact tracing are voluntary. Individual participation should be based on informed, affirmative consent, not coercion. Only collect individuals’ personal information needed for the public health objective. No other personal information should be collected in testing, contact tracing, and public information portals. Do not use or share individuals’ personal information for any other purposes. It is important to avoid “mission creep” and to prevent use for purposes unrelated to the pandemic such as for advertising, law enforcement, or for reputation management in non-public health settings. Secure individuals’ personal information from unauthorized access and use. Information collected from testing, contact tracing and information portals may be very revealing, even if it is not “health” information, and security breaches would severely damage public trust. Retain individuals’ personal information only for as long as it is needed. When it is no longer required for the public health objective, the information should be safely disposed of. Be transparent about data collection and use. Before their personal information is collected, individuals should be informed about what data is needed, the specific purposes for which the data will be used, and what rights they have over what’s been collected about them. Provide accountability. There must be systems in place to ensure that these principles are followed and to hold responsible parties accountable. In addition, individuals should have clear means to ask questions, make complaints, and seek recourse in connection with the handling of their personal information. The groups asked Vice President Pence for a meeting to discuss their concerns and suggested that the Coronavirus Task Force immediately create an interdisciplinary advisory committee comprised of experts from public health, data security, privacy, social science, and civil society to help develop effective standards. The Consumer Federation of America (link is external) is a nonprofit association of more than 250 consumer groups that was founded in 1968 to advance the consumer interest through research, advocacy, and education. The Center for Digital Democracy (CDD) is recognized as one of the leading NGOs organizations promoting privacy and consumer protection, fairness and data justice in the digital age. Since its founding in 2001 (and prior to that through its predecessor organization, the Center for Media Education), CDD has been at the forefront of research, public education, and advocacy. -
Google’s (i.e., Alphabet, Inc.) proposed acquisition of Fitbit, a leading health wearable device company, is just one more piece illustrating how the company is actively engaged in shaping the future of public health. It has assembled a sweeping array of assets in the health field, positioning its advertising system to better take advantage of health information, and is playing a proactive role lobbying to promote significant public policy changes for medical data at the federal level that will have major implications (link is external)for Americans and their health.Google understands that there are tremendous revenues to be made gathering data—from patients, hospitals, medical professionals and consumers interested in “wellness”—through the various services that the company offers. It sees a lucrative future as a powerful presence in our health system able to bill Medicare and other government programs. In reviewing the proposed takeover, regulators should recognize that given today’s “connected” economy, and with Google’s capability and intention to generate monetizeable insights from individuals across product categories (health, shopping, financial services, etc.), the deal should not be examined solely within a narrow framework. While the acquisition directly bolsters Google’s growing clout in what is called the “connected-health” marketplace, the company understands that the move is also designed to maintain its dominance in search, video and other digital marketing applications. It’s also a deal that raises privacy concerns, questions about the future direction of the U.S. health system, and what kinds of safeguards—if any at all—will be in place to protect health consumers and patients. As health venture capital fund Rock Health explained in a recent report, “Google acquired Fitbit in a deal that gives the tech giant access to troves of personal health data and healthcare partnerships, in addition to health tracking software.” Fitbit reports that “28 million active users” worldwide use its wearable device products. For Google, Fitbit brings (link is external) a rich layer of personal data, expertise in fitness (link is external) tracking software, heart-rate sensors, as well as relationships with health-service and employee-benefit providers. Wearable devices can provide a stream (link is external)of ongoing data on our activities, physical condition, geolocation and more. In a presentation to investors made in 2018, Fitbit claimed to be the “number one health and fitness” app in the U.S. for both the Android and Apple app store, and considered itself the “number one “wearable brand globally,” available in 47,000 stores, and had “direct applications for health and wellness categories such as diabetes, heart health, and sleep apnea.” “Driving behavior change” is cited as one of the company’s fundamental capabilities, such as its “use of data…to provide insights and guidance.” Fitbit developed a “platform for innovative data collection” for clinical researchers, designed to help advance (link is external) “the use of wearable devices in research and clinical applications. Fitbit also has relationships with pharmacies, including those that serves people with “complex health conditions.” Fitbit has also “made a number of moves to expand its Health Services division,” such as its 2018 acquisition of Twine Health, a “chronic disease management platform.” In 2018, it also unveiled a “connected health platform that enables payers and health systems to deliver personalized coaching” to individuals. The company’s Fitbit Health Solutions division is working with more than 100 insurance companies in the U.S., and “both government sponsored and private plans” work with the company. Fitbit Premium was launched last year, which “mines consumer data to provide personalized health insights” for health care delivery. According to Business Insider Intelligence, “Fitbit plans to use the Premium service to get into the management of costly chronic conditions like diabetes, sleep apnea, and hypertension.” The company has dozens of leading “enterprises” and “Fortune 500” companies as customers. It also works with thousands of app developers and other third parties (think Google’s dominance in the app marketplace, such as its Play store). Fitbit has conducted research to understand “the relationship between activity and mood” of people, which offers an array of insights that has applications for health and numerous other “vertical” markets. Even prior to the formal takeover of Fitbit by Google, it had developed strong ties to the digital data marketing giant. It has been a Google Cloud client since 2018, using its machine learning prowess to insert Fitbit data into a person’s electronic health record (EHR). In 2018, Fitbit said that it was going to transfer its “data infrastructure” to the Google Cloud platform. It planned to “leverage Google’s healthcare API” to generate “more meaningful insights” on consumers, and “collaborate on the future of wearables.” Fitbit’s data might also assist Google in forging additional “ties with researchers who want to unlock the constant stream of data” its devices collect. When considering how regulators and others should view this—yet again—significant expansion by Google in the digital marketplace—the following issues must be addressed: Google Cloud and its use of artificial intelligence and machine learning in a new data pipeline for health services, including marketing Google’s Cloud service offers “solutions” (link is external) for the healthcare and life sciences industry, by helping to “personalize patient experiences,” “drive data interoperability,” and improve commercialization and operations”—including for “pharma insights and analytics.” Google Cloud (link is external) has developed a specific “API” (application programming interface) that enables health-related companies to process and analyze their data, by using machine learning technologies, for example. The Health Care Cloud API (link is external)also provides a range of other data functionalities (link is external) for clinical and other uses. Google is now working to help create a “new data infrastructure layer via 3 key efforts,” according to a recent report on the market. It is creating “new data pipes for health giants,” pushing the Google Cloud and building “Google’s own healthcare datasets for third parties.” (See, for example, “G Suite (link is external) for Healthcare Businesses” products as well as its “Apigee API Platform,” which works with the Cleveland Clinic, Walgreens, and others). Illustrating the direct connection between the Google Cloud and Google’s digital marketing apparatus is their case study (link is external) of the leading global ad conglomerate, WPP. “Our strong partnership with Google Cloud is key,” said WPP’s CEO, who explained that “their vast experience in advertising and marketing combined with their strength in analytics and AI helps us to deliver powerful and innovative solutions for our clients” (which include (link is external) “369 of the Fortune Global 500, all 30 of the Dow Jones 30 and 71 of the NASDAQ 100”). WPP links the insights and other resources it generates from the Google Cloud to Google’s “Marketing Platform” (link is external) so its clients can “deliver better experiences for their audiences across media and marketing.” Google has made a significant push (link is external) to incorporate the role that machine learning plays with marketing across product categories, including search and YouTube. It is using machine learning to “anticipate needs” of individuals to further its advertising (link is external) business. Fitbit will bring in a significant amount of additional data for Google to leverage in its Cloud services, which impact a number of consumer and commercial markets beyond (link is external) health care. The Fitbit deal also involves Google’s ambitions to become an important force providing healthcare providers access to patient, diagnostic and other information. Currently the market is dominated by others, but Google has plans for this market. For example, it has developed a “potential EHR tool that would empower doctors with the same kind of intuitive and snappy search functionality they've come to expect from Google.” According to Business Insider Intelligence, Google could bundle such applications along with Google Cloud and data analytics support that would help hospitals more easily navigate the move to data heavy (link is external), value-based care (VBC) reimbursement models (link is external).” Google Health already incorporates a wide range of health-related services and investments “Google is already a health company,” according (link is external) to Dr. David Feinberg, the company’s vice president at Google Health. Feinberg explains that they are making strides in organizing and making health data more useful thanks to work being done by Cloud (link is external) and AI (link is external) teams. And looking across the rest of Google’s portfolio of helpful products, we’re already addressing aspects of people’s health. Search helps people answer everyday health questions (link is external), Maps helps get people to the nearest hospital, and other tools and products are addressing issues tangential to health—for instance, literacy (link is external), safer driving (link is external), and air pollution (link is external)…. and in response, Google and Alphabet have invested in efforts that complement their strengths and put users, patients, and care providers first. Look no further than the promising AI research and mobile applications coming from Google and DeepMind Health (link is external), or Verily’s Project Baseline (link is external) that is pushing the boundaries of what we think we know about human health. Among Google Health’s initiatives are “studying the use of artificial intelligence to assist in diagnosing (link is external) cancer, predicting (link is external) patient outcomes, preventing (link is external) blindness…, exploring ways to improve patient care, including tools that are already being used by clinicians…, [and] partnering with doctors, nurses, and other healthcare professionals to help improve the care patients receive.” Through its AI work, Google is developing “deep learning” applications for electronic health records. Google Health is expanding its team, including specifically to take advantage of the wearables market (and has also hired a former FDA commissioner to “lead health strategy”). Google is the leading source of search information on health issues, and health-related ad applications are integrated into its core marketing apparatus A billion health-related questions are asked every day on Google’s search engine, some 70,000 every minute (“around 7 percent of Google’s daily searches”). “Dr. Google,” as the company has been called, is asked about conditions, medication, symptoms, insurance questions and more, say company leaders. Google’s ad teams in the U.S. promote how health marketers can effectively use its ad products, including YouTube, as well as understand how to take advantage of what Google has called “the path to purchase.” In a presentation on “The Role of Digital Marketing in the Healthcare Industry,” Google representatives reported that After conducting various studies and surveys, Google has concluded that consumers consult 12.4 resources prior to a hospital visit. When consumers are battling a specific disease or condition, they want to know everything about it: whether it is contagious, how it started, the side-effects, experiences of others who have had the same condition, etc. When doing this research, they will consult YouTube videos, read patient reviews of specific doctors, read blog articles on healthcare websites, read reviews, side-effects, and uses of particular medicines. They want to know everything! When consuming this information, they will choose the business that has established their online presence, has positive reviews, and provides a great customer experience, both online and offline. Among the data shared with marketers was information that “88% of patients use search to find a treatment center,” “60% of patients use a mobile device,” “60% of patients like to compare and validate information from doctors with their own online research,” “56% of patients search for health-related concerns on YouTube,” “5+ videos are watched when researching hospitals or treatment centers,” and that “2 billion health-related videos are on YouTube.” The “Internet is a Patient/Caregiver’s #1 confidant,” they noted. They also discussed how mobile technologies have triggered “non-linear paths to purchase,” and that mobile devices are “now the main device used for health searches.” “Search and video are vital to the patient journey,” and “healthcare videos represent one of the largest, fastest growing content segments on YouTube today.” Their presentation demonstrated how health marketers can take advantage of Google’s ability to know a person’s location, as well as how other information related to their behaviors and interests can help them “target the right users in the right context.” To understand the impact of all of Google’s marketing capabilities, one also should review the company’s restructured (and ever-evolving) “Marketing Platform.” Google’s Map Product will be able to leverage Fitbit data Google is using data related to health that are gathered by Google Maps, such as when we do searches for needed care services (think ERs, hospitals, pharmacies, etc.). “The most popular mapping app in the U.S…. presents a massive opportunity to connect its huge user base with healthcare services,” explain Business Insider Intelligence. Google has laid the groundwork with its project addressing the country’s opioid epidemic, linking “Google Maps users with recovery treatment centers,” as well as identifying where Naloxone (the reversal drug for opioid overdoes) is available. Last year, Google Maps launched a partnership with CVS “to help consumers more easily find places to drop off expired drugs.” Through its Waze subsidiary, which provides navigation information for drivers, Google sells ads to urgent care centers, which find new patients as a result of map-based, locally tailored advertisements. Google’s impact on the wearable marketplace, including health, wellness and other apps The acquisition of Fitbit will bolster Google’s position in the wearables market, as well as its direct and indirect role providing access to its own and third-party apps. Google Fit, which “enables Android users to pair health-tracking devices with their phone to monitor activity,” already has partnerships with a number of wearable device companies, such as Nike, Adidas and Noom. Business Intelligencer noted in January 2020 that Google Fit was “created to ensure Android devices have a platform to house user-generated health data (making it more competitive with Apple products). In 2019, Google acquired the smartwatch technology from Fossil. Fitbit will play a role in Google’s plans for its Fit service, such as providing additional data that can be accessed via third parties and made available to medical providers through patients’ electronic health records. The transaction, said one analyst, “is partly a data play,” and also one intended to keep customers from migrating from its Android platform to Apple’s. It is designed, they suggest, to ensure that Google can benefit from the sales of health-related services during the peak earning years of consumers. The Google Play app store offers access to an array of health and wellness apps that will be impacted by this deal. Antitrust authorities in the EU have already sanctioned Google for the way it has leveraged its Android platform for anti-competitive behavior. Google’s health related investments, including its use of artificial intelligence, and the role of Fitbit data Verily is “where Alphabet is doing the bulk of its healthcare work,” according to a recent report on the role AI plays in Google’s plans to “reinvent the $3 Trillion U.S. healthcare industry.” Verily is “focused on using data to improve healthcare via analytics tools, interventions, research” and other activities, partnering with “existing healthcare institutions to find areas to apply AI.” One of these projects is the “Study Watch, a wearable device that captures biometric data.” Verily has also made significant investments globally as it seeks to expand. DeepMind works on AI research, including how it is applicable to healthcare. Notably, DeepMind is working with the UK’s National Health Service. Another subsidiary, Calico, uses AI as part of its focus to address aging and age-related illnesses. Additionally, “GV” (Google Ventures) makes health-related investments. According to the CB Insights report, “Google’s strategy involves an end-to-end approach to healthcare, including: Data generation — This includes digitizing and ingesting data produced by wearables, imaging, and MRIs among other methods. This data stream is critical to AI-driven anomaly detection; Disease detection — Using AI to detect anomalies in a given dataset that might signal the presence of some disease; and Disease/lifestyle management — These tools help people who have been diagnosed with a disease or are at risk of developing one go about their day-to-day lives and/or make positive lifestyle modifications. Google has also acquired companies that directly further its health business capabilities, such as Apigee, Senosis Health and others. Google’s continuous quest to gather more health data, such as “Project Nightingale,” has already raised concerns. There are now also investigations of Google by the Department of Justice and State Attorney’s-General. The Department of Justice, which is currently reviewing the Google/Fitbit deal, should not approve it without first conducting a thorough review of the company’s health-related business operations, including the impact (including for privacy) that Fitbit data will have on the marketplace. This should be made a part of the current ongoing antitrust investigation into Google by both federal and state regulators. Congress should also call on the DoJ, as well as the FTC, to review this proposed acquisition in light of the changes that digital applications are bringing to health services in the U.S. This deal accompanies lobbying from Google and others that is poised to open the floodgates of health data that can be accessed by patients and an array of commercial and other entities. The Department of Health and Human Services has proposed a rule on data “interoperability” that, while ostensibly designed to help empower health services users to have access to their own data, is also a “Trojan Horse” designed to enable app developers and other commercial entities to harvest that data as an important new profit center. “The Trump Administration has made the unfettered sharing of health data a health IT priority,” explained one recent news report. Are regulators really ready to stop further digital consolidation? The diagnosis is still out! For a complete annotated version, please see attached pdf
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Press Release
Popular Dating, Health Apps Violate Privacy
Leading Consumer and Privacy Groups Urge Congress, the FTC, State AGs in California, Texas, Oregon to Investigate
Popular Dating, Health Apps Violate Privacy Leading Consumer and Privacy Groups Urge Congress, the FTC, State AGs in California, Texas, Oregon to Investigate For Immediate Release: Jan. 14, 2020 Contact: David Rosen, drosen@citizen.org (link is external), (202) 588-7742 Angela Bradbery, abradbery@citizen.org (link is external), (202) 588-7741 WASHINGTON, D.C. – Nine consumer groups today asked (link is external) the Federal Trade Commission (FTC), congressional lawmakers and the state attorneys general of California, Texas and Oregon to investigate several popular apps available in the Google Play Store. A report (link is external) released today by the Norwegian Consumer Council (NCC) alleges that the apps are systematically violating users’ privacy. The report found that 10 well-known apps – Grindr, Tinder, OkCupid, Happn, Clue, MyDays, Perfect365, Qibla Finder, My Talking Tom 2 and Wave Keyboard – are sharing information they collect on users with third-party advertisers without users’ knowledge or consent. The European Union’s General Data Protection Regulation forbids sharing information with third parties without users’ knowledge or consent. When it comes to drafting a new federal privacy law, American lawmakers cannot trust input from companies who do not respect user privacy, the groups maintain. Congress should use the findings of the report as a roadmap for a new law that ensures that such flagrant violations of privacy found in the EU are not acceptable in the U.S. The new report alleges that these apps (and likely a great many others) are allowing commercial third parties to collect, use and share sensitive consumer data in a way that is hidden from the user and involves parties that the consumer neither knows about nor would be familiar with. Although consumers can limit some tracking on desktop computers through browser settings and extensions, the same cannot be said for smartphones and tablets. As consumers use their smartphones throughout the day, the devices are recording information about sensitive topics such as our health, behavior, religion, interests and sexuality. “Consumers cannot avoid being tracked by these apps and their advertising partners because they are not provided with the necessary information to make informed choices when launching the apps for the first time. In addition, consumers are unable to make an informed choice because the extent of tracking, data sharing, and the overall complexity of the adtech ecosystem is hidden and incomprehensible to average consumers,” the letters sent to lawmakers and regulators warn. The nine groups are the American Civil Liberties Union of California, Campaign for a Commercial-Free Childhood, the Center for Digital Democracy, Consumer Action, Consumer Federation of America, Consumer Reports, the Electronic Privacy Information Center (EPIC), Public Citizen and U.S. PIRG. In addition to calling for an investigation, the groups are calling for a strong federal digital privacy law that includes a new data protection agency, a private right of action and strong enforcement mechanisms. Below are quotes from groups that signed the letters: “Every day, millions of Americans share their most intimate personal details on these apps, upload personal photos, track their periods and reveal their sexual and religious identities. But these apps and online services spy on people, collect vast amounts of personal data and share it with third parties without people’s knowledge. Industry calls it adtech. We call it surveillance. We need to regulate it now, before it’s too late.” Burcu Kilic, digital rights program director, Public Citizen “The NCC’s report makes clear that any state or federal privacy law must provide sufficient resources for enforcement in order for the law to effectively protect consumers and their privacy. We applaud the NCC’s groundbreaking research on the adtech ecosystem underlying popular apps and urge lawmakers to prioritize enforcement in their privacy proposals.” Katie McInnis, policy counsel, Consumer Reports “U.S. PIRG is not surprised that U.S. firms are not complying with laws giving European consumers and citizens privacy rights. After all, the phalanx of industry lobbyists besieging Washington, D.C., has been very clear that its goal is simply to perpetuate a 24/7/365 surveillance capitalism business model, while denying states the right to protect their citizens better and denying consumers any real rights at all.” Ed Mierzwinski, senior director for consumer programs, U.S. PIRG “This report reveals how the failure of the U.S. to enact effective privacy safeguards has unleashed an out-of-control and unaccountable monster that swallows up personal information in the EU and elsewhere. The long unregulated business practices of digital media companies have shred the rights of people and communities to use the internet without fear of surveillance and manipulation. U.S. policymakers have been given a much-needed wake-up call by Norway that it’s overdue for the enactment of laws that bring meaningful change to the now lawless digital marketplace.” Jeff Chester, executive director, Center for Digital Democracy “For those of us in the U.S., this research by our colleagues at the Norwegian Consumer Council completely debunks the argument that we can protect consumers’ privacy in the 21st century with the old notice-and-opt-out approach, which some companies appear to be clinging to in violation of European law. Business practices have to change, and the first step to accomplish that is to enact strong privacy rights that government and individuals can enforce.” Susan Grant, director of consumer protection and privacy, Consumer Federation of America “The illuminating report by our EU ally the Norwegian Consumer Council highlights just how impossible it is for consumers to have any meaningful control over how apps and advertising technology players track and profile them. That’s why Consumer Action is pressing for comprehensive U.S. federal privacy legislation and subsequent strong enforcement efforts. Enough is enough already! Congress must protect us from ever-encroaching privacy intrusions.” Linda Sherry, director of national priorities, Consumer Action “For families who wonder what they’re trading off for the convenience of apps like these, this report makes the answer clear. These companies are exploiting us – surreptitiously collecting sensitive information and using it to target us with marketing. It’s urgent that Congress pass comprehensive legislation which puts the privacy interests of families ahead of the profits of businesses. Thanks to our friends at the Norwegian Consumer Council for this eye-opening research.” David Monahan, campaign manager, Campaign for a Commercial-Free Childhood “This report highlights the pervasiveness of corporate surveillance and the failures of the FTC notice-and-choice model for privacy protection. Congress should pass comprehensive data protection legislation and establish a U.S. Data Protection Agency to protect consumers from the privacy violations of the adtech industry.” Christine Bannan, consumer protection counsel, EPIC -
In response to a call (link is external) for submissions by the UN Committee on the Right of the Child (link is external) on the topic of children’s rights in relation to the digital environment, CDD joins academics and advocates in submitting comments. The group calls on the Committee to recognize the far-reaching harms caused by digital marketing and the personal data extraction on which it is predicated. Many digital marketing practices infringe many rights enshrined in the UN Convention on the Rights of the Child (link is external). The Committee ought to recognize the need to protect children from these harms so children can fully enjoy the opportunities digital environments offer for their development and fulfilment of their rights.
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Around the world citizens (link is external) and governments (link is external) are putting efforts toward limiting the marketing of unhealthy foods to children in order to address the growing obesity (link is external) epidemic worldwide. In the US, Congress and the Federal Trade Commission rely on weak self-regulatory industry standards, but under Canadian Prime Minister Justin Trudeau, the government of Canada wishes to see restrictions placed on the marketing of food and beverages to children. This was a goal written directly into the Health Minister's mandate letter (link is external) signed by Trudeau in October 2017. As a result, Health Canada, the department of the Canadian government with responsibility for national public health, is considering new regulations that would impose broader restrictions on food advertising that is targeted at those under 17. It could cover everything from TV, online and print advertising to product labelling, in-store displays and even end some sponsorships for sports teams. Health Canada's consultations (link is external) on how it should approach restricting advertising of "unhealthy food and beverages" to kids began in June of 2017 and concluded in early August last year. Although a few contributors opposed any attempt to restrict marketing to children, the summary report (link is external) states that "Overall, the proposed approach and supporting evidence for restricting marketing of unhealthy food and beverages to children were well received." The authors of the report point out that the "issue of age was not an area of inquiry," but most contributors supported the idea of including children between 13 and 17 years of age. Aiming to define "unhealthy foods," the consultation proposed to focus on restricting certain nutrients of concern (sodium, sugars, and saturated fats), and most commentators supported setting the stricter threshold option (of 5% ) for the proposed restrictions, which were based on a percentage of daily values (% DV). Commentators strongly preferred that option over the weaker proposal (15% DV). Using the percentage of daily values to define which foods are "healthy" or "unhealthy" relies on the already existing mandatory food labelling for most relevant foods. In addition to the proposal to restrict certain nutrients of concern, the proposed restrictions to the marketing of non-sugar sweeteners to children was also positively received. For the consultation, Health Canada looked at the Quebec ban (link is external) on advertising to children, which has been in place since 1980, and covers any advertising, not just food-related advertising. In that province, companies cannot market unhealthy food to children under 13 years old. Quebec has the lowest obesity rate (link is external) in Canada among children aged six to 11 and the highest rate of fruit and vegetable consumption. The Stop Marketing to Kids Coalition (link is external) (M2K Coalition), which includes the Heart and Stroke Foundation of Canada, the Childhood Obesity Foundation, the Canadian Cancer Society, Diabetes Canada, Dietitians of Canada, and the Quebec Coalition on Weight-Related Problems, supports the so-called Ottawa Principles (link is external). These evidence-based, expert-informed and collaboratively arrived principles call on governments to restrict the commercial marketing of all food and beverages to children and youth age 16 years and younger. Restrictions would include all forms of marketing with the exception of non-commercial marketing for public education. The M2K Coalition has taken this stance because of the complexities associated with defining healthy versus unhealthy food. The ad industry in Canada has some self-regulatory restrictions in place under the Canadian Children's Food and Beverage Advertising Initiative (link is external). That program, in which many major food companies are participants, sets out nutrition criteria for products that can be advertised in environments where kids under 12 make up 35 percent or more of the audience. The Association of Canadian Advertisers has criticized Health Canada's proposal as "significantly overbroad," calling it an "outright ban on most food and beverage marketing in Canada." The Canadian advertising initiative has tightened its criteria over time and is now monitoring online advertising more closely. 2016 was the first full year in which participating companies that advertise to kids had to ensure their products met new, tighter limits (link is external) on calories, sugar, sodium and saturated and trans fats. However, in 2017, a study (link is external) from the Heart and Stroke Foundation of Canada called into question how effective this effort has been. It looked at the most popular websites visited by children and teens, and found ads for products high in sugar, salt or fat. During the time that the Canadian government began to explore the right approach to restricting the marketing of unhealthy foods to children, Senator Nancy Greene-Raine introduced a private members bill in the Senate in the fall of 2016, seeking to amend the Food and Drugs Act to prohibit the marketing of unhealthy foods and beverages to children (Bill S-228). This would put the activities of Health Canada on a legal basis. The Senator amended the bill to reflect the federal government’s proposed approach on raising the age limit to age 16 and under and kept the focus on “unhealthy” food and beverages. Bill S-228, The Child Health Protection Act (link is external), unanimously passed the Senate in September 2017. Two amendments to the bill were introduced during the first hour of debate in the House of Commons in December 2017, which included a reduction in the age of protection to under 13 (from 17) years, and the introduction of a 5-year post-legislation review period. The rationale for the change in the age amendment was to make the bill more likely to withstand a court challenge, given that the Quebec legislation restricting marketing to children under 13 years withstood a legal challenge in the case of Irwin Toy v Quebec (1989). In this case, the Supreme Court of Canada allowed limits on commercial advertising to children under 13 as constitutionally valid. The Court confirmed that "...advertising directed at young children is per se manipulative." (link is external) And so, while the Court found that the restrictions violated the freedom of expression under the Charter of Rights and Freedoms, a majority of the Court considered this violation to be a justifiable limitation necessary to protect children. For now, the bill is working its way through Parliament. Hopefully, the food industry will not further water down the requirements of the bill. If all goes well, our neighbor to the north will have a law in place by September 2018 that will advance public health and put children's health above the profits of the food industry. --- See attached infographic.
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Press Release
Death of Net Neutrality Will Spur Greater Loss of Digital Privacy, Further Content Consolidation & Control
Statement of Jeff Chester, CDD
The phone and cable lobby will use its new power over the Internet to further erode the privacy rights of Americans. Comcast, AT&T, and Verizon will be entirely free to tap into the data flowing from our mobile devices, PCs, gaming and streaming platforms and set-top boxes. These ISP giants have already built up a formidable (link is external) commercial data gathering and Big Data analytics infrastructure. Now they will expand their gathering of our personal information, inc. financial, health, media use, and also force competitors to share the data they collect. If you want ISPs to give you preferential treatment, content providers will be forced to give up your data, so phone and cable can further expand their ad revenues. Independent and small content companies—including non-commercial and diversely-owned services—will be pressed to consent to terms that favor the digital gatekeepers that control our broadband highway. The FCC’s Net Neutrality decision will trigger a powerful wave of consolidation and deal making that further reduces the range of content and services we should expect in the 21st Century (including for children). We also believe that Google, Facebook and other providers will likely make their peace with the big ISPs, creating a powerful alliance that controls the U.S.’s digital destiny. CDD will be a part of the collaborative work to address this. We urge everyone to also “follow the data” as they examine the digital marketing plans of Verizon, Comcast and AT&T (link is external). There they will find plenty of opportunity to educate the public about our digital future has been placed at great risk.
