by Gordon Hull
News this week of a planned asthma inhaler that connects to the Internet of Things. On the one hand, this seems like a pretty good use of the Internet: as you try out different medicines, they can learn precisely how well those medicines work, and work in genomics might even show that some medicines work better for some people and other medicines work better for others. All the data can all get amalgamated so that you can get an inhaler that works sooner. Some time ago, I suggested in a few posts that there are really two different kinds of biopolitics at work here – a mid-century public-health-oriented variety, which is being eclipsed by an individualizing, neoliberal version. The asthma inhaler shows that how we interpret big data will make a difference in which, a point which I want to make by way of the water crisis in Flint, Michigan (I’m not using the word ‘tragedy’ because ‘tragedy’ implies inevitability, and the problems in Flint were absolutely not inevitable). In Flint, we see the decay, if not active destruction, of a public health infrastructure under the weight of neoliberal policies.
On the public health front, the data from things like this inhaler might produce some important public health discoveries: what if the people of Flint turn out to have been breathing air so toxic that it is associated with a higher incidence of asthma? The answer to that question depends partly on who has access to the data. As Frank Pasquale has argued at length in the context of Pharma, for big data to make a meaningful public health impact, it is going to have to be de-siloed, and publicly accessible. The experience of Flint’s water supply is strong evidence that he is right, because it shows the disaster that neoliberalism can otherwise become as it individualizes and privatizes health information.

