A recent report, Building H Index 2024, by Building H, which is part of the Public Health Institute, rated and ranked popular products and services based on how they impact their users’ health, focusing specifically on non-healthcare-related items.

The authors, Steve Downs and Thomas Goetz, co-founders of Building H, identified more than 75 services and products across the transportation, housing, food, and entertainment industries and reviewed their influence on health behaviors related to time spent outdoors, social engagement, sleeping, physical activity, and eating.

A health index to hold companies accountable

Housing leads the way: Culdesac, a car-free apartment community, topped the rankings for providing outdoor spaces, fresh food access, and social engagement, setting a benchmark for health-positive housing developments.

The Building H Index identifies and ranks products and services that can affect human health by influencing behavior. Items that modify diet, physical and outdoor activity, sleep, and social engagement can affect mental and physical health and even increase the risk of chronic diseases, and their influence should be scrutinized.

Each item was given an H-score between 0 and 100; a higher score indicates that the service or product has a more positive influence, with 0 being the worst across all five domains and 50 indicating a neutral influence.

The highest score received by a service or product was 82, while the lowest was 18. Among the top scorers, three were from the housing industry, particularly focused on car-free apartment communities emphasizing social interaction and outdoor spaces. Meanwhile, most of the lowest scorers came from the entertainment sector, with streaming services scoring poorly. Seven of the lowest scorers belonged to the entertainment industry (video streaming); two were food and grocery delivery services.

The authors noticed that many services and products affect multiple behaviors, with almost 60% of the items they assessed influencing all five behaviors. Food delivery services go beyond impacting eating habits as they also affect time outdoors, social interaction, and physical activity.

Concerning news about consumption

Technological advances have focused on making products more widely available and easy to use, but recent innovations appear to make unhealthy items easier to access and more difficult to resist.

The authors discussed the use of autoplay in streaming services, which encourages binge-watching. Hulu was one of the first streaming services to enable users to disable autoplay as early as 2022, and since then, almost all streaming platforms have followed suit, showing that small changes can improve health outcomes. Streaming services can also affect healthy eating, exercise, social contact, and sleep.

AI in social media: Social media platforms are deploying AI to optimize content feeds, which can increase user engagement but also deepen negative impacts on sleep, social interaction, and mental well-being.

Meanwhile, social media platforms deploy techniques like notifications, social rewards, and infinite scrolls, which are designed to encourage users to return and keep them on the platform for long periods.

When ordering products online, users are exposed to cross-selling, which can increase unnecessary and unplanned purchases.

Food and grocery delivery services like Shipt have introduced features such as a “hosting hub” that helps users plan social gatherings, while Blue Apron launched a picnic meal option in 2023 to encourage outdoor activities—both changes responding to previous health-focused recommendations from the Building H Index.

Artificial intelligence is exacerbating these trends, with food delivery services offering autonomous delivery in some areas and social media companies using it to increase engagement. As autonomous vehicles become more common, some researchers believe it will increase automobile use for short trips, with environmental consequences.

Junk entertainment vs. junk food: Streaming services were rated even lower than fast food in the Index, as they negatively impact multiple health behaviors, including sleep, exercise, and social connection.

Another emerging concern is that many of these products are designed to minimize or even eliminate human contact. At the same time, companies may find encounters between people ‘inefficient’ from the perspective of products; they are critical for health and well-being.

For instance, DoorDash has introduced an AI-powered voice service that enables restaurants to handle delivery orders without human staff, limiting social interaction. Buying items from brick-and-mortar stores is now easier than ever without interacting with their employees.

The healthier options

On the bright side, the report found that companies in every industry have found ways to make their products healthier for customers, including chain restaurants focusing on nutritional quality, avoiding drive-through services, and walkable restaurant locations.

While most game publishing companies offer products that keep people indoors and alone, there is one that requires people to be more active outdoors. Niantic Labs, the top scorer in entertainment, developed augmented reality (AR) games like Pokémon GO, which encourage users to engage in physical activity and spend time outdoors. Bicycle-related offerings were among the top-scoring products in transportation, as were micromobility companies that offered social, outdoor, and active modes of transport.

The authors identified housing companies that have focused on developing car-free apartment communities where residents can access fresh food and gather in outdoor social spaces.

More builders and developers are building amenities beneficial for health through bikeable or walkable areas or swimming pools, gyms, outdoor grills, and playgrounds. However, the builders who scored the highest in terms of health also have the most expensive products; the benefits of living in healthier communities will disproportionately be experienced by the wealthy.

Conclusions

The authors note, ‘Our aim with this Index is not simply to scold – we want to challenge all companies to make their products healthier today. Even products that might never be outright “good for you” can still be better.’

The report highlights the many opportunities that each company has to make its offerings healthier through minor modifications. Even services that are not meant to be good for users, such as streaming entertainment, can be improved by allowing users to turn off autoplay, which is now a feature on almost all major platforms following Building H’s previous recommendations.

Bedtime modes on smartphones, gaming platforms, and social media platforms can help users meet their goals for healthier sleep patterns. Meanwhile, the food industry can find ways to prioritize social interaction between customers and staff, seeing it as a chance to build relationships.

Opportunities for companies to improve include respecting consumers’ preferences, limiting their attempts to push extra consumption, and defaulting to healthier options. They can design experiences and environments that make healthier behaviors more accessible by monitoring trends and making relevant information available.

The report also highlights how some companies have already implemented such changes, like Blue Apron’s picnic meal kits and Shipt’s hosting hub, which facilitate social engagement and outdoor activity. Industries can think about meeting users’ broader needs while prioritizing their health.