A blog covering the health/care ecosystem and people.

People spend one-half of their lives in “less-than-good health,” we learn early in the paper, Adding years to life and life to years from the McKinsey Health Institute. In this data-rich essay, the McKinsey team at MHI sets out an agenda that could help us add 45 billion extra years of higher-quality life equal to an average of six years per person (depending on your country and population demographics). The first graphic from the report illustrates four dimensions of health and the factors underneath each of them that can bolster or diminish our well-being: personal behaviors (such as sleep and diet),

Without trust, people do not engage with health care providers, health plans, or life science companies….nor do many people accept “science fact.” I explore the sad state of Trust and Health Care. published in the Medecision Liberate Health blog, with a positive and constructive call-to-action for health care industry stakeholders to consider in re-building this basic driver of well-being. That is, trust as a determinant of health. Edelman’s 2022 Trust Barometer came out in January 2022, coinciding as it annually does with the World Economic Forum’s meeting in Davos, Switzerland. Every year, WEF convenes the world’s biggest thinkers to wrestle with the

s in the seventh annual 2022 Brand Relevance Index from Prophet. The research developed a list of 50 companies representing what Prophet characterizes “the brands that people can’t live without in 2022.” For the 7th year in a row, Apple tops the study. Following Apple, the nine companies rounding out the top ten most relevant brands were Peloton, Spotify, Bose, Android, Instant Pot, Pixar, Fitbit, TED, and USAA. There are relative newbies in this list, representing consumers’ collective response to the COVID-19 pandemic and new life-flows. Put Calm and AfterPay in that category, along with Beyond Meat, and Zelle. The

On the Michael Graves Design company’s website, they talk about “Design for All” and “The House and Everything in it.” “Michael Graves Design exists to offer products that create moments of joy in your life.” Prominently featured in the Health section on the homepage are “walking canes reimagined.” The company has unveiled its partnership with CVS Health to continue the architect-turned-disability rights advocate’s legacy combining brilliant design with  mainstream retail accessibility and another riff on accessibility: for health care and caregiving. Graves passed away in 2015. He continues to inspire the Michael Graves Design team/family with the mission: “By focusing

The Future of Wellness in 2022 is, “shifting from a ‘feel-good’ luxury to survivalism as people seek resilience,” based on the Global Wellness Institute’s forecast on this year’s look into self-care and consumer’s spending on health beyond medical care — looking beyond COVID-19. GWI published two research papers this week on The Future of Wellness and The Global Wellness Economy‘s country rankings as of February 2021. I welcomed the opportunity to spend time for a deep dive into the trends and findings with the GWI community yesterday exploring all of the data, listening through my health economics-consumer-technology lens. First, consider

Health care must confront its role in the climate crisis, a JAMA viewpoint asserted on January 31, 2022. Dr. Kenneth Kizer and Dr. Kari Nadeau recommended that, “Instead of contributing to climate change, health care as an enterprise could become a model for environmental sustainability.” This ethos was called out at the recent COP26 UN Climate Conference which resulted in a portfolio of health care initiatives for providers, globally, to address climate change as a macro determinant of health. Consumers — now morphing into health citizens — also can (and should) play starring roles in doing what we can in daily

As physicians deal on the frontlines in Year 3 of the COVID-19 pandemic, they’re stressed, anxious, and angry concludes the Medscape 2022 Physician Burnout & Depression Report. This year, the tagline focuses on stress, anxiety and anger. [Over the past couple of years, the study has used the word “suicide” in the title of the report, FYI]. Those reporting burnout are more likely women physicians than males (56% vs. 41%), work in the ER or critical care departments, and deal with too many bureaucratic tasks like charting and paperwork. For this annual look into the state of U.S. physicians mindsets

The four top trends to watch for this week at CES 2022 are transportation, space tech, sustainable technology, and digital health, based on Steve Koenig’s annual read-out that kicks off this largest annual conference featuring innovations in consumer electronics. Last night, Steve discussed these trends for media attendees, of which I am one (gratefully) participating in #CES2022 virtually from the hygienic comfort and safety of my home health hub (more on that later in this post). All four of these mega-themes impact health and well-being in some way. “Space Tech?” you  might wonder. Yes. My friend Dorit Donoviel can be

I cannot recall a season when so many health consumer studies have been launched into my email inbox. While I have believed consumers’ health engagement has been The New Black for the bulk of my career span, the current Zeitgeist for health care consumerism reflects that futurist mantra: “”We tend to overestimate the effect of a technology in the short run and underestimate the effect in the long run,” coined by Roy Amara, past president of Institute for the Future. That well-used and timely observation is known as Amara’s Law. This feels especially apt right “now” as we enter 2022,

The pandemic has put health care top-of-mind for health citizens the world over. As the public health crisis continues its up-and-downticks around the globe, people are connecting health care to their national economies and politics, based on a global survey from the Pew Research Center, Citizens in Advanced Economies Want Significant Changes to Their Political Systems. For this analysis, the Pew research team assessed the views of some 2,600 health citizens living in 17 developed countries in February 2021. The study report was published in late October 2021. Shown in the first bar chart, the majority of people in at least

While nurses were in short supply before 2020, the coronavirus pandemic and stress on front-line health care workers exacerbated the shortage of nursing staff globally. This urgent call-to-action became the rallying cry and objective for this weekend’s #NurseHack4Health, “The Front Line Is Shrinking,” with the goal of building a sustainable workforce of the future. I’m grateful to the nurse leadership teams at Johnson & Johnson, Microsoft, and Sonsiel for inviting me to participate in another round of the #NurseHack4Health hackathon pitches over the past weekend. This year inspired nearly 800 registrants from at least 48 countries to convene via Microsoft

The most effective, engaging, and enchanting digital health innovations speak to patients beyond their role as health consumers and caregivers: digital health is at its best when it addresses peoples’ health citizenship. I had the great experience brainstorming the convergence of digital health, wearable tech, user-centered (UX) design, and health citizenship with João Bocas, @WearablesExpert, in a on his podcast. And if those topics weren’t enough, I wove in the role of LEGO for our well-being, “playing well,” and inspiring STEM- and science-thinking. João and I started our chat first defining health citizenship, which is a phrase I first learned from

Before the coronavirus emerged, the top causes of death in developed countries were heart disease, cancers, diabetes, and accidents. Then COVID-19 joined the top-10 list of killers in the U.S. and the issue of pandemic preparedness for the next “Disease X” became part of global public health planning. But the biggest health threat to human life is climate change, according to a new report from the World Health Organization titled The Health Argument for Climate Action. It’s WHO’s special report on climate change and health, dedicated to the memory of Ella Kissi-Debrah — a child who died succumbing to impacts

My latest essay for Medecision’s Liberation site digs into the sobering statistics on clinical burnout across the medical professions. From doctors to nurses, physician assistants and other licensed allied health human capital, our health care providers are in a world of hurt. This was initiated with the emergence of the COVID-19 pandemic. But the public health crisis, Delta variant, and lack of universal precautions adopted by U.S. health citizens have exacerbated an already-challenging scenario for individual clinicians and the organizations with whom they work and collaborate. But there’s an even bigger picture, and that’s the risk clinician burnout in its

The COVID-19 pandemic exacerbated food insecurity in the U.S., a situation that was already challenging for millions of American families before the public health crisis emerged. While several Congressional and administrative actions were implemented in 2020 and the first half of 2021, the issue of food insecurity — defined as being unable to acquire enough food due to insufficient money or resources — remains a tragic aspect of daily living for many Americans — and especially for children who live in households where jobs have been lost and incomes reduced. Nutrition security has also been a health risk where people

“Racial and ethnic inequities in the US health care system have been unremitting since the beginning of the country. In the 19th and 20th centuries, segregated black hospitals were emblematic of separate but unequal health care,” begins the editorial introducing an entire issue of JAMA dedicated to racial and ethnic disparities and inequities in medicine and health care, published August 17, 2021. This is not your typical edition of the Journal of the American Medical Association. The coronavirus pandemic has changed so many aspects of American health care for so many people, including doctors. Since the second quarter of 2020,

“We don’t un-learn,” Dr. Amy Abernethy asserted as she shared her pandemic perspectives on a panel with 2 other former U.S. health policy and regulatory leaders. The three spoke about navigating compliance (think: regulations and reimbursement) in an uncertain world. An uncertain world is our workplace in the health/care ecosystem, globally, in this moment. So to give us some comfort in our collective foxhole, my last post for this week of immersion in #HIMSS21 is based on the keynote speech of Michael Dowling, CEO of Northwell Health. Dowling keynoted on the theme of “Leading for the Future,” sharing his lessons

The COVID-19 pandemic sparked a reappraisal of value-based care, a shift to remote and virtual care, and acceleration of healthcare stakeholders’ investments in Artificial Intelligence-based solutions, Philips discovered in the 2021 Future Health Index, the company’s latest survey conducted among 2,800 health care leaders working in 14 countries. This week at the 2021 annual HIMSS conference, Philips is “making the case for moving to the cloud,” discussing the Philips HealthSuite, a cloud-based platform for connecting providers and patients, devices (and the data they generate), and care across the health care continuum. That’s a big promise and vision, so to kick

The U.S. Olympic team will be competing in Tokyo for first-place medals across many athletic events, each nation’s most physically-fit citizens going for gold. When it comes to the U.S. ranking on the world roster of population health outcomes, American ranks low on many key metrics, especially given that the U.S. does rank #1 in one key stat: healthcare spending. Reminding us of America’s lowly-placed health outcomes, the Eli Lilly Company is collaborating with Team USA, the US Olympic and Paralympic teams, to promote “Our Collective Health” with the message that, “Watching the success of our athletes will once again

“What if…healthcare happened where we live, work, play, pray and shop, delivering the highest levels of retail experience?” I asked and answered in my book HealthConsuming: From Health Consumer to Health Citizen. The chapter called “The new retail health” began with that “what if,” and much of the book responded with the explanation of patients evolving toward health consumers and, ultimately, health citizens empowered and owning their health and care. This week, Dollar General announced the hiring of its first Chief Medical Officer, Dr. Albert Wu. With that announcement, America’s largest dollar-store chain makes clear its ambitions to join a

Some of America’s least-healthy communities are also those that index greater for vaccine hesitancy and other risks for well-being, found in U.S. News & World Report’s 2021 Healthiest Communities Rankings. U.S. News collaborated with the Aetna Foundation, CVS Health’s philanthropic arm, in this fourth annual list of the top geographies for well-being in the U.S. Six of the top ten healthiest towns in America are located in the state of Colorado. But #1 belongs to Los Alamos County, New Mexico, which also ranked first in ___. Beyond Colorado and New Mexico, we find that Virginia fared well for health in

In 2020 in the U.S., 380,000 people are expected to die due to COVID-19. These people lost due to the coronavirus would, collectively, have lived another 5.5 million life-years would they not have succumbed to the virus. COVID-19 has cut lives short relative to their life expectancy, calculated in an analysis by the Pew Research Center based on CDC data from 2019 and 2020, coupled with additional statistics on life expectancy by age and gender. The bottom-line from the Pew Research Center’s analysis, simply stated, is that, “The pandemic…has killed many Americans who otherwise might have expected to live for

As vaccinations jabbed into peoples’ arms in the U.S. continue to immunize health citizens from contracting the coronavirus, millions of folks are looking forward to getting back inside restaurants to enjoy meals out, as well as un-masking when grocery shopping. But people in the U.S. love their food both outside and inside the home: about one-half of people in the U.S. are continuing to cook at home more, according to the 2021 Food & Health Survey published today by the International Food Information Council (IFIC). This sixteenth annual report is a go-to for those of us in the health/care ecosystem who

Most people in the U.S. who have received at least one COVID-19 vaccine shot have a welcoming side-effect: peace of mind and mental health, according to a survey conducted by Walgreens in April 2021. Three in four people said that getting vaccinated positively impacted their mental health, feeling some kind of relief, thankfulness, or optimism, among other sentiments. Walgreens conducted the poll online among 1,500 U.S. adults over 18 years of age between April 19 and 21st, 2021. The activities people are most excited to do once vaccinated with full immunity are to see family and friends (among 60% of

While the “in-person” visit to a doctor or medical professional continues to rank first as consumers’ most-trusted information source, the virtual doc or clinician rose in trust during the COVID-19 pandemic, according to Euromonitor’s latest read on Consumer Health: Changes in Consumer Behaviour during COVID-19 . The first four most-trusted sources for health information in 2021 remained the same short-list from 2020: doctors in-person, pharmacists, nutritionists and dieticians, and government or NGOs. But fifth place slipped from family and friends to the pharma industry, and sixth in line went to virtual doctors or medical professionals rising from 9th place in

Our feet have become an important health focus during the pandemic, as the importance of exercise-as-medicine and mental health helper has looked to walking, running, and biking as good-for-us physical activities. The Mayo Clinic published an informative piece on Feet and the COVID-19 Pandemic, and the Cleveland Clinic posted advice on exercising during the pandemic earlier this month with the strong recommendation of walking. So it makes sense that the apparel category whose brand equity grew most between 2020 and 2021 was footwear, announced in the Brand Finance Apparel 50. Each year, Brand Finance evaluates the value of “brands,” as

The United States has among the highest per capita incomes in the world. The U.S. also has sustained among the highest death rates per 100,000 people due to COVID-19, based on epidemiological data from the World Health Organization’s March 28, 2021, update. Higher incomes won’t prevent a person from death-by-coronavirus, but risks for the social determinants of health — exacerbated by income inequality — will and do. I have the good fortune of access to a study group paper shared by Paul Sheard, Research Fellow at the Mossaver-Rahmani Center for Business and Government at the Harvard Kennedy School. In reviewing

As the coronavirus crisis stretched from weeks into months, now over one year since being defined as a pandemic, U.S. consumers have made significant investments into their homes for working, educating students, cooking, and working out. Welcome to the “rebalancing of the homebody economy,” in the words of McKinsey, out with new data on consumer sentiment during the coronavirus crisis. The continued penetration of vaccines-into-arms in the U.S. is fanning optimism in terms of household economics, personal spending — especially on experiences that get folks “out” of the house. Still, the Homebody Economy will persist even post-COVID, with a growing

The Wall Street Journal featured the grocery chain Kroger in an article yesterday titled, COVID-19 Vaccinations, Tests Give Boost to Kroger’s Health Ambitions. “With 2,250 pharmacies and 220 clinics largely in the Midwest and the southern U.S., Kroger is the fourth-largest pharmacy operator by script count,” the Journal noted, adding details about Walmart, CVS Health, and Walgreens all fast-expanding their respective health care footprints. As more consumers view their homes as personal and safe health havens, there is no shortage of suppliers in the food, retail, and mobility sectors working fast to meet that demand for convenient and accessible services.

A Year into our collective coronavirus experience, Americans remain stressed, with physical health taking a back seat to our daily grinds based on the 2021 Stress in America survey from the American Psychological Association (APA). The APA has been updating us on U.S.-stress for several years, and more frequently since the start of the COVID-19 pandemic at the start of 2020. In their latest report, APA updates their previous profiles of Americans’ stress looking into different demographic groups and coping mechanisms. The topline, across all adults living in America, is that one-half have delayed or cancelled health care services. One-half has

“So close and yet so far” feels like the right phrase to use a year after the World Health Organization used the “P-word,” “pandemic,” to describe the coronavirus’s impact on public health, globally. One year and over 550,000 COVID-related deaths in the U.S. later, we face a New Reality that Dr. Michael Osterholm and I are brainstorming today at the 2021 South-by-Southwest Festival. Usually held live and very up-close-and-personally crowded in Austin, Texas, this year we are all virtual — including the film, music, and interactive festivals alike. While I regret to not be in the same room as Dr.

More Americans are happier in March 2021 than they’ve been for a year, based on consumer research from Civic Science polling U.S. adults in early March 2021. For the first time, a larger percent of Americans said they were better off financially since the start of the pandemic. This week, Civic Science shared their latest data on what they’re seeing beyond the coronavirus quarantine era to forecast trends that will shape a post-COVID America. Buoying peoples’ growing optimism was the expectation of the passage of the American Cares Act, which President Biden signed into effect yesterday. The HPA-CS Economic Sentiment Index

Five years ago, in 2016, the W2O Group said that, “Relevance is reputation.” That year the firm began to study the relevance of, well, relevance for organizations especially operating in the health/care ecosystem. 2020 changed everything, the W2O team asserts, now issuing its latest look into the issue through the Relevance Quotient. Relevance is built on recognizing, meeting and exceeding stakeholder expectations of organizations. In the Relevance Quotient methodology, W2O Group defines key stakeholders as employees, patients (including the sick and the well, caregivers, consumers, et al), health care providers, advocacy groups, analysts and investors, policy makers, journalists and media outlets.

Some people remark about 2020 being a “lost year” in the wake of the coronavirus pandemic. That happens to be a true statement, sadly not in jest: in the U.S., life expectancy at birth fell by one full year over the first half of 2020 compared with 2019, to 77.8 years. In 2019, life expectancy at birth was 78.8  years, according to data shared by the National Center for Health Statistics (NCHS), part of the Centers for Disease Control and Prevention (CDC). Life expectancy at birth declined for both females and males, shown in the first chart. The differences between

At the start of CES 2021, I had the opportunity to catch up with Karsten Russell-Wood, Portfolio Marketing Leader, Post Acute & Home, Connected Care at Philips. We brainstormed just as CES 2021 was going to “open,” virtually, for the consumer electronics conference’s first all-virtual meeting. Philips, a longtime major exhibitor at CES, created an entirely new online experience for the CES attendees – a sort of virtual gallery of different exhibits that are accessed from a single point in a “room” with various entry points. One of the company’s key messages for CES 2021 was health care delivered outside

Physicians in the U.S. are experiencing “death by 1,000 cuts,” according to the 2021 Medscape Physician Burnout & Suicide Report. Medscape polled 12,339 physicians representing over 29 specialties between late August and early November 2020 to gauge their feelings about work and life in the midst of the coronavirus pandemic. Medscape researched its first Physician Lifestyle Report in 2012. That research focused on physician “happiness” and work-life satisfaction. In 2013, the issue of burnout was called out on the cover of the report, shown here with the question, “does burnout affect lifestyle?” In 2015, the Physician Lifestyle Report was titled,

On U.S. Election Night, November 3, 2020, CNN’s John King stood in front of the “Key Race Alert” screen, announcing state-by-state polling results with the oft-used headline, “Too Early To Call.” That persistent media-moment was stressful for the millions of voters watching the multiple hairline-close battles from state to state. Then there was that company logo strategically placed at the lower left corner of the screen, as in “Brought to you by Calm.” Calm is but one of a growing portfolio of tools that health citizens can use to manage anxiety and stress, get to sleep (and stay sleeping), and

The coronavirus pandemic disrupted and re-shaped the annual CES across so many respects — the meeting of thousands making up the global consumer tech community “met” virtually, both keynote and education sessions were pre-recorded, and the lovely serendipity of learning and meeting new concepts and contacts wasn’t so straightforward. But for those of us working with and innovating solutions for health and health care, #CES2021 was baked with health goodness, in and beyond “digital health” categories. In my consumer-facing health care work, I’ve adopted the mantra that our homes are our health hubs. Reflecting on my many conversations during CES

The pandemic has digitally transformed those people who could work from home, school at home, and undertake daily life-flows as health citizens tried to keep the coronavirus (and other people) at-a-distance. “Emerging hand-in-hand with place displacement, activity displacement is simply about the change in how people do things. Almost overnight, school lessons and doctors’ appointments were online. Yoga classes, concerts and weddings were streamed via Zoom,” Fjord Trends 2021 from Accenture Interactive observes. “Historically, people have often been quick to adopt new digital technology and slower to adapt to what it can help them achieve,” Fjord noted. But COVID-19 has

In the U.S., the latest read on supply-and-demand for COVID-19 vaccines illustrates a gap between what had been promised for the first phase of vaccine rollout versus the reality of supply chain challenges, cold storage, and 50-state and local fragmentation at the last mile for U.S. health citizens. An op-ed published in yesterday’s Washington Post by Dr. Robert Wachter of UCSF and Dr. Ashish Jha of Brown University found these two wise physicians feeling “punched in the face” with the state of coronavirus vaccination in America. As a result, they soberly, pragmatically recommended administering just the first jab of vaccine

Before the coronavirus pandemic, patients had been transforming into health care payors, bearing high deductibles, greater out of pocket costs, and financial risk shifting to them for medical spending. In the wake of COVID-19, we see health consumers-as-payors impacted by the pandemic, as well as for existing diagnoses and chronic care management. There is weakening in U.S. consumers’ overall household finances, the latest report from the U.S. Bureau of Economic Analysis (BEA) asserted (published 25 November 2020). In John Leer’s look into the BEA report in Morning Consult, he wrote, “Decreases in income, the expiration of unemployment benefits and increased

The coronavirus pandemic has shifted everything that could “come home,” home. THINK: tele-work, home schooling for both under-18s and college students, home cooking, entertainment, working out, and even prayer. All of this DIY-from-home stuff has been motivated by both mandates to #StayHome and #WorkFromHome by government leaders, as well as consumers seeking refuge from contracting COVID-19. This risk-shift to our homes has led consumers to re-orient their demands for home purchase features. Today, home is ideally defined as a safe place, offering comfort and refuge for families, discovered in the America at Home Study. The Study is a joint project of

One in two U.S. adults say their concerns about personal health and wellness increased in the past year: in particular, stress and anxiety, and sleep and eating habits. Despite spending more time at home due to the COVID-19 pandemic, few people believe they live in a “healthy home.” The vast majority of consumers are concerned about some aspect of their home’s health, like air or water quality, according to Healthy Home Technologies , a report published in October 2020 by the Consumer Technology Association (CTA), convener of the annual CES. For the research, CES interviewed 1,500 U.S. adults in late

2020 marked the centennial anniversary of the 19th Amendment to the U.S. Constitution, giving women the right to vote. In this auspicious year for women’s voting rights, as COVID-19 emerged in the U.S. in February, women’s labor force participation rate was 58%. Ironic timing indeed: the coronavirus pandemic has been especially harmful to working women’s lives, the Brookings Institution asserted last week in their report in 19A: The Brookings Gender Equality Series. A new study from Tia, the women’s health services platform, looks deeply into COVID-19’s negative impacts on working-age women and how they would advise the next occupant of

In May 2020, the Oxford English Dictionary (OED) re-visited the acronym, “PPE.” As OED evolves the definition of PPE, the wordsmiths could borrow from OSHA’s website, noting that PPE, “is equipment worn to minimize exposure to hazards that cause serious workplace injuries and illnesses. These injuries and illnesses may result from contact with chemical, radiological, physical, electrical, mechanical, or other workplace hazards. Personal protective equipment may include items such as gloves, safety glasses and shoes, earplugs or muffs, hard hats, respirators, or coveralls, vests and full body suits.” Perhaps Definition 3 in the OED could be updated by a blog

The coronavirus pandemic has spawned many side-effects re-shaping consumers’ everyday lives. Among them, more time at home, DIY life-flows, and financial well-being are driving growth of self-care health care. An article in the latest Drug Store News talks about consumers growing more health-conscious, adopting natural, homeopathic products. “It’s about more than washing your hands,” David Salazar explains. “Fending off illness has become a state of mind for many consumers throughout the COVID-19 pandemic.” In feeling dis-empowered in the face of the pandemic – with the first shock of the Great Lockdown and stay-at-home mandates – we’ve taken on more do-it-yourself behaviors, from

In terms of income, U.S. households entered 2020 in the best financial shape they’d been in years, based on new Census data released earlier this week. However, the U.S. Census Bureau found that the level of health insurance enrollment fell by 1 million people in 2019, with about 30 million Americans not covered by health insurance. In fact, the number of uninsured Americans rose by 2 million people in 2018, and by 1.9 million people in 2017. The coronavirus pandemic has only exacerbated the erosion of the health insured population. What havoc a pandemic can do to minds, bodies, souls, and wallets. By September 2020,

In the U.S., symptoms of depression were three-times greater in April 2020 in the COVID-19 pandemic than in 2017-2018. And rates for depression were even higher among women versus men, along with people earning lower incomes, losing jobs, and having fewer “social resources” — that is, at greater risk of isolation and loneliness. America’s health system should be prepared to deal with a “probable increase” in mental illness after the pandemic, researchers recommend in Prevalence of Depression Symptoms in US Adults Before and During the COVID-19 Pandemic in JAMA Network Open. A multidisciplinary team knowledgeable in medicine, epidemiology, public health,

In the COVID-19 era, most U.S. consumers believe they have an obligation to share personal health information to stop the spread of the coronavirus. However, only 44% would be willing to share their personal data with a national database, a MITRE study learned. Only one-third of Americans would be willing to share their temperature, 29% their location, and one-fourth information about their chronic conditions. The Harris Poll conducted the study among 2,065 U.S. adults 18 and over in mid-June 2020 to gauge peoples’ perspectives on health data and privacy. Three-quarters of people in the U.S. believe that data privacy “is a