From Health Indicators to Health Activation
Public health already has many important indicators.
Communities track diabetes rates, obesity rates, mortality rates, chronic disease burden, mental health burden, and healthcare utilization. These are lagging health indicators that often tell us where harm has already been done.
San Antonio’s top cause of death is heart disease [1].
Great, now what can we do about it?
According to Public Health 3.0 guiding principles, public health needs actionable, geographically granular, and timely intelligence as essential infrastructure, especially when communities are trying to address upstream social determinants of health across sectors [2].
Timely and actionable are important.
Tracking obesity hardly seems timely. Heart disease and higher-than-average mortality rates for diabetes are not very actionable.
Manufacturing and production learned a long time ago that preventative maintenance is cheaper and more productive than reactive maintenance.
Why do we treat healthcare any differently?
That is why the next leap in public health will be health activation as the preventative layer.
The Case for Health Activation
The data is already out there.
For every $1 spent on preventive healthcare, also known as keeping people healthy and fit, returns $3–$8 in avoided cost [3, 4].
Most cities have the pieces they need for programming. Maybe that is a Mayor’s Fitness Council, a Metro Health organization to guide policy, or simply engaged citizens.
So how do we create actionable intelligence that helps cities, public-health organizations, and partners like gyms understand what is happening early enough to act?
Why Verified Activity Matters
A person can enroll in a program and never engage.
A gym membership can exist without behavior change.
A city can fund access without knowing whether access turned into adherence.
An employer can offer a wellness benefit without understanding whether employees are actually being supported.
Verified activity helps close that gap.
It gives operators and partners a better way to understand whether people are showing up, whether they are coming back, whether participation is sustained over time, and whether support is needed before disengagement becomes failure.
This matters because objective activity data has become increasingly important in health research.
A Nature Medicine study using wearable-device data from 96,476 UK Biobank participants found that higher physical activity energy expenditure was associated with lower mortality risk, and that higher-intensity activity was associated with greater risk reductions at a given activity volume [5].
Wearable activity trackers also appear to have practical intervention value. A Lancet Digital Health umbrella review found that activity trackers can improve physical activity and related physiological and psychosocial outcomes across clinical and non-clinical populations [6].
The lesson is not that every city wellness program should become a wearable program.
The lesson is that better activity data can support better decisions.
Better decisions are what allow wellness efforts to mature into infrastructure.
The Gym Is an Underused Public-Health Asset
Gyms are often treated as private businesses sitting outside the public-health conversation.
We believe that is a missed opportunity.
In 2024, there were 77 million gym memberships sold with about 66.4% retained. Put another way, 26 million cancelled [7].
If we can move the dial on retention to 80% or higher, that means millions of people going from a future health indicator to a health activator.
And a healthy population is a force for economic development [8].
Gyms are where health behavior often becomes visible.
They are physical access points, community nodes, coaching environments, adherence environments, and places where people try, fail, return, build confidence, and start again.
If a city wants to understand whether access turns into sustained behavior and economic development, then gyms are one of the most practical places to start.
What Groe Does
Groe was created as an AI-driven platform to help gym owners get the actionable intelligence they need to keep members coming back.
Equipment use and social connectivity are two powerful signals that can help improve member experience, staff capacity, and operational awareness.
That matters because staff capacity is one of the biggest limiting factors in any real-world fitness intervention.
A gym can have the right mission and still miss the moment when a member starts to disengage.
A facility can have usage patterns that create friction, but staff may not see those patterns clearly enough to intervene.
So a program can lose adherence before anyone knows support is needed.
We believe that the same data that can help gyms improve retention can become actionable intelligence for a City Wellness Program.
In that model, retention becomes more than a business metric.
Retention becomes adherence.
Adherence becomes health activation.
Health activation produces public-health outcomes.
And when public-health outcomes improve, the whole city wins.
The Model Worth Proving
The model should start with high-need populations.
It should build with gyms, not around them.
It should use privacy-first verified activity data.
It should activate support when adherence drops.
It should measure longitudinal outcomes honestly.
It should evaluate what works and scale only what proves useful.
That brings us back to the original problem.
Public health indicators tell us where harm has already accumulated. Health activation helps us intervene before that harm becomes another statistic.
Instead of only asking how many people have diabetes, obesity, heart disease, or poor mental health days, we can also ask whether people are gaining access, showing up, staying engaged, and receiving support early enough to change the trajectory.
That is what makes verified activity data valuable.
It connects the upstream behavior to the downstream outcome.
It gives cities, gyms, public-health leaders, and community partners a shared feedback loop.
It helps move wellness from intention to infrastructure.
Health as Infrastructure
For Groe, that is the system worth building.
Because health infrastructure needs more than ambition.
It needs access, measurement, accountability, trust, operators, and data that turns into action.
That is how fitness becomes more than a membership.
That is how gyms become more than facilities.
That is how wellness becomes more than a benefit.
That is how health becomes infrastructure.
And that is how cities can move from tracking health indicators to becoming health activators.
References
[2] Wang YC, DeSalvo K. Timely, Granular, and Actionable: Informatics in the Public Health 3.0 Era. Am J Public Health. 2018 Jul;108(7):930-934. doi: 10.2105/AJPH.2018.304406. Epub 2018 May 17. PMID: 29771614; PMCID: PMC5993377.
[3] Thompson AG, Subedi M, Morrow AE, Smith CL, Bigelman KA. Evaluating the Return on Investment of U.S. Army Holistic Health and Fitness Performance Teams: A Matched Difference-in-Differences Study of Readiness and Economic Outcomes. Sports Med. 2026 Feb 12. doi: 10.1007/s40279-026-02399-3. Epub ahead of print. PMID: 41678032.
[4] Wellness programs on the rise. Biotechnol Healthc. 2010 Spring;7(1):29-30. PMID: 22478810; PMCID: PMC2873731.
[5] https://www.nature.com/articles/s41591-020-1012-3
[7] https://www.healthandfitness.org/2025-fitness-industry-benchmarking-report/
[8] Raghupathi V, Raghupathi W. Healthcare Expenditure and Economic Performance: Insights From the United States Data. Front Public Health. 2020 May 13;8:156. doi: 10.3389/fpubh.2020.00156. PMID: 32478027; PMCID: PMC7237575.