25: Health in the App Store

The introduction of CareKit at Apple's March event was a public reaffirmation of their commitment to improve public health. It was also a powerful statement that iOS devices are key to that mission. The Apple Watch and the M-series chips in modern iPhones have certainly made progress in raising public awareness of fitness goals like standing time and step counts. And the studies on Parkinson's disease made possible by ResearchKit are very impressive, even if they aren't garnering public attention in the same way.

This all paints a picture of iOS being a very wholesome platform, and of course that's how Apple would like us to see it. But eight years into its life, iOS is nothing without third-party software and the App Store ecosystem built around it. Criticism of the App Store is so commonplace that it's easy to dismiss as picking low-hanging fruit — but Apple has planted a whole orchard full of it.

"Gem packs! Get yer gem packs here!"

"Gem packs! Get yer gem packs here!"

The one area of the App Store that seems most opposed to Apple's health efforts is the Top Grossing chart. I'm not the first to question whether Apple is proud of what dominates there: largely "free-to-play" games that attempt (and clearly succeed!) to extract In-App Purchase dollars at every turn. I don't want to label these games as evil — many are just the modern equivalent of pay-per-play arcade games, with the major difference being that you don't have to physically feel each quarter slip out of your hand forever. What troubles me are the apps that are thinly veiled gambling, with "casino" and "slots" right in the app titles.

Gambling addiction is a serious mental health issue. Estimates vary widely, but there are millions affected in the United States alone, and some of them must be the iOS device owners who push these apps up the charts. This is a major reason why simple elimination of the Top Grossing chart won't fix the App Store economy: it might alleviate the rich-get-richer problem among developers, but it would only mask the poor-get-poorer problem among some App Store consumers.

Apple should absolutely view this as a black mark on their health record. The only way to eliminate it is by strong enforcement against predatory apps in their marketplace. Yet they are encouraging some of the bad behavior, even featuring sales on IAPS of "gem packs", "gold", "orbs", and the like. Turning their backs on these lucrative apps means a decline in the value of Apple's 30% cut, but looking at their various *Kit efforts, it's clear that they are willing to take some of their war chest and devote it to the noble mission of improving the world. Just the same, the App Store is a worldwide force, a multi-billion dollar industry in its own right, and Apple should make certain that it is a humane one.