Result
Diurnal stress varies across geographic zones and then countries within the zone
We found the global average SR to be 76.95 ± 14.28. Additionally, we found distinct differences across continents when comparing the average SR of UH ring AIR users. Users in Europe (77.88 ± 1.45) had the highest average SR (implying the lowest stress levels), with GCC (76.49 ± 0.65) and Americas (77.26 ± 2.34) having only slightly lower average SR than Europe. The lowest average SR (highest stress levels) was registered in Asian users (74.93 ± 2.03; Figure 1).
Figure 1: Barplot depicting the difference in the average SR score of regions from the global average SR score (76.95 ± 14.28).
When comparing countries within a given geographic group, we found interesting regional patterns (Figure 2). In Asia, users in Hong Kong had the highest average stress scores (77.32 ± 13.05) whereas those in India had the lowest average stress scores (70.96 ± 15.32). Globally, Indian users had the lowest SR, with a reduction of 6.05 points compared to the global average. In the Americas, Brazilian users had the highest average SR (79.32 ± 12.90) while users in Mexico had the lowest average SR (73.97 ± 14.17). In Europe, users from Portugal had the highest average SR (81.18 ± 12.95), which was also the highest globally. Their SR was 4.16 points above the global average. The lowest SR in Europe were seen in users from Slovakia (74.95 ± 14.02). In the Middle East, Saudi Arabia (76.03 ± 14.43) and the UAE (76.95 ± 14.28) users had similar average SR. In Africa and Oceania, South Africa and Australia, were the only included countries (see methods) with average stress scores of 80.97 ± 12.58 and 78.29 ± 12.84, respectively.
Figure 2: Barplot depicting the difference in the average SR score of a country from the global average SR score (76.95 ± 14.28).
Stress scores improve with age
Next, we stratified the users based on their age (Figure 3). Users below the age of 25 showed the lowest SR across all continents. Additionally, we saw that the average SR increased with age, with users above the age of 65 having the highest SR. On average there was a 9-point difference in the average SR between 65+ and <25 age groups. Users in the 25-34 year age bracket experienced nearly a 2-point increase in average SR compared to users under 25, except in Asia where the average SR between these age groups was comparable.
Figure 3: Graphical representation of change in the average stress score for each region by age group. The error bars denote the 95% confidence interval. N(Asia) = 1,65,344, N(Americas) = 2,01,891, N(Europe) = 1,88,432, N(GCC) = 23,983, total data points across all age groups.
Conclusions, Limitations and Future Directions
Chronic stress not only impacts the immediate quality of life but also has a cumulative impact on health span and lifespan in terms of increasing risks for NCDs 3. It is an amalgamation of an individual’s age, genetic make-up, lifestyle, socioeconomic status, socio-cultural background, history, and prior exposure to stressful experiences 7. These factors change with work habits and lifestyle changes as we age. This analysis was motivated by establishing demographic characteristics of the Ultrahuman Ring AIR userbase - the global aggregate and region-wise trends. The findings from our survey indicated complex associations that influence SR and hence lead to the disparity between countries and age, underscoring the need for public health strategies that are tailored to understand local socially ingrained motivations. For instance, traditionally Japan has been associated with higher work pressures than India, however, emerging trends within the Indian workforce indicate longer working hours and additional stress on people with families 11. Since the SR is an aggregate measure of stress from all directions, agnostic wearable data can become key in parsing complex relationships of an individual with his/her social environment.
Stress is traditionally measured using self-reported questionnaires, particularly in population studies, which primarily assess an individual's perception and subsequent recognition of stress 7,10. The availability of dynamic metrics such as Ultrahuman SR allows the user to enhance his/her self-awareness of the physiological impact of the situations they experience throughout the day. The concept of “eu-stress” and “dis-stress” is also less frequently employed to analyse effects. For example, when stress is aligned with circadian rhythm or voluntary physical activity, it has less adverse impact than when the stressor is presented in the evening or night. This timing effect is captured in the total SR output. This may also be a reason for better stress management across senior age groups as students and early career professionals, likely end up pushing later hours due to work and social motivations.
Limitations of the study include countries with over 100 users, therefore, these results may be more weighted towards countries with larger Ring AIR userbase. The general fitness levels of the Ultrahuman Ring AIR user base are higher than the general population and hence may not be generalizable to the extended urban population in most countries. Moreover, these results might not capture regional variations within countries. As this is an opening analysis, we refrained from creating complex mathematical models to test the trends we observed. Future surveys will delve into the underlying factors influencing these regional and age-related variations in stress levels. Exploring the influence of cultural, socioeconomic, and environmental factors are important drivers that merit deeper examination into this phenomenon.
The SR can serve as a valuable tool for monitoring stress levels not just in individuals but also relevant for public health analyses. The continuous tracking and analysis of this can help identify trends and inform pre-emptive measures to reduce stress and improve well-being.
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