A toast to the program I built at Apple with Singapore — and a case for why wellness is infrastructure, not a nice-to-have.
Tim Cook once said, “If you zoom out into the future, and you look back, and you ask the question, ‘What was Apple’s greatest contribution to mankind?’ It will be about health.”
I used to think about that line often when I worked at Apple. And it comes to mind again for me today because the team I led at Apple may have produced one of the strongest proof points for why he’s right.
Last week, Singapore’s Health Promotion Board announced that LumiHealth — the health and wellness program built in partnership with Apple — will conclude on May 31, 2026, after six years. The program reached 377,000 Singaporeans. Participants completed 32.9 million workouts. A study with Swiss Re estimated that sustained activity improvements could reduce mortality by 3 to 13 percent, with the greatest impact on previously sedentary and older participants.
Not just engagement metrics or step counts. Mortality reduction. A health game with a cartoon character, daily challenges, and voucher rewards produced the kind of outcome that many clinical trials aspire to.
I led the team at Apple that pursued this opportunity, designed the program, and launched it end to end — from the first meeting with Singapore’s government to the moment it went live in the middle of a global pandemic. As LumiHealth winds down, I find myself holding two feelings at once: pride in what we built and proved, and the bittersweet recognition that the program is ending while its lessons are only beginning to land.
This is that story.
It Started with a Watch and a Simple Insight
Before LumiHealth existed, I was leading Apple’s early partnerships with Vitality, the South African insurance company that pioneered “earn your watch” programs. The concept was straightforward: subsidize an Apple Watch (as I explored in Apple Watch as an AI-powered health device) for members, and reward them for closing their Activity Rings. Stay active, and the Watch pays for itself.
What we learned from Vitality was foundational. The simple mechanic of rewarding daily behaviors — in particular physical activity — turned out to be a remarkably powerful lead horse for broader behavior change. People who started closing their Rings didn’t just move more. They started paying attention to their sleep. They made better food choices. The Watch on the wrist became a daily reminder that their health was something they could actively shape.
But Vitality was an insurance product. I kept thinking: what if you could do this at the scale of an entire country? What if a government — not an insurer — was the one investing in its citizens’ daily health behaviors?
That question led me to Singapore.
A Meeting in Cupertino, Two Years Before Launch
I had been following Singapore’s National Steps Challenge, a nationwide program run by the Health Promotion Board that gave citizens pedometers and rewarded them for walking. By the time we began our engagement, the National Steps Challenge had already reached 1.7 million unique participants across its first six seasons — nearly a third of Singapore’s adult population — with simple trackers and step rewards. It was proof that an entire nation could be nudged toward healthier behavior through daily micro-incentives. LumiHealth was the next evolution: deeper engagement, richer health behaviors, and Apple Watch as the platform. We weren’t starting from scratch. We were building on a foundation Singapore had already laid.
Two years before LumiHealth launched, I hosted members of Singapore’s Health Promotion Board and Economic Development Board in Cupertino. That meeting was the beginning of everything. Singapore had been soliciting proposals from international healthcare and technology companies on ways to enrich the lives and health of its population. We weren’t the only company at the table. But we had a thesis — built on what we’d learned from Vitality — about how the Apple Watch could be the platform for a national behavior change program that went far beyond step counting.
What followed was two years of intense co-creation. Frequent trips to Singapore. Deep immersion in the public health system. And a growing conviction, on both sides, that we were building something that hadn’t been done before.
Before LumiHealth even launched, we were in dialogue with other governments interested in the model. Saudi Arabia’s Ministry of Health. Taiwan’s government. The approach we’d developed with Singapore wasn’t just a one-off project — it was becoming a template for how governments could partner with technology companies to improve population health.
What Singapore Taught Me About Public Health
I’ve worked with health systems and enterprises around the world. Nothing prepared me for Singapore.
The thing that made it different from anywhere else was the connectivity. Everyone in Singapore’s government knows everyone. The integration across agencies — HPB, the Ministry of Health, EDB — meant that connections which would take months of bureaucratic threading in other countries happened over WhatsApp. Not recklessly. Efficiently. The product of a small, tightly networked government that genuinely operates as a system rather than a collection of silos.
But the speed wasn’t the real revelation. The philosophy was. HPB didn’t treat wellness as separate from healthcare. Prevention, screening, community fitness, nutrition, mental well-being — all of it was integral to a holistic health system. And the leader of HPB, Yoong Kang Zee, was the visionary we worked with who set the direction and made the Apple partnership possible. The National Steps Challenge wasn’t a marketing campaign. It was infrastructure.
I saw this firsthand. My team and I visited community health centers and polyclinics. We watched evening exercise classes for seniors at community centers — rows of older Singaporeans following along to structured routines, night after night. We walked through hawker centers and neighborhoods where public health wasn’t an abstraction but a visible, daily presence. Singapore had woven health promotion into the fabric of daily life, and it was run by the government not as a side initiative but as core policy.
In the U.S., we talk about “upstream prevention” and “social determinants of health” as aspirational concepts. Singapore was already doing it at national scale.
A big part of building LumiHealth was trust-building — the kind that happens over dinners, late-night conversations, and karaoke, not just conference rooms. The relationship between our team and HPB became a real partnership, and that trust is what allowed us to take creative risks with the program design.
Designing a Health Game (and Worrying It Wouldn’t Work)
Here’s what I’ll admit: we weren’t sure it would work.
The core bet of LumiHealth was that a game — complete with a cartoon character, narrative progression, and incremental challenges — could drive sustained behavior change at population scale. Not just among young, tech-savvy users who already owned Apple Watches and played games on their phones. Among older adults. Among people managing chronic conditions. Among the sedentary.
There was real internal skepticism about this. A character named Lu, a friendly intergalactic explorer who advances through different worlds as you complete health challenges, could easily feel childish or gimmicky. Would a 60-year-old with diabetes really be motivated by helping a cartoon alien get home? Would the game mechanic feel patronizing rather than engaging? The doubt wasn’t unreasonable. Most gamified health apps skew young. We were betting that the behavioral mechanics — not the aesthetic — would transcend demographics.
We bet right. But until we saw the data, we didn’t know for certain.
Here’s what we designed, and why:
A character you care about. Lu gave the program a narrative arc. Users weren’t just closing rings; they were helping Lu travel through different worlds. Every healthy action advanced Lu’s journey. This transformed the emotional relationship with the program from obligation to investment. One user captured it perfectly: “Even when I felt tired, lazy and sticky from sweat, I found myself pushing for a few more reps so that Lu could advance further in his journey. This was the first game where the more I played, the more calories I burned.”
That user wasn’t a twentysomething gamer. She was a desk worker who described herself as struggling with discipline and motivation. Exactly the person the skeptics said wouldn’t engage with a game mechanic.
Small steps, not big leaps. Early challenges were deliberately easy. Close all three Activity Rings once in a week. Do a 15-minute outdoor walk. Complete a breathing session. The program adapted to each user’s baseline and progressively increased the ask. We worried this would make the program feel unserious. Instead, it’s what made it accessible. Meet people where they are, and they’ll surprise you with how far they go.
Multi-week quests for sustained habit formation. Beyond daily challenges, we designed structured quests focused on specific goals: building strength, improving sleep, managing weight, cognitive health. The weight management quest was built around a deceptively simple daily ask — log your weight — backed by clinical evidence that daily self-monitoring leads to sustained behavior change. 86 percent of users participated in at least one quest.
Incentives as a bridge, not a crutch. Users initially could earn up to S$380 in vouchers. The rewards mattered, and they got people in the door and sustained engagement through the early friction of habit formation. But the design layered extrinsic rewards on top of intrinsic motivators: the satisfaction of closing rings, Lu’s progression, visible evidence of improvement. The goal was always to build habits that would sustain after the rewards tapered.
Holistic by design. LumiHealth wasn’t a fitness app. It reminded users to get flu vaccinations, complete health screenings, and do diabetes risk assessments. It included mindfulness challenges, breathing exercises, mood tracking, and journaling prompts. 74 percent of participants completed mental well-being challenges. One user described how the breathing prompts during stressful workdays were “much appreciated for someone like me who tends to get jittery and tightly wound up when the going gets tough.”
This reflected HPB’s philosophy — health is not just about exercise, but about sleep, nutrition, mental well-being, and preventive care, all connected — embedded into every layer of the product.
Launching in a Pandemic
We designed LumiHealth in a pre-COVID world and launched it in October 2020, right in the middle of one.
I flew to Singapore on a plane with maybe twenty passengers. The airport was a ghost town. I entered on a special visa that spared me the standard two-week quarantine, but the tradeoff was a strict schedule and being chaperoned constantly. And then we launched a national health program to a country that was still figuring out what “normal” meant.
But I believe COVID made LumiHealth more relevant, not less. People were isolated, struggling to maintain routines. The structured daily nudges, the gentle progression, the sense of accomplishment from completing challenges — these were exactly what people needed when their normal rhythms had collapsed. The program gave people a reason to get moving, to pay attention to their sleep and mental health, during a time when all of those things were under siege.
The Numbers — and Why They’re Extraordinary
Here are the outcomes, reported as the program winds down:
- 377,000 Singaporeans used the program over six years
- 32.9 million workouts completed — averaging over 20 per participant per month, double pre-LumiHealth levels
- Users with low activity levels increased weekly exercise minutes by 54 to 88 percent
- Users with higher BMI (23+) increased weekly exercise by 42 percent
- 86 percent participated in structured multi-week quests
- 74 percent completed mental well-being challenges
- Over 6,300 participants engaged with chronic condition management quests for hypertension and diabetes
- Swiss Re study estimated 3 to 13 percent mortality reduction if activity improvements were sustained
That mortality number is the one that stays with me. We set out to build a health game. The data suggests we may have helped people live longer.
But here’s what makes these results truly unusual: the greatest impact was on the people who were hardest to reach. The previously sedentary. The older participants. The higher-BMI users. In most wellness programs, the fit get fitter and everyone else drops out. LumiHealth reversed that pattern. The people who started furthest from healthy had the most to gain — and they stayed.
That wasn’t an accident. It was the design working as intended: start easy, meet people where they are, build gradually. But seeing it validated at this scale was a genuine surprise, and the most meaningful outcome of the entire program.
The Team
I want to take a moment to recognize the Health Strategic Initiatives team at Apple, the team I proudly built and led.
Mithun Patel drove the product strategy and program management with relentless clarity. Kumiko Toft led design through the character debates and quest structures that became the soul of the program. Najiah Ramlee and Eric Tseng became our bridge to Singapore, integrating our team with the ecosystem. Andy Pham led engineering through the complexity of building a health platform with partners that had to work flawlessly at national scale. Mike Barnes brought the data science rigor that allowed us to measure what mattered. Maziar Brumand held the commercial and operational complexity together. And Josh Thompson and Thomas Clinton served as the commercial leads who connected the program to Apple’s retail presence and channel partners, making sure the Apple Watch wasn’t just a health device but an accessible one for Singaporeans. These are just a few of the people who made it real.
I remember our trips to Singapore together — walking through community centers, watching those evening exercise classes for seniors, seeing how a country runs public health not as an afterthought but as essential infrastructure. Those visits shaped how the team built the product. You can’t design for a population you haven’t taken the time to understand, and this team took the time.
The team has since been integrated back into the broader Health organization at Apple. Many are still there; many, like me, have moved on. But LumiHealth was a cross-functional effort, built in genuine partnership with HPB, and the best work always is.
Wellness Is Infrastructure
LumiHealth disproves three things the healthcare industry still gets wrong.
First, that incentive-based wellness programs are shallow engagement plays that don’t produce real health outcomes. LumiHealth produced measurable mortality benefit estimates, not just engagement metrics, not just step counts, but the kind of outcomes that clinical trials aspire to.
Second, that population-scale behavior change is unrealistic. Singapore did it. 377,000 people over six years, with sustained engagement and measurable impact across demographics. It’s not unrealistic. It’s under-invested.
Third — and this is the one I feel most strongly about — that wellness is “soft.” That it’s a nice-to-have, separate from the serious business of clinical care. LumiHealth proved the opposite. When you treat wellness as public health infrastructure — when a government invests in daily habits the way it invests in hospitals and clinics, and when technology and behavioral science are deployed at population scale to support it — you get outcomes that rival clinical interventions. Prevention isn’t soft. It’s the hardest, most scalable lever we have.
Singapore understood this before anyone else. They built national infrastructure around it. And for six years, LumiHealth proved that it works.
Which brings me to this moment in the United States. Whatever you think about the politics surrounding it, the MAHA movement and the current administration’s focus on prevention and chronic disease represent a genuine opening. CMS has announced MAHA ELEVATE, a $100 million model funding evidence-based lifestyle and behavioral interventions for Medicare beneficiaries, with physical activity and nutrition required in every proposal. States are establishing their own commissions to tackle chronic disease through prevention. For the first time in a long time, the U.S. policy conversation is shifting toward the upstream, toward the behavioral, toward the idea that health systems should invest in keeping people well — not just treating them when they’re sick.
LumiHealth is proof that this works. Not in theory. At scale, over years, with hard outcomes. The question is whether the U.S. — or any country — will invest in wellness infrastructure with the same conviction Singapore showed six years ago.
Six years. 377,000 people. 32.9 million workouts. And somewhere in those numbers, lives extended, maybe by years. We set out to prove that wellness could be infrastructure. Singapore let us try. The program is ending, but the proof remains. Now it’s everyone else’s turn.
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