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How to design a universal language for health? Emojis of course.

Techly's Guest Post Series
At present, more than 400 million people have Type 2 Diabetes and this number is projected to grow massively in the coming years. This condition hits ethnic minorities, low literacy groups, indigenous people, migrants and lower socio-economic communities the hardest.

Many of the debilitating and life-threatening complications caused by Type 2 Diabetes are entirely preventable if people are given access to the right information and tools. But communicating something as complex as managing a chronic disease to people who might have low literacy, live remotely, in different countries and speak different languages remains a huge challenge.

Through my work with Emojifit Diabetes, I have been able to design an app which helps people prevent the complications of Type 2 Diabetes. Our app targets these people, and to address their needs I was asked to design a universal language for health, which was daunting, to say the least.

My solution – emojis.

It’s not widely known but emojis have in recent years been classified as an official world language, however many of the emojis you might be familiar with are far from ideal. They’ve often been designed in a light-hearted or humorous way. Plus, they generally have nothing to do with health. So I had to make my own (with a lot of help).

Our users are from a broad range of demographics, different ages, genders and body types. From the research we conducted, we found that users did not respond as positively to depictions of people that looked different to themselves. This presents an obvious problem; how can you depict every possible demographic for each emoji? And even if you did, how would you present these options for the user to choose from? The solution was to side step this and avoid depicting any culturally or physically identifying bodily features. For example, when designing emojis for physical activities, you can just show the accessories used without showing the bodies involved.

Physical activity emojis

Credit: D’Arcy Ellis

Obviously many of our emojis also describe serious medical conditions, so it is vital they are not seen to trivialise either the users or the health condition. For example, when depicting heart disease drawing the obvious love heart shape does not convey the serious nature of this condition, using a more anatomically correct drawing was found to be more effective in these instances.

Risk factors emojis

Credit: D’Arcy Ellis

This is not to say that all medical conditions should be depicted in a graphic way. When I first designed the emoji to depict vision loss caused by small blood vessel damage in the eye, using an anatomical organ didn’t go down well with the trial users at all. It was considered too macabre.

Eye disease emojis

Credit: D’Arcy Ellis

Using emojis in a medical context can also present a range of unique design problems. It’s not always possible to depict medical conditions directly for cultural or religious reasons. Considering sexual health, for example, neither a depiction of the organs affected or the physical activities involved was appropriate. But, both women and men suffer from complications due to small blood vessel damage associated with diabetes. Women have difficulty with arousal and men experience problems with erections.

In this case these issues were overcome using older symbolic language. So far both have been well received, however the risk with more abstract symbology like this is that they may not be well understood globally, so further testing will be needed to understand the extent of this phenomenon.

Sexual Health emojis

Credit: D’Arcy Ellis

Finally, depictions of emotions and moods, this is probably the easiest application of emojis which can be leveraged to depict even complex conditions like depression.

Depression emojis

Credit: D’Arcy Ellis

As a result of this work Apple has approved our app in all languages, we are being used in 30 countries worldwide from Nepal to Brazil, the Philippines, France and Kenya. The combination of art, research and collaboration with the users has created a unique and powerful tool. Hopefully, this approach and a dedication to universal accessibility will catch on in the sphere of medical apps, the problems we face are big but there is huge potential to improve.

D’Arcy is the co-founder and lead designer for the mHealth app emojifit, working to develop both the user interface and in-app communication tools, focussing on chronic disease care, prevention and education.

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