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When Stephen Friend left Apple in 2017 after a stint helping to jumpstart its health efforts, the company’s marketing engine was already promoting a future that hadn’t arrived: Apple devices were going to help you live a healthier life.

In reality, iPhones, Apple Watches, and competitor products were collecting a flurry of data about activity, heart rate, and sleep. But the evidence they could detect disease or actually improve health outcomes was nascent.

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