After reviewing this week’s learning resources respond to the following prompts:
- In your own words, describe how technology is changing or will change the healthcare industry.
- Identify at least 3 technological health innovations from your resources that you found to be particularly interesting. Explain the potential positive and negative impacts of these innovations on society. Negative impacts may include ethical dilemmas posed by the technology.
Remember to use your own words, using your best writing skills, cite your sources, and provide a reference list.
Health and Technology – Historical Perspectives
BEHS
1
03: Technology in Contemporary Society
Week 6
Credit: Katherine Im (2021, July)
1
Important areas related to health
Medical care
Biomedical research
Public health
Health care
Longevity
Medical care
Professions dedicated to the treatment and prevention of illness
Heavy reliance on technology:
Diagnostic tools (e.g., blood tests, scanning)
Treatment (e.g., surgery)
Pharmaceuticals (e.g., vaccines, antibiotics)
http://amsaofumiami.webs.com/aboutamsa.htm
3
Biomedical Research
Basic scientists who translate laboratory observations to clinical therapies and treatments
Very heavy reliance on technology (computers, statistical modeling, laboratory equipment and techniques, etc.)
http://www.blog.gurukpo.com/human-genome-project
4
Public Health
Protects and improves the health of communities through prevention research, health promotion, and public education efforts
Large scale efforts
Emphasis on prevention
Source: http://www.whatispublichealth.org/
Image source: http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=ze_6gLpMyQNFIM&tbnid=nxb235TfnNNgxM:&ved=0CAUQjRw&url=http%3A%2F%2Fwww.practicefusion.com%2Fehrbloggers%2F2010%2F08%2Femrs-need-to-report-public-health.html&ei=Btz3Ufb7JJT84AOEr4HgCA&bvm=bv.49967636,d.dmg&psig=AFQjCNEvlFjlkgj_rKvgXukBfAnsofM4Fg&ust=1375284590253421
5
Health Care
Umbrella term that encapsulates many components
Includes health care policies and insurance
Includes patient records
Includes ancillary services (mental health, physical therapy, occupational therapy, holistic care)
Highly politicized due to $$$
Origins of medicine
Ancient Egypt (2600 BCE)
Imhotep – Important advisor to King Djoser
First known architect of pyramid
Diagnosed and treated over 200 diseases
Good understanding of anatomy
http://www.touregypt.net/featurestories/imhotep.htm
8
Ancient Greece (5th C. BCE)
Hippocrates – Father of Medicine
Hippocratic Oath – “first, do no harm”
Believed that illness had a natural cause
Image source: http://www.pbs.org/wgbh/nova/body/hippocratic-oath-today.html
9
First medical school (10th-13th c.)
Schola Medica Salernitana Italy
http://www.hektoeninternational.org/Schola-Medica.html
Image source: https://en.wikipedia.org/wiki/File:ScuolaMedicaMiniatura
10
Age of Enlightenment (1700-1800)
Rise of scientific inquiry, independent thinking, reason
The world operates according to unchanging laws of nature
People of reason can make the world better
http://library.thinkquest.org/26466/history_of_democracy.html
Image source: http://2.bp.blogspot.com/_SggBiqeyvJg/SxLEDTSc7yI/AAAAAAAAAvs/xw5Krdh-oIw/s1600/experimentwithanairpump2
11
1765
University of Pennsylvania
1st medical school in US
Technology and Medicine
Anthony Leeuwenhoek (1632-1723)
Invented the 1st microscope able to show bacteria, blood cells
http://www.microscope-microscope.org/basic/microscope-history.htm
Image source: http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=ix4wSR3jdsDRdM&tbnid=GsZB22cWvImBgM:&ved=0CAUQjRw&url=http%3A%2F%2Farchives.microbeworld.org%2Fmicrobes%2Ftools_microscopes.aspx&ei=sOb3UbrIN4364AOZ7oDoDw&bvm=bv.49967636,d.dmg&psig=AFQjCNGWhOK8WfSZTKK0rb6AzlEF_W8GGA&ust=1375287325544071
14
Edward Jenner (1749-1843)
Father of immunology
Vaccination for smallpox
Smallpox highly lethal, very disfiguring
Noticed that milkmaids who contracted coxpox (mild, related type of pox) didn’t contract smallpox
Exposed a little boy to cowpox, then injected him with smallpox – did not contract smallpox
1980 – Smallpox eradicated
http://www.pbs.org/wgbh/aso/databank/entries/dm79sp.html
16
Joseph Lister (1827-1912)
Discovered that antiseptics kill germs and reduce infection
http://en.wikipedia.org/wiki/Listerine
http://fontanapharmacy.com/products/Listerine-Original-Antiseptic-Mouthwash.html
18
Sanitation
Ignaz Semmelweiss (1818-1865) – “the Savior of Mothers”
Florence Nightingale (1820-1910)
http://en.wikipedia.org/wiki/Ignaz_Semmelweis
http://www.biography.com/people/florence-nightingale-9423539
19
Louis Pasteur (1822 – 1895)
Airborne microbes cause disease and putrefaction
Believed that all airborne-diseases could potentially have a vaccine
Developed vaccines for rabies
Discovered “pasteurization” – boiling liquids at a temperature that kills microbes without destroying the taste
http://www.historylearningsite.co.uk/louis_pasteur.htm
20
Robert Koch (1843 – 1910)
“Father of bacteriology”
Credited with finding the cause of tuberculosis, cholera, and anthrax
Meticulous laboratory scientist – developed important lab procedures for studying bacteria
http://www.nobelprize.org/nobel_prizes/medicine/laureates/1905/koch-bio.html
21
Wilhelm Conrad Röntgen
(1845- 1923)
1895 -accidentally discovered x-rays
Scanning technology
1972 – CT scan invented by Godfrey Hounsfield and Allan Cormack
1973 – PET scan invented by Michael Phelps
1981 – 1st MRI invented by Paul Lauterbur and Peter Mansfield
http://www.imaginis.com/ct-scan/brief-history-of-ct
http://www.ehow.com/about_6312378_history-pet-scans.html
http://www.diffen.com/difference/CT_Scan_vs_MRI
23
Robotic Surgery
daVinci System – FDA approved in 2000
2021 – over 7 million surgeries performed
http://en.wikipedia.org/wiki/Da_Vinci_Surgical_System
https://www.davincisurgery.com/#:~:text=Thousands%20of%20surgeons%20around%20the,using%20da%20Vinci%20surgical%20systems
24
Improvements in diagnosis and prevention changed demography of U.S.
1900 –high rates of death from acute illness earlier in life
2000 –high rates of death chronic illness later in life
Implications for longevity
Increase in co-morbidity
Implications for disability rates
Implications for health care costs
http://www.aacc.org/publications/cln/2009/july/PublishingImages/Newsbrief-fig_7-09
25
Technology bending nature
Reproductive technology
Cloning
Stem Cells
Reproductive Technology
Two major advances:
Birth control – 1960’s
Significant impact on the family structure
Fewer births
Mothers older, more financially stable
More infertility problems
Assistive Reproductive Technologies – 1970’s
http://birthcontroltab.com/wp-content/uploads/2012/03/Birth-control-advantages
27
Assistive Reproductive Technologies
IVF – In vitro fertilization – egg fertilized by sperm in a petri dish, implanted back in mother
Louise Brown, born July 25, 1978
1st “Test Tube Baby”
Introcytoplasmic Sperm Injection
Remove the egg, inject sperm directly into the egg, transplant
Used in cases of male infertility
Cloning
Producing an animal in a laboratory that is an exact genetic copy of another
Make a clone activity:
https://learn.genetics.utah.edu/content/cloning/clickandclone
Is it a clone or not game:
https://learn.genetics.utah.edu/content/cloning/cloningornot
Dolly the Sheep – 1st clone (Feb 22, 1997)
http://content.answcdn.com/main/content/img/getty/1/6/1797416
32
Potential uses of cloning:
Cloning research animals to study disease
Cloning stem cells to repair the human body
Cloning animals for pharmaceutical development
Reproducing extinct or dead species or animal (pets, humans)
Risks:
High failure rate
Development problems (large offspring syndrome)
Abnormal gene expression
Should we clone humans?
Stem Cells
Undifferentiated embryonic or adult cells
Used to create differentiated cells for therapeutic purposes
http://altered-states.net/barry/newsletter329/stem_cells_2
35
Medicine’s future
(see Week 6 Learning Resources)
http://s.ngm.com/2011/03/big-idea/img/organ-regeneration-ear-615
36
Not so farfetched?
http://blogs.voanews.com/russia-watch/files/2013/09/Frankenstein1
37
references
https://medicalfuturist.com/20-potential-technological-advances-in-the-future-of-medicine-part-i/#
https://www.livescience.com/64018-longevity-genetic-questioned.html
https://www.gutenberg.org/files/30240/30240-h/30240-h.htm
https://www.medicalnewstoday.com/articles/323343
Health and Technology – Applications
BEHS
1
03: Technology in Contemporary Society
Week 6
Credit: Katherine Im (2021, July)
1
Public Health Movement
Water sanitation
1854- Cholera was found to be caused by contaminated water supply
Late 1800’s – Water treatment, separation of water and sewer lines
1970 – EPA formed; 1st time clean water standards applied at the federal level
Image source: http://www.flickr.com/photos/48722974@N07/4515205247/
3
Immunizations
Before 1900, communicable diseases killed a significant proportion of the population
CDC now recommends 16 childhood vaccinations
Infant mortality declined significantly
http://www.cdc.gov/vaccinesafety/vaccines/multiplevaccines.html
Image Source: http://vaccineresistancemovement.org/wp-content/uploads/2010/05/Universal-Flu-Vaccine1
4
Motor vehicle safety
6x as many drivers today as in 1925
11x as many cars (215 million)
Despite more drivers and vehicles, 90% decrease in annual death rate since 1925
Why?
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4818a1.htm
Image source: https://www.google.com/search?q=click+it+or+ticket&hl=en&qscrl=1&rlz=1T4AURU_enUS502US502&source=lnms&tbm=isch&sa=X&ei=HO_3UcXaBLOx4AP_nYGwCg&ved=0CAcQ_AUoAQ&biw=1440&bih=698#facrc=_&imgdii=_&imgrc=exCiNo6UAu1UXM%3A%3BpAvQMTBs34ea0M%3Bhttp%253A%252F%252Fwww.pinevillepd.com%252Fwp-content%252Fuploads%252F2013%252F05%252FCIOT_daynight %3Bhttp%253A%252F%252Fwww.pinevillepd.com%252Fclick-it-or-ticket%252F%3B900%3B900
5
Better technology
In our vehicles:
head rests, energy-absorbing steering wheels, shatter-resistant windshields, safety belts, car seats
On the road:
breakaway sign and utility poles, improved lighting, barriers separating oncoming traffic, guardrails
In our laws:
enforcement of traffic safety laws reinforced by public education
What safety features are missing in this 1964 vehicle?
7
Food Safety
Pasteurization and sanitation
Regulation of pesticides and processing procedures
Nutritional supplements for improved health
Pellagra – niacin deficiency
Four Ds: diarrhea, dermatitis, dementia, and death
Eliminated by adding niacin to flour
http://www.meijer.com/assets/product_images/styles/xlarge/1001029_041250946823_A_400
8
Fluoridation of water supply
Image source: http://www.globalresearch.ca/wp-content/uploads/2012/06/131568
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4841a1.htm
9
Cavities a problem – usually resulted in tooth loss, infection
Related to poor overall health
1940’s – many communities added fluoride to the water
Highly successful in reducing cavities
Tobacco Use
1940’s and 50’s – research showed a causal relationship between cigarette smoking and lung cancer
Public health efforts:
economic costs of tobacco
treatment and prevention programs
Public policy efforts:
restrictions on cigarette advertising
enforcement of access laws
smoking bans in public places
increased taxation
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4843a2.htm
Image source: http://www.fwweekly.com/wp-content/uploads/2013/01/Smoking-1024×1008
10
Tobacco Use (cont.)
CDC estimates that 1.6 million deaths were prevented by anti-smoking campaigns
Internet has made medical information more accessible (WebMD, Mayo Clinic)
Self-diagnosis by the public –both good and bad
Technology and public health
Pros:
Better educated public
May encourage people to seek needed medical care
May encourage people to seek second opinions
Cons:
Research shows that people tend to believe they are seriously ill when they are not
Physicians feel they have to “compete” with the Internet, undermines their experience and authority
“Cyberchondriasis”
Health care system
http://www.improvingchroniccare.org/index.php?p=ICIC_Expanded&s=156
15
Health care includes:
Medical personnel
Mental health workers
Ancillary health care professionals
Public health workers
Case workers
Hospitals
Insurance companies
Medical information systems
Government agencies, policy makers
Evidence of healthcare system
Hammurabi code (1772 BC)
Establishes physician fees and punishment for malpractice
Healthcare system history
Before 1900:
Little known about disease
Most medical care took place in the home
Doctors not specialized
Most people died of acute illness
After 1900:
1929 – Blue Cross founded at Baylor University – 1st pre-paid hospital insurance
1930 – Blue Shield provided insurance for physician reimbursement
http://www.staysmartstayhealthy.com/health_care_history_inthe_united_states
18
Healthcare system history (cont.)
1955 – 70% of the population had health insurance coverage
1960’s – Medicare and Medicaid enacted
2010 – The Patient Protection and Affordable Care Act
2017 – The American Health Care Act
Cost of Healthcare
(2021)
Average cost per capita in the US $10,586/year
Highest in the world
Switzerland (2nd) $7,317/year
Concerns about the aging population
80% of healthcare costs are spent on 20% of the population, mostly older adults
72 million Baby Boomers
Source: https://worldpopulationreview.com/country-rankings/health-care-costs-by-country
20
Why so expensive?
Patients overutilize specialists
Inefficient and expensive diagnostic process
Billing structure – high incentive to do unnecessary procedures
High cost of pharmaceuticals
Extremely high administrative costs ($900/person)
US is slower than other countries to use technology to become more efficient and accurate
Fear of litigation
Services not well-coordinated
Quality of health care
Does the US have the best healthcare?
It depends…
US is the leader in innovation and research – cancer survival rates rank among the best
High safety standards
BUT:
Fewer physicians per capita than any other developed nation
Life expectancy at birth in the US lags behind the world average by about a year
Infant mortality in higher in the US than in any other developed nation
Focus on illness rather than prevention
Lifestyle choices lead to more chronic illness
http://pjustin.com/2011/03/02/the-paleo-experiment-1-how-to-eat-like-a-caveman/
23
More downside
http://www.census.gov/hhes/www/hlthins/data/incpovhlth/2011/highlights.html
https://policyadvice.net/insurance/insights/how-many-uninsured-americans/
24
Who gets the care? Health disparities among poor, minorities, and women
31 million uninsured –healthcare cost is the largest cause of bankruptcy among working families
According to the World Population Review (2021):
‹#›
https://worldpopulationreview.com/country-rankings/best-healthcare-in-the-world
25
Is healthcare a right?
http://georgiainfo.galileo.usg.edu/gastudiesimages/U.S.%20Constitution%20Preamble%203.htm
26
Is technology or policy the solution?
Medicine
Public Health
Health Care System
Biomedical Research
Technology
One major impact of technology on health and society – longevity
Life expectancy = the number of years the average person is expected to live
Life span = the upper limit of how long a person can live
1900: Life Expectancy = 47 years
2021: Life Expectancy
79.11 years in US (46th in the world)
85.29 years in Hong Kong (highest in the world)
Raises the question: What are the limits of life span?
Anti-aging industry was worth $191.5 billion in 2019
Projected to be worth $421.4 billion by 2030
Obsession with youth and immortality?
Source: https://www.prnewswire.com/news-releases/anti-aging-market-revenue-worth-421-4-billion-by-2030-ps-intelligence-301247104.html#:~:text=Anti%2DAging%20Market%20Revenue%20Worth%20%24421.4%20Billion%20by%202030%3A%20P%26S%20Intelligence,-News%20provided%20by
30
How long can we live?
Jeanne Calment
Oldest living person on record
Lived to 122 (1875-1997)
Jeanne Calment age 20: http://www.grg.org/images/JCalment201895
Jaenne
Calment centenarian: https://encrypted-tbn3.gstatic.com/images?q=tbn:ANd9GcTrnZTdJNaFH7QbcyMYG1dx_941sLeXBmYibvpcb59bPKjk6Na8eA
32
Born the year Alexander Graham Bell made his 1st voice transmission 1
Era of Jesse James gang 1
American Indians forced onto reservations 1
Met Vincent van Gogh 2
1 – http://www.historyorb.com/events-by-year.php
2 – http://anson.ucdavis.edu/~wang/calment.html
http://upload.wikimedia.org/wikipedia/commons/f/f4/Actor_portraying_Alexander_Graham_Bell_in_an_AT%26T_promotional_film_(1926)
http://www.ralphmag.org/CO/butch-cassidy-gang582x450.gif
http://www.artble.com/imgs/3/2/c/55784/vincent_van_gogh
http://myamericanodyssey.com/wp-content/uploads/2012/01/Indian_reservation_1892
33
Key to long life?
It depends…
For the average person:
Genetics contributes about 20-30% to life expectancy
Lifestyle choices are important in living longer and in better health
http://www.smchealth.org/sites/default/files/pictures/AAS/AsianOlderAdult_iStock_000018013869XSmall.JPG
34
Jeanne Calment:
Rode her bicycle until 100 years of age
Attribute her youthfulness to olive oil
BUT…
Ate 2 pounds of chocolate a week
Smoked until age 117
Key to long life?
Key to long life?
Research on “exceptional longevity” (.0017% of the population)
Centenarians (people who live to at least 100)
Super-centenarians (people who live to at least 110)
Genetics has a strong influence on fighting off disease
Key behavioral indicator: Immunity from stress
Image source: http://genomics.xprize.org/sites/genomics.xprize.org/files/styles/250×250/public/centenarians/Della%20Lundquist%20(centenarian%20at%20her%20100th%20birthday%20party) ?itok=R3pOivIq
36
How long can we live?
Experts think that the upper limit of human life span is about 122.
Advances in technology and longevity are likely to make the population have a longer life expectancy overall, but not increase life span.
Summary
Technology and health are closely linked
Significant implications for society
Ethics (cloning, stem cells)
Health care – human right or not?
Longevity
Can we live forever?
Should we?
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