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MODERN TECHNOLOGY IN
MEDICINE AND HEALTHCARE
Chapter 0
Module Introduction
Millions are Dying
• Fact:
Chronic Diseases kill Millions each year.
• Chronic diseases are the leading cause of death worldwide, resulting in roughly 40 million
deaths each year. They kill more people annually than any other cause (e.g. infectious
diseases, accidents, war, famine etc.).
• To place this number in perspective, the 2nd world war caused approximately 80 million
deaths over 6 years. This means that chronic diseases kills as many people as three
world wars running concurrently at the same time!
• Chronic diseases severely affects the quality of life of many and pose as a heavy financial
burden on individual families, as well as raising healthcare spending by governments.
• 80% of all deaths due to chronic diseases occur in low income countries, where the
diseases push many families into poverty due to heavy medical bills and loss of income.
GEH1032 Sem 1 2019-20 TK Chan Source: WHO World Population Ageing Report 2015, World Population prospects: 2015 Revision, Department of Statistics Singapore
Chronic Diseases
What are chronic diseases?
• Chronic diseases are long-term, generally incurable illness or condition that affect a person’s
daily life and require ongoing medical attention.
• They are non-infectious, incapable of being transmitted from one person to another.
• They are usually caused by the malfunctioning, breakdown or damage to body systems,
resulting in abnormal health conditions, i.e. diseases. Some common chronic diseases are heart
disease, stroke, cancer, arthritis, chronic lung disease, diabetes, osteoarthritis, dementia etc.
➢ Life expectancy at birth has risen substantially across the world. In 2015, life expectancy is
78 years in developed countries and 68 years in developing regions. In the 1900s, average
life expectancy was 45 to 50 years in the developed countries of that time.
Singapore: 80.7 for males, 85.2 for females (2017)1
➢ Total fertility rate has decreased significantly from 5 children per woman in the 1950s to 2.5
children in 2015 (global average). Singapore: 1.16 per woman (2017)2
➢ The elderly population (aged 60 years and above) stands at 901 million globally in 2015.
This number is expected to more than double to 2.1 billion by the year 2050. FYI
GEH1032 Sem 1 2019-20 TK Chan Source: WHO World Population Ageing Report 2015, World Population prospects: 2015 Revision, Department of Statistics Singapore
2050 FYI
World Population Demographics
Number of People
1950 2019
Year
In Singapore, the number of citizens aged 65 and above is
increasing rapidly. The elderly population has doubled
from 220,000 in 2000 to 440,000 today, and is expected to
increase to 900,000 by 2030.
Singapore is already the oldest nation in Southeast Asia.
The size of our elderly population is projected to more
than double that of the population of young people aged
15 and below by the year 2030.
Our ageing population will create profound challenges for
the country and the impact is already being felt today, e.g.
Straits Times 06 Dec 2017 rising healthcare expenditure, falling student numbers etc.
GEH1032 Sem 1 2019-20 TK Chan Source: UN Concise Report on World Population 2014, WHO World Population Ageing Report 2015, World Population prospects: 2015 Revision
Old Age Support Ratio
• The Old Age Support Ratio is the most commonly quoted statistic that provides a measure of the
extent and the burden of population ageing. This is also known as the Potential Support Ratio.
• This ratio refers to the number of people of working age supporting every elderly person.
• In Singapore, the support ratio is 4.8 in 2018 and this is projected to decrease to about 2.0
working adults per elderly by 2050.
13.5
Singapore Old Age Support Ratio*
11.3
10.5
9
7.4
5.7 5.4 5.1 4.8
• This ratio is not universally relevant to all aspects of human society. Its usefulness depends on
the specific contexts that we are considering. Using it as the sole indicator of all the various
effects of population ageing may be misleading.
• For healthcare demand and expenditure, the support ratio does not provide the full picture.
This is because it is not the elderly, but the people who are ill that require healthcare.
• More accurate indicators are the proportion of population who are in ill-health or the average
proportion of life lived in ill-health per person. Alternatively, we can consider the average
number of healthy years lived per person.
“ … while life expectancy rose over the past decade, healthy years rose faster.”
GEH1032 Sem 1 2019-20 TK Chan
Lifestyle Risk Factors for Chronic Diseases
Non-Modifiable Risk Factors
• Non-modifiable risk factors are factors that we are unable to alter or change.
• Examples: Age, Ethnic Background, Family History etc.
• The Notorious 5 risk factors are expressed through the intermediate medical risk factors such
as high blood pressure (hypertension), high blood glucose levels (hyperglycemia), high blood
cholesterol (particularly LDL cholesterol), low bone density (osteoporosis) etc.
• Many believe that if people develop chronic disease due to unhealthy lifestyles, they have no one
but themselves to blame. However, individual responsibility can have its full effect in reducing
lifestyle induced chronic diseases only if individuals
➢ are educated early in life on the importance of healthy living/aging and healthy life choices
➢ have reasonable access to healthy food and healthy living
➢ are encouraged by family and supported by society/government to make healthy life choices
How well chronic diseases are managed may determine whether the increase in
healthcare demand and spending will remain sustainable in the future.
▪ Reduce mortality (i.e. deaths from diseases) among patients, effectively extending life
span of the population while at the same time preserving the quality of life.
GEH1032 Sem 1 2019-20 TK Chan
Effective Use of Healthcare and Medical Technology
Some words of caution on Medical Technology:
➢ Research and implementation of new medical technology are expensive and they
cause a rise in healthcare spending.
Newer and advanced medical technology have been shown to contribute significantly to the
increase of healthcare costs, both for government and the patient. However, advancement in
medical technology serves to reduce disease incidences and to return sick people back into
health, who then return to contribute to the workforce and economy. The interdependency
between these factors are complex and not yet entirely understood.
• The module will concentrate on the applications of such medical technology in the
detection and treatment of age-related chronic diseases such as cancer, ischemic stroke
and heart disease (atherosclerosis), Alzheimer’s and Parkinson’s diseases, diabetes etc.
• Modern medical technology that we shall discuss can be broadly categorized into:
➢ Technology used for imaging (i.e. to look within the body)
➢ Technology used for treatment (i.e. to remove or kill the disease cells etc.)
• Physical units will be involved: e.g. nanometers (nm), centimeters per second (cm/s),
electron volts (eV), Joules per square meter (J/m2), Megahertz (MHz), tesla (T) etc.
• Physical constants will be involved: Plank’s constant h, speed of light c , electron charge
e, electron mass me etc.
• Formula sheet (equations and constants) will be given in the exam and term tests.
• You will need to know how to use a non-programmable scientific calculator. This is
required in both tests and exams.
(b) Final exam – 50% (Closed book, MCQs, MRQs + Long Answer Questions)
➢ The final exam will not only test your knowledge of the course content, but also
your display of your understanding, both in breadth as well as depth.
➢ A reasonable command of English is required, along with legible handwriting and
some sketching skills.
Consultation
• Preferred consultation mode is via email.
• Simple questions requiring short to moderate-length answers: via email or approach
me after the lectures.
• Complicated questions requiring long answers: Arrange for consultation date/time
over email.
I may not always be in office, so I urge all who need consultations with me
to always contact me via email.