The Future of Health, Wellness, and Wellbeing
By Alexandra Whittington, Steve Wells, and Rohit Talwar
How will we stay healthy in the 2020’s?
The future health agenda will be shaped by the convergence of strong forces from across society. Key factors include rising incidence of lifestyle conditions such as obesity and diabetes, an ageing society, escalating mental health challenges, medical breakthroughs, personalised health technologies, growing costs of care, and increased societal expectations. Here are some of the major developments in health, wellness, and wellbeing we see having an impact over the next several years.
Now to 2020
Evolving Attitudes to Mental Health
The issue of mental health is evolving from ‘my little secret’ to ‘our collective responsibility’. Hence mental health issues are being reconceived as just another illness for which we should not feel shame but should simply seek help. Increasing acceptance of the mental health challenges that go with life in the 21st century is allowing employees to seek effective diagnosis and treatment. This in turn should help reduce sickness absence and improve productivity. The notion of health and safety at work will also be expanded to include mental as well as physical attributes.
Individual Ownership of Health, Wellness, and Wellbeing
Companies and governments are placing greater emphasis on individuals’ responsibility for wellness. Private and social health systems are increasingly encouraging people to take preventative measures (diet, exercise, lifestyle choices) that reduce health risk factors. Health insurers are even using personal health monitoring technologies such as Fitbits to encourage customers to exercise: the more they exercise, the cheaper their health insurance.(1)
Increasing Significance of Fitness and Health
In the face of burgeoning healthcare costs and stratospherically unmanageable future projections, the importance of exercise, healthy dietary habits, and mental fitness will increasingly be emphasised. They will be promoted as the best and most cost-effective tactics against rising obesity and stress epidemics around the world, and to support aging Western societies. The focus will also intensify on employer health and wellness programs as a benefit to both the employee and employer in helping to minimise days lost through ill health.
Diagnostic Toilets, Watches, and Other Wellness Gadgets
The next few years will see a near exponential growth in the number of household and personal gadgets with health monitoring properties. Diagnostic toilets are already commonplace, and the next generation could detect metabolites, infections, sugar levels, intestinal microbiome, and even some cancer precursors.(2) Wearable and implantable medical devices already monitor vital signs and will increasingly diagnose conditions in real-time and transmit the data to an app or medical professional.(3) Over time, these devices will become increasingly sophisticated, adding visual recognition, sensors, and artificial intelligence (AI) analysis tools to diagnose a growing number of physical and mental health conditions.
Growth in e-Health/m-Health
The medical technology (MedTech) field is exploding with investment in new e-Heath and m-Health applications and devices. The US National Institutes of Health defines e-health as the "intersection of medical informatics, public health, and business, referring to health services and information delivered or enhanced through the Internet and related technologies."(4) Meanwhile, m-health is the "use of mobile and wireless devices to improve health outcomes, healthcare services, and health research."(5) The common factor is the use of big data, smart analytics, and reliable connectivity at the system and individual patient level in support of effective service configuration and delivery, patient engagement, and positive health outcomes.
Patient Monitoring and Advising from a Distance
The market for e-health services is projected to reach US $132Bn by 2023 (up from US $47.6Bn in 2018) including remote patient monitoring, mobile, and telehealth applications.(6) Remote patient monitoring is seen as an economically effective response to the rising healthcare costs that often accompany chronic conditions associated with an aging population and lifestyle risk factors.
2021-2026
Apps and e-Services to Diagnose and Manage Mental Health
The American Psychological Association estimates there are now 10,000 downloadable mobile apps to address common mental health problems like depression and anxiety.(7) The apps normalise conditions and can be used in combination with on-line and physical consultations with the patient’s healthcare professional.
Mental Health Identified as a Primary Driver of Future Societal Cohesion
Awareness is spreading of society’s mental health challenges. As a result, evidence may emerge about the relationship of individuals’ psychological wellbeing to the broader health of society. We may also uncover deeper insights on how more functional communities and societies address psychological disorders. Indeed, social cohesion is identified as one of the key characteristics of a resilient city. In response, the context for initiatives in approximately 100 major cities (e.g. Resilient Rotterdam)(8) is now one of developing resilience to the physical, social and economic challenges that current and future societies face.
Genetic Medicine / Personalised Medicine
The ability to treat disease is becoming specific enough to enable clinicians to move away from generic approaches to handling conditions. Personalisation provides individually targeted treatments and drugs tailored to a patient’s risk indicators, DNA, or microbiome profile. Localised hub pharmacies are likely to process the inactive carrier substances (excipients) and active ingredients to create personalised prescriptions and distribute the final medication to the patient by autonomous vehicle or drone.
Cheap Cancer Screening at Home
Cancer represents a broad range of conditions, but a number of them could be covered by a range of non-invasive diagnostic home test kits. For example, a simple, inexpensive saliva test will soon be available to detect tumour signatures in a subject’s saliva, which may enable early detection in the home rather than the clinic.(9) Could the use of such self-diagnostic technologies ever be a factor in an individual acquiring health insurance or even a job?
New Cures from Bacteria That Live in the Human Body
Medical science is building a growing understanding of the microbiome – the tiny organisms, including bacteria, that live in the human body.(10) The hope is that combining these insights with techniques from synthetic biology may result in major discoveries related to a variety of conditions. Microbes are something that synthetic biologists see as highly engineerable and capable of providing the tools to treat a range of conditions. If successful, applications could include digestive disorders (e.g. ulcerative colitis and inflammatory bowel disease), Type 1 diabetes, mouth sores caused by chemotherapy, and the prevention of HIV infections.
Medical Tricorders
Star Trek offered us a tantalising glimpse of the ultimate in futuristic technologies – including the Tricorder which could scan and treat a vast range of conditions. A $10M Tricorder XPRIZE competition was launched in 2012 and a number of promising candidates emerged. A few years on and instant medical diagnosis device may be within reach after MIT researchers used a Nokia 770 tablet as the basis for a Tricorder. The result is DxtER, a small unit with a range of specific medical peripherals, including a sensor for heart and lung sounds, and an ECG monitor for measuring heart rate and rhythm. The solution also includes a device for analysing blood glucose and white cell count - a sign of infection and inflammation when raised.(11) The use of increasingly sophisticated Tricorder-type devices could reveal acute medical conditions sooner than might otherwise be the case, helping to ensure early treatment for better patient outcomes.
A 2020’s Healthcare Revolution
Self-management, mental health, personalised medicine, and medical innovation are vital drivers of the health care transformation that is now underway. As these examples show, by the 2030’s we may gain the ability to push the medical horizon even further, perhaps with drastically improved genetic treatments, extended lifespans, and elimination of major diseases.
Simultaneously, a growing gap between needs and resources suggests governments will be looking to drive responsibility to the individual – encouraging, incentivising, and punishing us towards better self-care, including physical health, diet, and mental wellbeing. These kinds of insights are useful for highlighting future opportunities in the medical ecosystem. Self-care, for example, could be a major growth sector in the economy and a driver of health tourism in the 2020’s. The future of health and wellness is a vital area to monitor into the next decade and beyond.
References:
1. https://www.ft.com/content/bb9f1ce8-f84b-11e6-bd4e-68d53499ed71
2. https://www.digitaltrends.com/cool-tech/the-modern-toilet-in-our-homes-and-businesses-have-evolved/
3. https://www.marketwatch.com/press-release/diagnostic-wearable-medical-devices-market-size-analytical-overview-growth-factors-demand-and-trends-forecast-to-2025-2019-03-12
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1761894/
5. https://www.himss.org/dinitions-mhealth.
6. https://www.digitaljournal.com/pr/4198806
7. https://gadgetsandwearables.com/2019/03/08/mental-health-apps/
8. https://100resilientcities.org/cities/rotterdam/
9. https://www.stateofthefuture.ae/
10. https://www.weforum.org/agenda/2014/08/14-technology-predictions-2020/
11. https://www.zdnet.com/article/building-the-tricorder-the-race-to-create-a-real-life-star-trek-medical-scanner/