myforesight - health & lifestyle

LEADER’SINSIGHTSIn Person withProf. Datin Dr. Clara L. Chee

EXPERTS’INSIGHTSLinking Foresightto Action: A HealthCase Study

COVERSTORYPreserving HEALTH@ Home: a LIFESTYLEThat Pays

VIEWPOINTSConsumerismTrend in Malaysia

04 14 1806

02/2013

Preserving

HEALTH@Home:aLIFESTYLE

That Pays

TOWARDSEXCELLENCE IN

RAIL INNOVATION,SUSTAINABILITY

AND MOBILITY

Register your interest with us at www.railbusinessasia.orgContact us at +603 2176 8705 or email us at [email protected]

HOSTED BY : MEDIA PARTNERS : SUPPORTED BY :ORGANISED BY :

ADVISORMohd Yusoff Sulaiman

EDITOR-IN-CHIEFRushdi Abdul Rahim

WRITERSProf Datin Dr. Clara L. CheeLois MacklinLeah SorokaMohd Afzanizam Mohd BadrinMohd Hasan Mohd SaaidAni Suzila AnasNatrah Mohd Emran

CONTRIBuTORSNorsam Tasli Mohd RazaliAmallia Ahmad ZainiAhmad Nazri AbudinHanis Husna Bazin

PuBLISHED BY

Malaysian Foresight InstituteMIGHT3517, Jalan Teknokrat 563000 Cyberjaya,Selangor Darul Ehsanwww.myforesight.my

FOR INQuIRIESmyForesight®

Phone : +603 8315 7888Fax : +603 8312 0300E-mail : [email protected] : www.myforesight.my

DISCLAIMERAny article included in thispublication and/or opinionsexpressed therein do notnecessarily reflect the views of themyForesight® but remain solelythose of the author(s).

The Publisher is not to be heldresponsible for any copyrightviolation of articles, which havebeen provided by contributingwriters

PP17630/12/2012(031478)

EDITORIAL BOARD

features

04 06 14

02/2013

inside25EDITOR’S NOTE

03 Initial Thoughts

LEADER'S INSIGHTS04 In person with

Prof Datin. Dr. Clara L.Chee

EXPERTS' INSIGHTS06 Linking Foresight to Action: A Health Case Study

COVER STORY14 Preserving HEALTH @ Home: a LIFESTYLE That Pays

VIEWPOINTS18 Consumerism Trend in Malaysia

25 Non-Communicable Diseases (NCDs)Is it a future without hope?

31 Family & Home: The Next Decade

34 FORESIGHT INTERCONNECT™myForesight® Book Club

INFOGRAPHICS35 Envisioning The Future of Health Technology

36 Youth-Consumerism

38 Baby & Gadget

40 A Lifetime of Medical Check-ups

02/2013myForesight®

3

myForesight®

3

InitialThoughts

editor’s note

BY

RuSHDI ABDuL [email protected]

The recent passing away of YBhg. Datuk Dr.Mahani Zainal Abidin, Chief Executive of ISIS

is indeed a big loss to Malaysia and foresight. Shehas been one of the proponents and supporterof technology foresight and her insights wouldbe missed. Our condolences also goes to thefamily of Ms. Natrah Mohd Emran, myForesight®senior analyst on the passing of her father on thevery same day. Both lost their lives to cancer, aleading cause of death accounting for morethan 7 million deaths annually worldwide. Grimstatistics indeed.

The passing of the people you know has theeffect of making us be reflective and take a lookat how we conduct ourselves; certainly oursedentary lifestyle needs to change, a boost andTLC perhaps – I mean not just Tender, Loving andCare but also Therapeutic Lifestyle Changes toour mental, medical and public health. As westrive towards becoming a high income society,work has taken precedence over our well-being;neglecting the needs of our physical being. Ourlifestyle is perhaps ill suited to what our bodyneeds. A statistic released by World HealthOrganization projected that by 2030 theproportion of total global deaths due to lifestylediseases is expected to increase to about 70percent. You can read more on these lifestylediseases in “Non-Communicable Diseases (NCDs):a Future without hope?

We are all aware that lifestyles are determined bya variable causes; upbringing and values as wellas influences in the cultural, physical, economic,and political environments. It is without a doubt,

technology has encroached into almost everyaspect of our life. Technology has become sopervasive that unconsciously we have becometoo dependent on it to an extent that some viewtechnology as a destructive force of our lives and values.

Therefore, in this issue we’ll discuss abouttechnology influences in our lifestyle. As a casestudy, we cite linking foresight to action forCanada whereby the paper focuses on how todeliver foresight insights to key decision makers– initiatives jointly undertaken by the Science andTechnology Foresight Policy Division of HealthCanada and Alberta Innovates – TechnologyFutures. The piece on ‘Family & Home: The NextDecade’ dwells on the issues of technology

influencing the future homes. Whereas the articleon ‘Home healthcare’ uncovers on how home isbeing transformed to be center for futurehealthcare and wellness.

myForesight® also had the opportunity tocapture the views of Prof. Datin Dr. Clara L. Chee;founder and chairman of Clara International. Hereshe shares her thoughts and views on the needto maintain a healthy lifestyle. Her holistic viewon beauty and the importance of balancing ourlives by going back to nature and takingadvantage of technology to improve life issomething we could take on board.

We can’t address lifestyle without talking about howwe consume things. Therefore in this issue we providea piece on consumerism – consumer lifestyles(called psychographics) and how it becomes animportant factor in determining how consumersmake their purchase decision. The article‘Consumerism trend in Malaysia’ provides insightson how consumerism interacts and intertwinedwith many other trends hence, influences ourcurrent and future behavior and culture.

Speaking of consumption, we are approachingthe holy month of Ramadhan soon. It is a time forinner reflection, devotion to God, and self-control.Perhaps the timing is right; not just for the Muslims,to provide a break from our overindulgence –towards a healthier lifestyle regime.

We hope you find this issue beneficial. Wishingyou great months ahead.

“

Hi, greetings from myForesight®.I am starting this editorial with a somber mood.

”

Our condolence goesto the family of DatukDr. Mahani ZainalAbidin & Mr. MohdEmran Abdullah. Bothlost their lives tocancer, a leadingcause of deathaccounting for morethan 7 million deathsannually worldwide.

02/2013 myForesight®

4

leader’s insights

Prof Datin Dr. Clara L. Chee In person with

The Cosmeceutical industry

I’ve been in this industry for more than 30 years.And I can see that the industry is expanding

and growing ever since. Back in the early days,women were more concern about beauty andlong term care. However, today young girls and boyshave started to take care of their skin once theyreach puberty. Today’s active lifestyle – rich in proteinand carbohydrate diet, the environment and thehormonal changes – has all contributed to thechanges and problems of the skin. Thus, early skincare and treatment is very important.

Now, beauty and fashion is no longer associatedor exclusive for women only. There are also risingawareness among men. Everyone has started totake extra effort in ensuring a healthy and goodskin. For instance, during a job interview it iscrucial for you to look presentable. Smart looking,tidy and confident is essential in almost everyprofession. In order to have self-confidence, youhave to care of how you look, and also yourhealth. All these factors definitely contribute tothe growth of this industry.

Definition of BeautyTo me beauty means healthy skin with naturallook that makes people feels comfortable andpleasant. It should come from within. The radianceand aura reflected the beauty from your heartthrough your appearance. Looking beautiful fromthe inside (kind hearted) and outside.

Healthy lifestyle is also important, and this startsfrom home. It is the duty of the parents to teachtheir young ones good manners, being respectfuland thankful. Good human characteristic is alsorequired so that we can lead a happy andharmonious life within the society. We need to bebalanced physically, mentally and spiritually.

Secrets to youthful looking skinSkin protection and taking good care of our skinis important, especially if we wish to maintain theyouthful look even at the later age. We need to

ensure that we have a good skin care productrange that is suitable to our climate and weather.Lifestyle and culture can also give certain impactto our skin. The westerners, with temperateweather, love to get under the sun and gettanned. They have less melanocyte; therefore,they need not have to worry about gettingpigmentation. Malaysia is blessed with hot sunthroughout the year. Therefore, the need for skincare and protection products that are suitable fortropical humidity and heat are crucial asoverexposure to the sun damages your skin.

Back to nature productsDuring my childhood, I was exposed to theformulae using natural and herbal ingredient inmy daily life. My father used his own formula toproduce his own hair pomade by mixingpetroleum gel with jasmine flower. Even mymother used ‘jamu’, herbs and vegetable as herbeauty care ingredients. Both my parents inspireme to further my study in formula science. Whileothers are using orthodox drugs such asparacetamol, antibiotics and so on, we use herbsand vegetable from our own garden that are freefrom pesticide to cure sickness and preventillness. You see, going back to basic comesnaturally to me; it is so much in me.

A niche marketI graduated with a degree in Science (Chemistry) and,later on, the Honorary Doctorate (PhD) in Medicinaland Cosmetic Products Technology. I believe that theexposure I gained while studying abroad has givenme a very good reasoning power. I learnt that the

basic materials of beauty products are mainlypetroleum based or mineral-oil based. There was, andstill is, a huge tank of this substance ready for toiletriesproduction that would be exported under differentbrands to many countries like Australia, US, Singapore,and Hong Kong. So I thought, what has beenformulated there might not be suitable to bemarketed to tropical climate countries. From there onI started to formulate my own products that are herbalbased. I then shared my idea and experience withMalaysian Herbal Corporation (MHC) back in 1997,and also to other local players to encouragecommercialisation of local herbs and cosmeceutics.

Please don’t be confused on the difference betweencosmeceutics and toiletries. Toiletries functions as acleanser, to clean skin but not enriching or enhancing it.Meanwhile cosmeceutics contains active ingredientssuch as herbal extracts to help nourish and care forthe skin. It acts to improve your skin to be healthier. Askin treatment product that is safe, clean and ‘halal’.

Healthy lifestyle the natural wayWe are also spreading our wings to the nextdimension in ensuring and maintaining healthylook and lifestyle. We are currently workingclosely with Forest Research Institute Malaysia(FRIM) to identify the active ingredients for herbalformulation for halal herbal capsule. We also didR&D together with Institute Medical Research(IMR) to formulate the alternative to HormonalReplacement Therapy (HRT).

There are cases reported on the after effect of theHRT such as breast and womb cancer. Having thisin mind, we opt to use herbs as the alternative toprevent and also cure illness.

Now, beauty and fashionis no longer associatedor exclusive for womenonly. There are alsorising awareness amongthe men.


5

leader’s insights

Trends in skin care products’developmentA lot has been happening in the local herbalindustry since the late 90’s, both positively andnegatively. The worrying and disturbing trendswould be the introduction of hormonalingredients for beauty treatment. Hormonalingredients in skin care products might beharmful and damaging to your internal organssuch as liver and kidney. Long term usage maycause adverse effects. For example, excessive useof placenta cream or lanolin cream can causeextra hair growth on skin. Sadly, the innocentconsumers are always confused by misleadinginformation and advertisement in the market. However, there is also positive inclination in this industry towards a more healthy, natural andclean products. I strongly emphasize in usingherbal based products in skin care. In my case, Ifelt very blessed and thankful by the environment

I am in. We have strong government support andinitiatives like what is being offered by the EastCoast Economic Region (ECER), and good climateto plant our own raw material. I can claim that herbsfrom tropical climate are the most powerful. However,lack of promotions on their special properties hasresulted in low appreciation on our local herbs.

I am a very keen advocate in halal practices and halalherbal products. Halal or “Chin Chan” is clean, trueand safe. It is not only for the Muslim. I havepreached this understanding to my counterpartin China back in 1993. I believe, with these threeelements, there will be no harm and no sideeffects. A simple example is in food preparation, ifit is halal it will not cause food poisoning or diarrhoea.Therefore, we worked for halal formulation andall of our products are certified Halal.

Nip-Tuck on the riseI have a feeling, as an adult, we have to educateour young generations to value what has beengifted to us by God. The features that we havenow are from God, and we are the most perfectcreation to represent our ancestor. We should feelproud and respect it.

Originally, plastic or cosmetic surgery is to helpreconstruct damages due to misfortunes such asburnt and deformation. It is to give the patientstheir original look, not modifying it. But, nowadayswe can see many people are undergoing plastic

surgeries for beauty purposes. We have readnumerous cases of botched cosmetic surgeriesreported over the years, which even led to deathcases. One will always have to weigh all the riskand benefits of cosmetic procedure beforemaking any commitment. And we should realizethat this kind of human made beauty is notinherited. The child of a person who did plasticsurgery will inherit their parents’ original look. Iam afraid that this trend can be a cause of brokenmarriage, especially if it is solely based on looks.And, to me, honesty definitely plays a role.

There is also misleading understanding on Botoxtreatment, another hormonal (toxic) treatment whichcan lead to skin cancer. This is what happened whenwrong introductions were made in promoting beauty.

Developing Resources in AestheticsI have started a college on the second year ofClara’s establishment. It is first known as ClaraBeauty Treatment Centre & Therapy Academy.The trainers are all my comrades during the studyyears. The students have to undergo aestheticexamination where they are being evaluated andgraded based on international standards byinternational examiners. Our certificates are globallyrecognised. We are the first college recognised bythe Malaysian Qualifications Agency (MQA) foraesthetic education.

Currently we have schools in all major statesthroughout the country. Since its establishment,we have trained over 10,000 graduates and thereare high demands for them locally and overseas,especially from Singapore and China. We alsohave students from different countries like Japan,France, Africa, India and the neighbouring countries.We even have male students in our academy and,surprisingly, they are more saleable!

High Technology in HerbalI was motivated with the advancement of hightechnology because only through technology I’llbe able to come out with more formulation. AndI can also apply this in the manufacturing line.

Our factory is certified with the halal and goodmanufacturing practise (GMP) certification andwe are also a BioNexus company.

Ultimately, high technology is critical in promotingHerbal industry. It is a promising market and hashigh potential. I urge for continuous supportsfrom the government, especially in terms ofgrants, so that we can do more clinical study. Weshould also emphasis on herbal cultivation toensure continuous supply for the local industry.We have all the advantages here in Malaysia …. Imean, why not take the opportunities and exploremore? Plant more! Formulate and produce localquality product. I believe that one day the worldwill look for our products. But first, we have tobelieve in our herbs to bring it to the next stage.

It acts to improve yourskin to be healthier.A skin treatmentproduct that is safe,clean and ‘halal’.

Prof.Datin Dr. Clara L.CHEEFounder & ChairmanCLARA InternationalProf. Datin. Dr. Clara L. Chee is Malaysia’s renownedcosmetologist, entrepreneur and lecturer who startedher own beauty business since 1977. From a very humblebeginning her beauty empire has expanded intoSouth-East-Asia market known as the ClaraInternational Beauty Group which encompassedherbal based skin care and beauty treatmentproduct, beauty center franchisee and distributionship and Aesthetic College.

She received her Degree in Science (Chemistry)from University of Missouri, USA in 1983. In 1990 shewent to University of De Monfort, United Kingdom(formerly known as Leicester Polytechnic) to furtherknowledge and research in medicinal & CosmeticProducts Technology. She was later conferred theHonorary Doctorate (Ph.D) title in Cosmetic Science &technology in 1996 from Pacific Western University USA.

She also holds position as the Head of research &development for Best Cosmetics Laboratories Sdn.Bhd, President of Malaysian Beauty TherapyAssociation (MBTA), Chairman of CIDESCOMalaysian Section, Director of Artiste Academy,South East Asia and many others.


6

LINkING FORESIGHT TO ACTION:

A HEALTH CASE STuDY

Lois Macklin, B.Sc., M.A., Ph.D.Principal Business Advisor-ForesightAlberta Innovates-Technology [email protected]

BY

Leah Soroka, B.Comm. M.Sc.Director, S&T Foresight and Science PromotionDivision Science Policy Directorate of Health [email protected]

experts’ insights

SummaryIn Canada, a federal government department and a provincially owned research corporation have collaboratively implemented a majorforesight initiative designed to anticipate future challenges and opportunities related to improving the health status of Canadians in asingle generation (to 2030). The premise underpinning the project design was that simply conducting foresight activities is often insufficientto effect forward looking decisions or behavioural change. Foresight activities must be designed with the intent to take action. This paperfocuses on the cumulative learnings about how to deliver foresight insights to key decision makers in a way that impacts present daydecisions. The following is a summary of the key learnings from the Health Foresight Initiative that the authors consider useful contributionsto the field of foresight.


7

experts’ insights

1) Deep understanding of emergent complexissues takes multiple conversations spread overa sufficient period of time to allow reflection.Several iterations of the large and smallengagement sequence are required to achieve adeeper understanding of the forces and factorsat play and how they interrelate. Arriving atrecommendations that result in the implementationof complex adaptive management responsesmay require several months of ongoing work andprovocative discussion.

2) Workshops that engage larger numbers ofparticipants typically make only incrementalcontributions to current knowledge. Large group events surface a plethora of ideasand perspectives but rarely generate more thanincremental advances in thinking.

3) Highly innovative thinking is best done bysmall groups of high intensity creatives.Certain dynamic thinkers have an innate ability to“reperceive” and challenge deeply held assumptions.

They produce the best work in small group settingsbut make valuable contributions in large groupsthrough the introduction of provocative ideas.

4) Decision makers must be engaged bothintellectually and emotionally.The presentation of foresight findings in the form of awell-written rationale and strategic plan is not necessarilysufficient to ensure consideration by decision makers.Emotional connectivity must be established throughthe use of provocative engagement processes andmultiple media (e.g., video, music, and voice) reportingand communication mechanisms.

5) The leadership of a major foresight projectrequires a complex and unique set of skills.More than good management skills are requiredto design, organize and execute a major foresightevent. The responsibility requires a uniquecombination of leadership, abstract thinking,experimentation and organizational abilities thathas yet to be fully appreciated by many whocommission foresight projects.

6) Development of a cascading communicationsstrategy is critical for presentation of foresightfindings to key decision makers.Frequent cascading communications tailored totargeted decision makers expands the capacityof the recipients to embrace new ideas andcommit to action.

• At the time of this writing, the insights andfindings of the Health Foresight Initiative are being linked to key strategic decision making andplanning processes within both participating organizations. At Health Canada, a set of recommendations for short, medium and longerterm actions that will provide both quick resultsand business continuity have been presentedthrough a series of presentations and publications.Alberta Innovates-Technology Futures has incorporated the findings into a corporate Health Research and Investment Strategy for consideration by the Board of Directors.

1. IntroductionBetween December 2009 and March 2011,a major collaborative foresight initiative wasundertaken by the Science and TechnologyForesight Policy Division of Health Canada(a federal government department) andAlberta Innovates-Technology Futures (aprovincially owned research institution).The project (referred to in this paper as theHealth Foresight Initiative) involved theimplementation of an iterative multi-faceted foresight process to gain newinsights and understanding about scienceand technology investments that could betaken today, which would contribute toimproving the health of Canadians in asingle generation (to 2030).

The Health Foresight Initiative wasconceptualized and designed to overcomethe challenges related to translating theknowledge and insights gained from foresightactivities into tangible recommendationsthat result in actionable decisions. Withinthe context of government bureaucracies,

powerful system-level impediments makethe utilization of foresight findings for thepurposes of public policy developmentdifficult. In the demanding milieu of the ofthe public service, these constraints canlimit the efficacy of foresight as a decisionmaking tool (Macklin, 2010).

This paper is a report on the work of theHealth Foresight Initiative. It explores thesource of impediments to translatingforesight insights into action and then goeson to describe the design considerationsemployed during the Initiative to overcomethese real or perceived barriers. Bypresenting this case study, the authorshope to make a valuable contribution to avoid in the literature related to linkingforesight to actionable decisions.

1.1 Why It Is Difficult To Link Foresight to ActionMany organizations, including government,increasingly recognize the value of long-term thinking to inform strategic planningprocesses. However, a review of foresightliterature indicates that the generation ofnew ideas and insights through strategic

conversations is insufficient to lead toaction. In part, this may be due to thechallenges of making decisions in the faceof complexity, but it is also related to aperception by senior decision makers of riskand being overwhelmed. Acting uponthese ideas and insights often requiressignificant system level transformationsthat challenge traditional approaches anddecision making processes.

Research shows that human decisionmaking in any complex context is difficult(Brehmer, 1992; Chermack, 2004; Dorner,1996). Brehmer (1992) suggests thatdecision making in such contexts is oftencomplicated by:1) the requirement for a series of decisions

rather than a single decision, 2) interdependence; in that current decisions

constrain future decisions, 3) an environment that changes as a result

of decisions made, and4) the need for critical timing and correct

ordering.Furthermore, differing space and timeperspectives may be expected to impact

decision making by bringing differentapproaches and priorities (Slaughter, 1993).In the realm of public service, decisionmaking is particularly complex. To startwith, every public policy has three keyelements: problem definition, the setting ofgoals and outcomes, and the choice ofpolicy instrument whereby those goals areachieved and the problems addressed (Pal,2006). The choice of policy instrumentsmust facilitate achievement of the desiredgoals and outcomes. Furthermore, horizontalalignment is required with other policyagendas that exist at the regional, national,and international level. Development ofeach element occurs at a different stage ofthe public policy making process and is initself complex. Consequently, the moremultifaceted the issue the more difficult itis to define the problems, set policy goalsand make decisions about how to achievethe desired goals. This difficulty is particularlyexacerbated when decisions made in the presentmust accommodate the changes and

uncertainty that occur over long periods of time.The complexity of undertaking decisions inthe public arena is further compounded bythe capricious nature of politics. There is anexpectation for a high degree of certaintythat generally cannot be found whenaddressing such complex issues, whichmakes it very difficult for decision makers inthe public service to undertake proactivedecisions without incurring political risk.Increasing public scrutiny combined withthe short electoral cycle means that electedofficials are highly incented to deliver shortterm goods and benefits and delay theimposition of costs (Pal, 2006). “Generativelycomplex problems” (Kahane, 2004) thatrequire sacrifice now for the delivery ofbenefits beyond the boundaries of theelectoral cycle, present a politicallyunpalatable decision making dilemma.

Chermack (2004) identifies two otheroverarching categories of decision failure:1) simple explainable error or mistake and2) when the unusual happens and theguiding cognitive map and mental modelis rendered obsolete. The first category

denotes the statistical reality that someerror is inevitable. Failure of the cognitivemap occurs when it becomes difficult foran individual to articulate what theenvironment requires because a systemlevel discontinuity has occurred, makingtheir mental model obsolete. Chermack(2004) describes the tendency of decisionmakers to either ignore or underestimatethe contribution of disruptive internal andexternal systemic elements. Instead, decisionsare often based upon by habit, conformity,social pressure, or personal interest.

The literature also asserts that the key toimproving decision making and ultimatelyimproving outcomes lies in changing oraltering current mental models (Senge,1990; Chermack, 2004; van der Heijden,2005). As the clock speed of changeincreases and the decision making contextbecomes more complex and dynamic, there-calibration of existing mental modelsbecomes essential for good decisionmaking. Wack (1985) stated that in order tooperate in an uncertain world peopleneeded a way to “reperceive” and questiontheir assumptions about the way the worldworks, thereby changing the currentdecision making premise.

Despite the growing body of opinion thatforesight activities can lead to theimplementation of different (and ideallyimproved) courses of action, many keydecision makers are still reluctant toincorporate foresight findings into theirdecision making processes. The foresightwork described in this case study wasundertaken as a means to help leadership“reperceive” the future of health andunderstand the forces and factorsimpacting the wellness of the nextgeneration of Canadians. The HealthForesight Initiative was consciouslydesigned and communicated so that seniordecision makers in government cancomfortably utilize the informationgenerated to inform decisions about thefuture direction of health policy and relatedinvestments.

2. The Health Foresight InitiativeCase StudyThe Health Foresight Initiative involved theimplementation of an iterative multi-facetedforesight process to gain new insight andunderstanding about how to improve thehealth of Canadians in a single generation.More specifically, the goal was to informboth lead organizations about innovativescience and technology investments thatcould be made today that would improvepopulation health outcomes in the future.

The Initiative involved approximately 250stakeholders and professionals from theCanadian health sector. Project events wereheld in Ottawa, Ontario, Jasper, Alberta, andMontreal, Quebec. Table 1 presents theseries of workshops that comprised the HealthForesight Initiative and their respectiveoutcomes. Pertinent to the interpretation ofthe table is the labelling of events as eitherEngagement (E) or Innovation (I). Engagementevents were characterized as being largerin nature and involving a multidisciplinarygroup of stakeholders mainly drawn fromthe health sector. Engagement events weredesigned to foster an understanding of thecomplexity of the issue, surface a variety ofperspectives and ideas, and extend currentavenues of dialogue as they relate to the futurehealth of Canadians. The engagement eventswere particularly effective at creating mutualunderstanding and developing a commonlanguage amongst diverse stakeholders.

The innovative events involved a smallernumber of highly innovative thinkers (seesection on participant selection). These eventswere designed to challenge conventionalopinion and push current thinking about howto improve health outcomes into unchartedterritory. The ideas that surfaced were intendedto be provocative and disruptive in nature andwere used to stimulate new dialogue in thebroader audiences of the engagementevents and the health sector in general.

During the execution of the 16 month initiative,the project leaders also drew upon externalsources of ideas and inspiration such ashealth sector meetings, publications, andconferences. Of particular significance wasa conference hosted by the Institute for theFuture Science and Technology Foresight in PaloAlto, California, USA. Participation in this eventresulted in the identification of 16 specific scienceand technology advancements that couldenhance human health. These findings wereintroduced into the Health Foresight Initiativedialogue for validation and consideration.

The last event of the Health ForesightInitiative at the McGill University WorldPlatform Conference on Health, concludedon March 17, 2011. As of the writing of thispaper, Health Canada and Alberta InnovatesTechnology Futures are in the process ofdeveloping key recommendations forpresentation to executive within theirrespective organizations. Communicationof these recommendations is expectedthroughout 2011 and 2012.


8

experts’ insights

More than goodmanagement skillsare required to design,organize andexecute a majorforesight even


9

experts’ insights

Table 1 Description of Health Foresight Initiative Workshops and Key Findings

Key Findings

•� developed the focal question• developed mutual understanding• developed a common language• developed an understanding of the changing trends impacting

human health in the next 20 years

• determined which trends were most uncertain and highly impacting•� developed four plausible scenarios• created an initial assessment of science and policy needs that may

be required to adapt or provide service in each of the scenarios• challenged current views and assumptions

• identification of system level contradictions that will create tensionswithin the system

•� identification of health solutions to resolve system level tensions

• key insights and understandings about future research andinvestment opportunity areas in health related technology

• conceptualization of the Health Conveyor Model(See section 5 for description)

• conceptualization of a new framework for health care deliveryin Canada based on the Health Conveyor Model.

• exploration of how technology can be applied to improvehealth outcomes

• share and validate the Health Foresight Initiative findings witha critical audience

Workshop Description

1. Trends and Drivers E 90

2. Scenario Creation E 40

3. Contradiction E 35Oriented Problem Solving

4. Jasper Innovation E 45Forum

5. Exploration of how I 10technology may beutilized to improve thehealth of Canadians

6. Development of I 10a new framework forenhancedhealth outcomes

7. McGill University E 55World Platform onHealth Conference

No. of Participants

*E= large engagement I* = small innovation engagement

Type

3. MethodologySimply conducting foresight activities isoften insufficient to affect forward lookingdecisions or behavioural change. It was thethesis of the project leaders that byrecognizing the challenges faced bydecision makers and designing the processin response, the efficacy of the HealthForesight Initiative would be significantlyenhanced. Key design considerations forlinking foresight to action included:

1) project leadership 2) design of the process 3) designing for engagement 4) designing for innovation 5) designing for communications

Consideration of these five aspects wasessential to derive good foresight insightsand empower transformational decisionsrelated to the application of science andtechnology for improving human health.

3.1 Project LeadershipIn the authors’ opinion, the competenciesrequired to execute a successful foresightproject are worth noting here. They extendwell beyond simple project managementto include the ability to lead a diverse group

of people through often highly sensitiveconversations and then deliver provocativeand potentially disruptive findings to anoften less than receptive audience ofdecision makers who may be deeplyuncomfortable questioning embeddedassumptions about the future.

Like many other high level deliberativeprocesses, addressing the future requiresstrong communication skills, the ability tomultitask, creative thinking and the flexibilityto adapt to changing circumstances includingresource availability. Leaders of major foresightinitiatives must apply the tools of complexadaptive management (Porter & Kramer, 2011).This approach entails an understanding ofthe benefits of planning accompanied bythe flexibility to maintain the focus on thefuture, make mid-course corrections to fulfillthe project objectives and respond to newinformation and developments as they arise.

Despite the fact that most foresight projectstypically have common elements (diversestakeholders, collaborative engagement,etc.), a depth of experience and knowledgeis required to choose foresight methodsappropriate to the organizational contextand the issue at hand. It is essential thatleaders of foresight work have the ability to

think critically about the way the future isdescribed and develop innovative linkagesto present day realities. Foresight is in itself,a disruptive technology. Thinking about aradically different future than has beencomplacently assumed, challenges peopleand organizations at profoundly deeplevels. Furthermore, there is a delicatebalance and potential tension betweenpervayers of convential wisdom who haveinvested interests in maintaining the statusquo and the attributes of emergent newsystems that may be described during theforesight process.

In order to maintain the commitment ofparticipants to the foresight process it isnecessary to build an environment of trust.Skill is required to negotiate highly sensitiveconversations that challenge deeplyembedded assumptions and mental modelsabout the future. To provide participantswith the level of comfort and safety neededfor such open and frank conversations, allevents of the Health Foresight Initiativewere conducted under Chatham HouseRule, which granted anonymity in writtenreports and conversations or presentationsconducted outside the workshops.

3.2 Design of the Process The design of the Health Foresight Initiativeinvolved a complex set of considerations toincrease the likelihood of the findingsbeing converted to action. These included:

• defining the focal question, • choice of foresight methodologies, • size of the workshops and facilitation, • budget and logistics • choice of participants, and • the communication strategy

3.2.1 Defining the Focal QuestionThe cornerstone of any foresight initiativeis the focal question. A well-conceived focalquestion sets the tone and scope of theentire foresight initiative. If the focalquestion fails to convey the appropriateinformation, the ensuing conversation mayfail in depth, scope and organizationalrelevance. The focal question in this casestudy explored “How to improve the healthof Canadian’s by 2030 (in a singlegeneration)”. It was designed to ensure a fullexploration of the forces and factors thatare affecting the health of the Canadianpopulation now and into the future.Current health sector dialogues in Canadaare dominated by discussions about thesustainability of the publicly funded healthcare system. It was a major challenge forthe project leaders to move the discussionsof the Health Foresight Initiative beyondthis present-day anxiety. The focal questionwas carefully phrased to encourageconsideration of the current Canadianhealth care system as only one of a suite offactors that can contribute to improvingthe health of Canadians. By referring to asingle generation, the focal questionimplicitly encouraged participants to thinkabout maintaining life-long health ratherthan how effective the health system is atcuring those who are ill. Other keyrequirements were that the focal question:

• was an open-ended yet focused inquiry; • did not suggest or lead to a specific “right”

answer; • contained emotive force and was intellectually

stimulating; • was succinct but challenging; and • was relevant to the participants involved.

3.2.2 The Choice of Foresight Methodologies The choice of foresight methodologyemployed at each workshop was guidedby the the cumulative findings fromprevious workshops and the level ofengagement appropriate for theparticipants invited. The workshops wereconsciously designed to move participantsout of their comfort zone, which oftenprovokes emotional response. This wasimportant because emotive moments

often signal that participants are in the processof recalibarting their mental models. The HealthForesight Initiative involved the organizationof seven different workshops (See Table 1).The strategic design considerations for eachare discussed below.

1) Trends and Drivers Workshop The Trends and Drivers workshop was theintroductory event of the Health ForesightInitiative. This was an exploratory exercise,the purpose of which was to vet the topicwith stakeholders in the health sector andbegin to build a common language andunderstanding about the forces and factorsthat would be impacting the health sectorand by default, the health of Canadians, inthe longer-term.

2) Scenario Creation WorkshopThe Scenario Creation Workshop was afoundational piece of work in the HealthForesight Initiative. The purpose of thisworkshop was to challenge the deeplyembedded assumptions that exist in theCanadian health sector about currenthealth care delivery and how the futurehealth outcomes of Canadians may beimpacted by technology. Using the trendsand drivers identified in workshop one, fourdistinct but linked narratives were createdabout the health of Canadians in 2030. Theprocess of creating these narratives servedto build solidity amongst the participantsabout the challenges to be addressed if thehealth outcomes of the Canadianpopulation are to improve over the nexttwenty years. In addition, the scenariosprovided an opportunity to test currentstrategies and discuss possible adaptivemanagement responses against a range ofpossible future outcomes. Achieving thisallegorical understanding was useful as itvalidated the relevance of the focal questionand forced preliminary exploration ofdisruptive or transformational solution sets.

3) Contradiction-Oriented Problem SolvingWorkshop Contradiction-oriented problem solving isfocused on finding fundamental contradictionswithin a system, identifying the coreproblems, and finding innovative solution

sets by applying experiential knowledge.The intent was to examine how scienceand technology can enable a response tocurrent and future challenges. Theapproach is based upon the work ofRussian scientist, Genrikh Altshuller(1984).This approach was chosen for the thirdworkshop of the Health Foresight initiativebecause project leaders recognized thatforesight events need to stimulateconversations and debates about variousdimensions of the problem. The scenarioscreated in workshop two were used as thebasis for identifying emerging tensionswithin the Canadian health system. Theworkshop was intended to bring aboutmoments of creative tension as it is throughthis tension that individuals often becomeaware of the need for action.

4) The Jasper Innovation ForumThe Jasper Innovation Forum engaged anentirely new group of participants. At thisworkshop, the conversation was purposelyfocused on improving child and maternalhealth. The objective was to produce a setof general recommendations for futureareas of technology research investment.Participants were broken into groups andtasked with answering specific questions(drafted by the project leaders) about therole of technology in improving future healthoutcomes for Canadians. Opportunity wasprovided for presentations by each of thegroups followed by a plenary discussion ofthe implications of those findings forimproving the Health of Canadians.


10

experts’ insights

An early step of thecommunicationstrategy was definitionof specificcommunicationsparameters for targeteddecision makers


11

experts’ insights

5) Workshop on How Technology MayImprove the Health of Canadians The first four workshops of the HealthForesight Initiative were all largeengagement processes. While eachsurfaced many ideas, the level of innovationthat emerged was only incremental and tosome degree, repetitive between events. Tomove beyond this plateau a group of tenhighly innovative thinkers were invited to aone day brainstorming session. Thepurpose of this workshop was to synthesisthe dialogue from the previous events,focus on the most salient findings andapply them in an innovative way to thefocal question. The result of this work wasthe conceptualization of a completely newmodel of health needs assessment calledthe Health Conveyor Model.

6) Workshop on the Development of aTechnology Supported Framework forEnhanced Health Outcomes in CanadaThe sixth workshop of the Health ForesightInitiative reassembled six of the ten peopleinvolved in workshop five, plus four newparticipants. This was an intense and fluidtwo day discussion focused specifically onthe identification of technologies requiredto empower individuals to take control oftheir own health and enable caregivers tosupport those who are unwilling or unableto help themselves. This workshop was awatershed event. It represented the firsttime that the conversation shifted todiscussion of what an emergent newhealth delivery system might be like, asopposed to the previous focus onextensions of the status quo. The workresulted in the articulation of a newframework for enhancing the health ofCanadians and an understanding of howdeployment of sensors and web-basedtechnologies could positively impact themanagement of five chronic conditionsincluding obesity, mental health, diabetes,aging and cancer.

7) Workshop at the McGill UniversityWorld Platform Conference on HealthThe purpose of holding the seventh workshop as part of a McGill Universityconference was to present a new approachto improving health outcomes thatrecognizes self-empowering technologiesas essential tools for maintaining the life-long health and wellness of Canadians. Byinviting comments from a critical audienceof academics and health professionals inthe prestigious setting of McGill University,the recommendations that emerge fromthe Health Foresight Initiative haveenhanced credibility.

3.2.3 Size of the Workshops and FacilitationOne of the hard but crucial aspects of aforesight process is to find ways of thinking

about systemic change and questioningcurrent assumptions. This requires a carefulsequencing and comparison of disruptiveideas with current assumptions. During theHealth Foresight Initiative two types ofworkshops were strategically employed;large engagement events that promotedincremental advances in current thinkingand smaller high intensity events intendedto developed disruptive and provocativenew ideas. By combining the two types ofevents, the depth and complexity of theideas generated was increased and theprobability of consideration of those ideasby key decision makers was enhanced.Professional facilitators were hired for all theworkshops of the Health Foresight Initiativebut they played a much subtler role in theinnovation workshops so that fluidspontaneity was not lost.

3.2.4 Budget and Logistics Collaboration between Health Canada andAlberta Innovates-Technology Futuresleveraged the leadership experience andfinancial contributions of eachorganization. The combined budget wassufficient to afford the hosting of theworkshops in various locations across thecountry, which created the opportunity toinvolve a greater number of participantsand incorporate a broader spectrum ofexpertise and knowledge.

The large engagement processes were themost costly events of the Initiative becausethey occasionally required paying forparticipant travel, and required more stafftime, hospitality costs, and the rental ofevent facilities.

3.2.5 Selecting Participants The choice of participants at each stage ofthe Health Foresight Initiative requiredcareful consideration on the part of theproject leaders. Depending upon the sizeand purpose of the workshop, differentknowledge sets and capacities wererequired. For that reason participation at allevents was by invitation only.

The largest events were the Trends andDrivers workshop, the Scenario Creationworkshop, the Jasper Innovation Forum,and the workshop at the McGill UniversityWorld Platform Conference on Health. Theproject leaders felt that in these largeengagements the best work would bedone by participants who had strongcompetencies in integrating andsynthesizing knowledge from a number ofdisciplines, had good analytic skills, andwho were skilled in inter-personalcollaboration and communication. Tominimize the chance of group bias, it wasimportant to assemble a multidisciplinarygroup of participants who could bring avariety of knowledge and perspectives tothe conversation. To create the appropriatebalance of positions and ideas, a mix ofsubject-matter experts, innovative thinkersand creatives was selected. Special effortwas made to solicit participation from thearts, civil society, the humanities, and othernon-health related disciplines. A crucialrequirement of all participants was thatthey exhibit an ability to question their ownassumptions and suspend disbelief.

Several of the participants in the largeengagement events were people ofinfluence in the health sector and whowere senior decision makers within theirrespective organizations.

These individuals had the greatest potentialfor translating new insights and knowledgegained from the foresight work intotangible present-day decisions and actions.Furthermore, they raised the profile of theinitiative and could influence the thinkingof others who did not participate. Theproject leaders considered the inclusion ofkey decision makers in the large events ascrucial to ensuring broader acceptance andultimately careful consideration of thefindings for decision making and strategicplanning purposes.

Project leaders also made special effort toattract several individuals who are uniquelysuited to doing foresight work. The fondlydubbed title of “wing-nut” (Soroka, 2010personal communication) was given to thistype of participant for their uncanny abilityto deal with dialectics and multiple solutionsets, critical thinking skills, and propensityto generate provocative new ideas. Thesehyper-innovators have a habit of looking fornew ideas and information, not just in theirfield and areas of focus but also acrossmany other disciplines. They have an innateability to make abstract linkages in waysthat quickly challenge the status quo andadvance current thinking. Because theywere often the source of radical new ideas,inclusion of these “remarkable people”(Schwartz, 1991) in the large engagementevents provided important intellectual

Thinking about aradically differentfuture than has beencomplacently assumed,challenges people andorganizations atprofoundly deep levels

12


experts’ insights

stimulation. In the smaller innovation workshops,the ability of these participants to navigatecomplex systems, creatively link concepts,and then translate this new knowledge intoactionable recommendations was ofparamount importance.

3.3 Designing for Engagement The large engagement events of the HealthForesight Initiative were characterized asfacilitated workshops typically involving over40 diverse stakeholders. Large amounts ofideas and dialogue were generated at theengagement workshops. Participants tendedto be deeply knowledgeable individualswith the ability to recognize a good idea,adapt it, and implement it if they desire. Anunderstanding of the complexity of theissue was forced by preventing prematureconsensus through the exploration ofsecond and third order consequences. Theexpectation was that participation in theengagement workshops would expose alarge number of influential people to aplethora of perspectives and ideas thatoriginated outside their respective areas ofresponsibility and expertise. This exposurewould challenge their current assumptionsabout the forces and factors that couldimpact population health by 2030 andbuild anticipation for release of the Initiativefindings and recommendations.

3.3.1 Designing for Innovation Small groups of highly motivated peopleare often most able to generate radical newideas. Consequently, participation in thetwo smallest workshops of the HealthForesight Initiative was purposely restrictedto ten people, many of whom were drawnfrom the pool of hyper-innovators. Theseinnovation workshops were designed to beintense and creative exchanges thatconsolidated previous dialogue intoinnovative new concepts. The purpose ofboth was to synthesize highly innovativepolicy and investment recommendationsfrom the dialogue of the first four events.

3.3.2 Designing for CommunicationFrom the onset, project leaders recognizedthe need for a determined communicationstrategy targeted at senior executives,health industry leaders and strategicpartners. Drawing from the field ofknowledge management, a “cascading”(Snowden, 2010) communication strategywas developed that entailed ongoingpresentations about the progress andfindings of the Health Foresight Initiative. Itwas based upon the premise that it is easierto introduce new ideas gradually, versus amass delivery all at once. This type of“cascading” communication is intended toexpand the recipient’s zone of proximaldevelopment (expansion of thought from one’sinitial position). The premise being that gradualuptake and expansion of understandingallows time for reflection and absorption ofnew concepts, building the receptor capacityof the target audience. Deployment of acascading communication approach was veryeffective at maintaining the profile of the eventover a 16 month period and building anticipationfor the project recommendations amongstkey decision makers.

An early step of the communication strategywas definition of specific communicationsparameters for targeted decision makers.Analysis of their thinking process, languageused, motivators, past actions, and casestudies where they were inspired to actallowed articulation of the foresightfindings in terms relevant to that decisionmaker’s context. A report was generatedupon completion of each workshop,accompanied by a number of other tailoredcommunication tools such as briefingnotes, concept papers and power- pointpresentations. Short video presentationswere created of the four scenario narrativesgenerated in workshop 2. Through the useof music, images and voice decision makerswere emotionally engaged in thesefictional futures in a way not possiblethrough the written word.

A second communication considerationwas related to participant engagement. Theability to attract the right participants isessential for successful foresight activities.Project leaders recognized the participantinvitations provided an opportunity tobuild expectation and raise the profile ofthe Initiative, given that many of thoseinvited were also key decision makers.Invitations were accompanied by a shortconcept paper that presented the focalquestion and discussed future healthrelated challenges. To make attendancemore attractive, each invitation articulateda value proposition for the invitee, i.e., theability to interact with other leadingthinkers from the health sector andexposure to leading edge thinking.

Throughout the Health Foresight Initiative,project leaders capitalized on as manyopportunties as possible to presentfindings to internal and external audiences.Comments and feedback received duringthese presentations were used to refine thecommunication process. Targetedcommunications about the HealthForesight Initiative findings will continue atHealth Canada and Alberta Innovates-Technology Futures throughout 2011 and2012 to ensure that the insights and findingscontinue to be actively incorporated intoongoing planning processes.

4. Health Foresight Initiative FindingsFour major insights emerged from the HealthForesight Initiative:

1) Technology can empower individuals totake greater responsibility for their ownhealth. Through personal data tracking andsharing capacities, engagement in socialnetworks and access to health and lifestyleinformation on the internet, individuals are ableto become proactive partners with physicians,communities of interest, and other healthcare service providers for illness prevention,treatment and wellness enhancement. 2) Health care professionals are now able toprovide many health related services toconsumers and patients any where in the world.Conversely, Canadians have unprecidentedaccess to a vast array of health care services(and products) from outside the publicfunded health care system. Severing thegeographic link between patient andphysician is a ‘game changer’ for the Canadianpublic health care system. 3) The ability to interpret and act upon theincreasing plethora of health related data andinformation will depend upon the ability ofthe user to validate and understand itsimplications. The inappropriate applicationsand use of data and knowledge byindividuals, health care professionals andorganizations is an emerging challenge. 4) Improving the health of Canadians willrequire the engagement and commitmentof Canadian society in general. Governmentcannot achieve this objective in isolation. Three factors emerged as particularlysignificant to Health Canada and AlbertaInnovates-Technology Futures during theHealth Foresight Initiative; (i) the need tobroaden the definition of, and approach to,health and wellness, (ii) the need to recognizethe individual as a full partner in maintaininghealth and wellness and (iii) the paramountrole of digital technologies in improving thehealth outcomes of Canadians. Morespecifically, the findings of the HealthForesight Initiative indicated that prioritiesmust be given to investment in science andtechnology areas that:

The purpose of theHealth ForesightInitiative was to informscience and technologyinvestment decisionstaken today in order toimprove the healthoutcomes of Canadiansover the next twentyyears

13


experts’ insights

• directly affect the health of the body; i.e. bio-medical monitoring devices

• enables the development and implementation of networks supportingenhanced health systems and that improve integration and sharing of health information, i.e. electronic health records.

• facilitate monitoring and analysis of environmental influences, enhances environmental quality and improves research capabilities, i.e. networked ubiquitous sensing devices for bio-medicaland environmental data collection.

Science and technology that integrates allthree areas should become policy andinvestment priorities (see Figure 1). Furthermore,future health policy and investmentdecisions should be directed toward thecreation of an enabling environment thatpromotes and encourages healthy living aswell as the treatment of illness.

5. CONCLUSIONSThe purpose of the Health Foresight Initiativewas to inform science and technologyinvestment decisions taken today in order toimprove the health outcomes of Canadiansover the next twenty years. To increase thelikelihood of the findings and insights beingused to inform strategic decisions, the projectdesign incorporated an iterative andintegrated process of foresight engagement,innovation and communication.

This robust foresight project design fosteredinnovative new ideas and solution sets thatare (at the time of writing) beingcommunicated to broad audiences of healthsector leaders and stakeholders forconsideration. Early indications are that thesefindings have been positively received by keydecision makers. They will continue to beincorporated into the strategic planning anddecision making processes of Health Canadaand Alberta Innovates-Technology Futuresover coming months.

THEENVIRONMENT NETWORKS

THE BODY

ENABLING HealthPrograms, Policies and S&T

Investments SCIENCE& TECHNOLOGY

References1. Altshuller, G. (1984). Creativity As an Exact Science: The Theory of the Solution of Inventive Problems. New York, USA:Gordon and Breach Science Publishing.2. Brehmer, B. (1992). Dynamic decision making: Human control of complex systems. Acta Psychological, 81, 211-241.3. Chermack, T. (2004). Improving decision-making with scenario planning. Futures, 36, 295-309.4. Dorner, D. (1996). The Logic of Failure: Recognizing and Avoiding Failure in Complex Situations. Reading,MA: Adison-Westly.5. Kahane, A. (2004). Solving Tough Problems. (1st ed.) San Francisco, CA: Berrett-Koehler Publishers Inc.6. Macklin, L. (2010). Case Study Analysis of the Efficacy of Scenario-based Planning as a Public Policy Formulation Tool. PhDThesis: University of Calgary.7. Pal, L. (2006). Beyond Policy Analysis: Public Issue Management in Turbulent Times. Toronto, Ontario: Thompson Nelson8. Porter, M & Kramer, M (2011). Creating Shared Value: How to Reinvent Capitalism and Unleash a Wave of Innovation andGrowth. Harvard Business Review, Feb, 62-77.9. Schwartz, P. (1991). The Art of the Long View. New York, New York: Doubleday.10. Senge, P. (1990). The Fifth Discipline. (1 ed.) New York, New York: Doubleday.11. Slaughter, R. A. (1993). Futures Concepts. Futures, 25, 289-314.12. Snowden, D. (2010). Cascading Communication Processes. Cognitive Edge Newsletter [On-line]. Available:http://www.cognitive-edge.com/newsletter.phpvan der Heijden, K. (2005). Scenarios: The Art of Strategic Conversation. (2nd ed.) Chichester, West Sussex, England: JohnWiley & Sons, Ltd.13. Wack, P. (1985). The Gentle Art of Reperceiving. Harvard Business Review, 63, 72-139.

Figure 1 Health Science and Technology Policy and Investment Priority Areas

14


BYMohd Afzanizam Mohd [email protected]

cover story

Discussions on the healthcare services in most developing countriesunderlined some issues and challenges with regards to:• rising income leads to demand for a better quality of life via quality-oriented healthcare services,• increased supply of healthcare services to cater for the increased number of aging population and

changed in lifestyles,• prevention and control of non-communicable and chronic diseases caused by modern lifestyle,• demand for increased accessibility of care outside hospitals, moving health services into the patients’

own homes; and• the need for services efficiency, personalisation and quality healthcare, and the constrain of limited

financial resources.

Home service is the fastest growing trendin healthcare. Cost plays a major role in

promoting this trend. Limited resources andincreasing healthcare costs have led toproposals to expand home care services.More individuals are self-managing theirhealth and preference for healthcare athome rather than in public or privatehospitals increases.

Modern lifestyle has made knowledge and skills ininformation and communication technology (ICT)essential. The rapid development of ICT offers hugepossibilities for the future, particularly in the healthcare

sector. Technological developments create opportunitiesfor people to get medical consultations and advicesfrom the comfort of their homes. At the Forsyth MedicalCenter in Winston-Salem, North Carolina, nurses canmonitor lives of some diabetes patients even whenthey’re not at the clinic using an app called Ginger.io.These modern technologies are utilised at hospitals inmost developed countries. IBM stated that thecombination of residential care and home healthcarecontributed $45 billion to the industry and is projectedto continuously grow i.

In Malaysia, the cost and quality of healthcare hasimproved. However, the adoption of technology forhealthcare at home, which is relatively new, is still at an

infant stage. The development for the adoption ofhome healthcare technology has been slow andunplanned. Although there are initiatives andexperiments in this area by public and private initiatives,they are hindered by several factors such as lack of anintegrated home care system and the unavailability ofsuitably trained technicians.

Home healthcare, in its traditional form, has existed inMalaysia for several years. Malaysians from all walks oflife get home visit services to care for women aftergiving birth and new born babies. Apart from post nataltreatment, mothers are given medical advices andlessons on childcare by government midwives andnurses that visit their homes.

Preserving

HEALTH@Home:aLIFESTYLE

That Pays

TYPE OF CARE

Tertiary

Secondry

Primary

TYPE OF CARE

SHMCH*

State HealthDepartment

District HealthOffice & Hospitals

CommunityClinics**

ADMINISTRATION LEVEL

Community / Village

*SHMCH- Specialised Hospitals and Medical College Hospitals** Community Clinics include health clinics, rural clinics, midwife clinics, mobile clinics

State

National

District

15


cover story

Home medical care in Malaysia has evolved. Not onlynew mothers and babies, but the elderlies andgeneral patients are also reaping the benefit ofhome visits by government medical staffs. And, ashome care technologies improve, the benefits willspread to all – not only modern mommies, theelderlies and general patients, but informalcaregivers, medical professionals and medicalorganisations too. Receiving healthcare at homesoon will become common.

Trend 1: Home as a Centre for FutureHealthcareNaomi Fired, vice president of Kaiser Permanente in2009, forecasted that by 2015 the home will be thehub of healthcare. His optimistic view for thedemand of home healthcare at home was based onand driven by the opinion of Dr Steven Landers wholisted five primary forces that will push for homemedical care. The five primary forces are agingpopulation, rapid development of ICT, increasemedical cost, privacy and personalisation, andpatients’ convenience.

The increase of aging population increases the needfor specialised medical attention. Studies have shownthat an elderly person faces a higher probability tosuffer chronic diseases such as cardiovascular disease(CVD) iii. CVD patients often need constant care andattention, thus the need for home medical care.

The rapid development of ICT accelerates theadoption of home tele-health care technology iv.Tele-health care focuses largely on remote patientmonitoring. In this capacity, Tele-health care allowsfor improved quality of life for many patientssuffering from chronic conditions.

Apart from meeting the driving goal in healthcare –improving the quality and accessibility to themedical treatment, Tele-health is cost effective.

The cost of healthcare is rising faster than the levelsof available public funding, thus increasing the needfor home healthcare. A study done by EconomistIntelligence Unit identified the main drivers of risinghealthcare costs in Europe as v:

• Aging populations and the related rise in chronicdiseases.

• Costly technological advances.• Patients’ demands, driven by the increased

knowledge of options and less healthy lifestyles.• Legacy priorities and financing structures that is

ill-suited to today's requirements.

Limited capacity of the health facility and costconstrained drives patients to consider home healthcare.Medical care at home provides considerableadvantages to consumers or patients, such as:

• Accessibility and cost benefits. Population growth will change the health delivery system. Today, almost everyone owned mobile devices that can be integrated with the healthcare monitoring systems using wireless mobile communication network technology that provides greater accessibility, freedom, portability and convenience,especially to elders and patients at homes. The long-term cost of medical and healthcare services can thus be reduced and, eventually, the overall quality of healthcare services can be improved.

• Personalisation. Healthcare at home provides convenience and privacy to the patients. This is part of consumers’ preferences that demands for personalised services.

• Cost concerns. Higher demand for healthcare services will result in increase of costs of medical and healthcare. The situation is also worsened by the absence of competitive market. Most patients are shifting towards home healthcare as a measure to minimise cost.

Current healthcare environment is characterized bythree major problems: accessibility, quality, and cost.All three are interrelated to one another. Theyinfluence the patient to decide where and when toget treatment – public medical facilities, privatehospitals and clinics, or at home. Private and publichealthcare providers seek to integrate healthcareservices in order to improve quality and ensureaffordability to all, whilst patients will look forconvenient health care services that offer costbenefits to them.

Current healthcareenvironment ischaracterized by threemajor problems:accessibility, quality,and cost

Figure 1 Hierarchy of public health care system in Malaysia ii

16


Trend 2: Acute Care at HomeTwo defining features that encourage homehealthcare market are the predominance of ‘for-profit facilities’ and the perception of low quality carein many public facilities vi. Home hospitalisationservices (HHS), already being used in manydeveloped countries such as Italy, Australia, Canada,England and Israel, become the alternative. The shifttowards a hospital-at-home model is meant forspecific patients and medical conditions that needto be supported by clinical research. HHS basicallyallows for diagnostic and therapeutic interventions,commonly carried out at the hospital, to beperformed at home. It has been projected that, inthe next twenty years, 46% of Americans whosurvive to the age of 65 will use home healthcare atsome point in their lives vii.

Conditions treated by a commercial venture in UScalled Clinically Home includes pneumonia, chronicobstructive pulmonary disease (COPD), heart failure,asthma, cellulitis, urosepsis and deep veinthrombosis viii. In Italy, HHS has been operating inTurin since 1985. It started with a stroke care project.Stroke is consuming 5% of all hospital resources ix.

However, there are obstacles faced in HHS programs.Currently, insurers are reluctant to providereimbursement and not many physicians are keento invest time and resources in this program.

Trend 3: Home as Centre of Wellnessand PreventionThe constant improvement of healthcare extendslife expectancy. On the other hand, infectiousdiseases and lifestyle diseases such as diabetes maymean a downturn in life expectancy. As the old

adage goes: Prevention is better than cure, theprevention of health problems through healthylifestyles is more effective than the increasing use ofmedicines. Exercise is the best prescription and, formany busy individuals, the option is to exercise at home.

The two main factors that would make home thecentre for wellness and prevention of illnesses in thenext decade are:

• Prevention vs. cost for healthcare. In most OECD countries, the share of gross domestic product devoted to healthcare expenditures has grown. Rising costs in healthcare will be inevitable. Per capita,the United States’ expenditure for healthcare is about three times the amount allocated by Finland. Total health expenditure as percentage of GDP in Malaysia is increasing – more than three folds.

Disease prevention is definitely important: 40% ofdeaths in the United States are consideredpreventablexii. The application of preventive practicesacross the lifespan will minimize risk factors andimprove survival as well as quality of life. Preventionservices can be in various settings, including the homexiii.

• Real-time health monitoring. Prevention of disease involves testing and screening. It is essential to prevent, avoid or predict future illness. This requires the implementation of health-related ICT that provides more cost-effective

healthcare. Research Specialist Rob Kaminsky suggests that ‘the Advanced Remote Patient Monitoring Systems allows physicians the ability to monitor and record everything from basic vital signs to cardiovascular and respiratory issues. This keeps patients out of the hospitals and in their homes where they are more comfortable unless actual treatment is needed xiv. However, adoption of technology by older adults is still limited. Health-related ICT for the elderly is suggested to be kept simple and able to demonstrate significant benefits to them xv. Familiarisation of the

cover story

Technologicaldevelopments createopportunities forpeople to get medicalconsultations andadvices from the comfortof their homes

Prev

alan

ce (%

)

Estim

ated

pop

ulat

ion

25

10

15

20

5

0

2,5000,000

3,000,000

3,500,000

4,000,000

4,500,000

5,000,000

2,000,000

1,500,000

1,000,000

2006

Est. population,2006 Est. population,2011 Prevalence projection, 2006 Prevalence projection, 2011

2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 200200

CurrentProject

Figure 2 Burden of Diabetes in Malaysia: Adults age 18 years & above x

17


cover story

Figure 3 Total Expenditure on Health, 1997–2008 (RM, Nominal Value) xi

TEH

(% G

DP)

(RM

Bill

ion)

TEH as percentage of GDPYear

8213.00

5,000.0

-1997 1998 1998 2000 2001 2002 2003 2004 2005 2006 2007 2008

10,000.00

15,000.00

20,000.00

25,000.00

30,000.00

35,000.00

40,000.00 6.00

5.00

5.00

3.00

2.00

1.00

-

2.90

3.20 3.203.40

3.703.80

4.58 4.51 4.22 4.33

4.784.75

8966.009734.00

11516.0012520.00

13620.00

19164.00

21378.4021914.79

24.79

30666.65 35148.96

technology via training and courses will increase the level of awareness and encourage the adoption of health-related ICT.

Trend 4: Special Care for Elderly at HomeOlder persons represent the largest and most activepopulation of healthcare and medication consumers.Most elderly people who need special care are livingat home, sometimes alone and unassisted. Theinfluencing factors for ‘senior living’ are:

• Accessibility to the quality healthcare: As the number of ‘empty-nest’ elderly rises in the country,ensuring accessibility to the quality healthcare is a public health concern. The modern social community called an ‘empty-nest’ elderly is usuallycategorised as a group who had higher income but less social support. This segment of the population has a higher prevalence of chronic diseases. They also had higher home healthcare needs and were willing to pay for home healthcare.

• Increasing health literacy of the population results in an exponential increase in public expectation for health care in most countries. In countries where healthcare budget is unable to keep up with the demand, healthcare services suffer. Facilities and services at public medical centres do not satisfy the population and services and treatment at private hospitals and clinics are expensive. As a result, more and more people are resorting to home healthcare.

• The availability of and access to primary healthcare. Primary care is the typical way patients access the healthcare system. Studies

show that the potential access to primary care is greatly dependent on spatial and aspatial dimensions of access xvi. The expanding linkages between the healthcare institution and senior living providers such home care, clinic and rehab providers provide a network of care services that begins in the home while also offers residential facilities when needed xvii.

Recent reforms have demanded a competitivemarket-driven approach to healthcare. Cost, timeand technology readiness will remain as the majorconcern to consumers. Various strategies has beenoutlined to increase health services to the public,including transfer of patients directly to home, earlydischarge, the increase of same day surgery, transferof elderly patients to low-intensity care settings anda variety of home-care initiatives such as HomeHospital or Hospital in the Home.

Changes in consumers’ behaviour and preferencetowards healthcare services that can providepersonalisation, convenience, effective option, costsconcern, accessibility and literacy improvement inhealth-related ICT will further boost the demand forhome healthcare as well as alter the delivery systemfor healthcare services. These changes have inspiredsome delivery system innovations. Medical clinics areappearing in retail stores. Physician house calls aremaking a comeback. These innovative accessapproaches offer important benefits if they are wellexecuted and the systems fully integrated.

Referencesi. ‘Redefining Value and Success in Healthcare’. February2012, http://www-935.ibm.com.ii. S.S. Radiah Shariff, Noor Hasnah Moin and Mohd Omar.2012. Location allocation modeling for healthcare facilityplanning in Malaysia. Computers & Industrial Engineering;62: 1000-10iii. Naughton C., Bennett K., Feely J. 2006. Prevalence ofchronic disease in the elderly based on a nationalpharmacy claims database. Age Ageing; 35(6):633-6.iv. Koch S. Home tele-health — current state and futuretrends. Int J Med Inform 2006;75(8):565-76.v. ‘The future of healthcare in Europe’. March 2011,http://www.managementthinking.eiu.com.vi. Grabowskia D.C., Feng Z., Hirth R., Rahman M., Mor V.2013. Effect of nursing home ownership on the quality ofpost-acute care: An instrumental variables approach.Health Economics 32:12– 21vii. Spillman, B.C., Lubitz, J., 2002. New estimates oflifetime nursing home use: have patterns of use changed?Medical Care 40 (10), 965–975.viii. ‘About Us,’ Clinically Home, viewed June 2013,http://clinicallyhome.comix. Dobkin, B. 1995. The economic impact of stroke.Neurology; 45: 56-60x. Global Science and Innovation Advisory Council Malaysia.Non-Communicable Diseases (NCD) in Malaysia. 2012.Malaysian Industry-Government Group for High Technology.xi. Malaysia National Health Accounts: Evidence to, Timefor Change. 2009. Ministry of Health, Malaysia.xii. McGinnis JM, Williams-Russo P, Knickman JR. 2002. Thecase for more active policy attention to health promotion.Health Affairs. 21(2):78-93.xiii. National Prevention Council, ‘National PreventionStrategy,’ 2011. US Department of Health and Human Services,Office of the Surgeon General, www.healthcare.gov.xiv. ‘Telemedicine and the Future of Healthcare IT’. May2013. http://blog.marketresearch.comxv. Heart T., Kalderon E. 2011. Older adults: Are they readyto adopt health-related ICT? Medical Informatics. 1-23xvi. Bissonnette L.,Wilson K., Bell S., Ikram Shah T. 2012.Neighbourhoods and potential access to healthcare: The roleof spatial and aspatial factors. Health & Place. 18: 841-853xvii. George Ydeinak, ‘Top 10 Trends in Senior Housing for2012,’ Senior Housing News, January 9, 2012,http://seniorhousingnews.com

Trend summaryConsumption is a basic fact of life. People neednecessities such as food, water, clothing, energy,etc. But they also desire nonessential things –such as travel, personal interactions, information,and entertainment – to enrich their lives.

Consumerism changes people’s lives.

• People gain access to novel products and servicesthat they could not realistically produce themselves,from fuel to imported food.

• Purchasing goods and services frees up time for people to pursue other activities, e.g. purchasing prepared food may free up time for leisure or education.

• Consumption styles and habits help define socialstatus, and people around the world are increasinglydefined by what and how they purchase. One’s purchasing styles and habits become clues to other people about what one considers important,whether it is the latest Nike shoes or organic food.For some people consumption provides ‘a commonbenchmark to measure personal accomplishment’.

• Consumerism can improve peoples’ lives, giving them access to useful products and services. But, at the same time, it also defines the haves and thehave-nots which may create personal dissatisfactionsand even societal instability. For example, the Chinese Ministry of Labor and Social Security recentlyreported that the emerging Chinese income gap could create social unrest in the country.

• Consumerism stokes the fires of national economies.It is estimated that two new jobs are created for every Chinese-made car that rolls off the productionline, and the salaries of these workers fuel other parts of the Chinese economy.


18

viewpoints

Introduction

LLifestyles that rely on consumer goods and that focus heavily on the acquisition of thesegoods continue to spread around the world. As this trend unfolds, purchasing power

determines social standing in society; and the type, price and brand of consumer goods and/orservices becomes the symbol of identity.

Globalization and rising incomes encourage consumerism. In developing countries middle classsocieties are emerging and gaining the financial means to pursue and support consumerlifestyles. The ideological obstacles that once kept consumerism in check in several parts of theworld have fallen away in recent decades with the decline of the Soviet Union and China’s changein its economic policy. In developed countries, consumerism continues to evolve. Consumerexpectations are rising and, for many people, things that were once considered ‘luxuries’ arebecoming ‘necessities’ – e.g., PCs, mobile phones, or international travel.

Malaysia could attain developed nation status by 2018, two years earlier than targeted, ifeconomic growth remains at 5.3% to 5.5% in the next four years. Malaysia’s current populationof 29.7 million is growing steadily at an annual rate of about 1.8%. Greater Kuala Lumpur is nowhome to six million people, which is 20% of Malaysian’s population and by the year 2020, therewill be 10 million people living in Kuala Lumpur and its surrounding areas. Increased populationsmean increased consumption in overall market. The country has seen a steady increase in thestandard of living and with it, its purchasing power (per capita income exceeds RM19,739or US$5,681).

BY

Mohd Hasan Mohd [email protected]

CONSuMERISM TRENDIN MALAYSIA


19

viewpoints

Scale of consumerism The urbanisation rate is expected to increase at acumulative annual growth rate (CAGR) of 1.2 per centbetween 2013 and 2018 in Asia Pacific. InMalaysia, about 2.6 million people are expectedto move from rural to urban areas in Malaysiabetween the same periods.

Urbanization and migration create employmentproblems. However, the unemployment rate inMalaysia has decreased 3.0% in April 2013 whilstthe unemployment rates of developed countries

such as United Kingdom and US are soaring – UK., 7.7%and US., 7.5% – for the same month.

Economists target the levels of inflation in Malaysiato be at 2.5% for 2013, taking into account the currentimplementation of the goods and services tax (GST)and the extension of retirement age to 60 starting1 July 2013.

In recognising the complexities of urbanisationchallenges, government agencies, policy makers andindustry players are formulating more integratedapproach to address the critical issues such as water,environment, waste and city planning in moreholistic way.

The Human Development Report 2013 highlightsMalaysia’s predicament which is seen to be in a‘middle-income trap’. The country is no longer ableto compete with neighboring countries in low-costproduction and lacks the skills for high-end tasks inglobal production networks. Malaysia’s progress isrestrained by inadequate research and developmentcapacity, lack of design and process engineers,and technical and production workers.

Malaysia’s economy isseen to be in a ‘middle-income trap’. The countryis no longer able tocompete with neighboringcountries in low-costproduction and lack theskills for high-end tasks inglobal production networks.

MALAYSIA INFLATION RATEAnnual Change Consumer Price Index

Jul/11 Jan/12 Jul/12

3.5

4

3

2.5

2

1.5

1

3.5

4

3

2.5

2

1.5

1

1.61.4 1.4 1.4 1.4

1.3

1.71.6

1.31.5

1.2

3.3 3.3 3.3

3.53.4 3.4 3.4

3

1.91.8

2.7

2.22.1

Jan/13

Figure 1 MALAYSIA INFLATION RATE: Annual Change Consumer Price Index


20

viewpoints

Like everywhere else in the world, the needs ofconsumers in Malaysia evolve and change overthe time.

• Geographic shiftConsumption in urban areas are significantly higher than in rural areas as proportion of urban population increased to 71.0 per cent in 2010compared with 62.0 per cent in 2000, accordingto Department of Statistics Malaysia (DOSM).

• Sustainable consumptionConsumers play an important role in sustainableconsumption. It is hard to fulfill the needs of consumers because they change over a time. What is important today might not be relevantin the next 100 years.

• Redirected consumerismConsumers around the world make their purchasingdecision based on ethical, religious, political, or other beliefs. For example, some Malaysians refuse

to buy Israel products due to Palestine’s issues; consumers in South Korea prefer national brand rather than global brand. It is important to note that this kind of consumerism factor driving the Korea’s economy. To date, Malaysia is unable to duplicate South Korean’s success as Malaysia’s consumerism is driven by western lifestyles.

• Beyond consumerismClimate change awareness and smart technologyinfluence consumers’ behavior and change their consumption culture.

1993/94* 1998/99* 2004/05 2009/10

2,5002,190

190

239

1,953

1,631

1,161

2,000

1,500

1,000

500

0

31101

124

327

2989

495

7548

444

167

213

3892103

314

27838333833333

444304300

5935

3939333

105

209317059

227

298444484

33633633

5630

3636333

78145175324168218848484444218421218421

33636333

4126

27666

Non-alcoholic Food & Beverage

Clothing and Shoes

Home Decoration and Appliance

Transportation

Recreation and Culture

Hotel and Restaurant

Average Monthly Household Expenditure

Alcoholic Beverage and Tobacco

Housing and Utilities

Health Care

Communications

Education

Goods and Services

Trend's relationship to sector

The spread of consumerism in developing countries is helping to foster the idea of the home as anextension of the self and a sign of upward mobility. “California-style” gated communities are poppingup for IT workers in India. It can also mean upgrading functionality in the home, e.g., with modernappliances. In developed countries the home has long been seen in these terms; aesthetics arecentral and people strive for the latest accoutrements.

In Malaysia, analysis by type of housing units shows that consumers prefer terrace / townhouses /cluster houses and flats / apartments / condominiums rather than detached and semi-detachedhouses. Green focus agenda is being adopted in almost all new construction planning.

The use of energy and natural resources rises in parallel with the rise of modern consumerism. Forexample, on the back of its shift towards consumerism China has become the world’s largest marketfor grain, meat, coal, and steel. This growth has also sparked a brisk trade in illegally harvestedlumber, leading to deforestation across Asia.

Generally, Malaysians are aware of energy efficiency. Consumers is Malaysia are looking for betterproducts in term of energy saving and fuel efficiency.

Consumerism Relevance to Business Sectors :

Business sector

Construction

Energy andnatural resources

Figure 2 Household Expenditure Trends, Malaysia 1993 to 2010

Malaysia’s progress isrestrained by inadequateresearch and developmentcapacity, lack of designand process engineers,and technical andproduction workers.

Source: Department of Statistics Malaysia

Change of Consumerism


21

viewpoints


FMCG help consumers efficiently and easily meet day-to-day needs such as personal care, mealpreparations, and home cleaning. At the same time, they provide consumers with relatively inexpensiveopportunities to purchase branded lifestyle products such as cosmetics and personal care products.

Consumerism in established and emerging markets is often supported by credit. Access to credit is on therise in developing countries, helping to finance consumers’ spending on cars, homes, householdappliances, etc.

Influential financial news magazine, The Economist, has named Malaysia as the world’s most importantIslamic-finance center. Malaysia’s Islamic banking assets growth rate is between 18% and 20% annually.Over the past few years takaful, an Islamic insurance scheme, has enjoyed significant expansion withan estimated average annual growth rate of 25% as apposed to 10.2% for the conventional insurancebetween year 2004 and 2007. Financial planning is becoming essential among Malaysian.

Consumerism means that people look at food not just as a source of calories, but also as a lifestyleproduct and even a mark of personal distinction, e.g., distinguishing oneself by eating ‘modern’packaged foods in the Third world, or Icelandic free-range lamb in the developed countries.

The practice of eating-out has become a trend among urban workers, students and even familiesbecause of work or there is no food available at home. In Malaysia, Halal status has been the mostimportant factor for Muslim consumers.

A rise in consumerism usually means governments will need to tackle questions of marketregulation, product and food safety, and authenticity in advertising. Governments must also decidewhich goods and services (such as phone service or water) are social goods and which are part ofthe market.

Government’s policy and regulation is one of the drivers in consumption trend. For example, byfocusing on green growth, Malaysia can expedite its target to reduce GHG by 40% in 2020 from itslevel in 2005. Malaysia is confident that the services sector will contribute 70% to the gross domesticproduct (GDP) by 2015.

Healthcare is part of the social and government sector in many parts of the world, but in others it is aconsumer service. Lifestyle drugs – prescription drugs that address conditions that are chronic butnot life-threatening – have become popular worldwide. Medical tourism is on the rise as a distinctform of consumer-focused medicine. These and other trends push medicine more towards theconsumer realm. Malaysia is ranked among the top five destinations for medical / health tourism.Factors such as cost-effective treatments, skilled medical professionals and government support aredriving the growth.

There is a big concern on dietary pattern such as eating outside, skipping meals and relying on fastfood. This dietary pattern contributes to non-communicable diseases associated with over nutritionnamely obesity, hypertension, coronary diseases and cancers.

Information technology, primarily the Internet, has become increasingly important to consumerismin recent years. E-commerce, collaborative filtering, eBay, and product research are just a few of theinnovations. Infotech devices have moved from geek to chic, and buying – and using – the latest ITfor some consumers in all three Worlds is a way to attain an air of coolness and modernity.

The numbers of people buying smartphones has increased to 7.7 million in January 2013. Broadbandpenetration in Malaysia increased from 55.6% in 2010 to 66.0% in 2012. Report by McKinsey &Company in 2012 placed Malaysia at third place among countries that enjoyed productivity increasefor SMEs due to web technologies. Sharing information on the internet enable consumers toaccess more options available online. Some consumers are moving towards ‘collaborativeconsumption’ where people make deals or swap things and services over the internet. eGovtinitiatives to transform government services online has increased productivity, specificallytowards a paperless government.

Leisure time is closely linked with consumerism in World 1 and is increasingly in other parts of theworld, with people spending time to go to the movies, travel, buy books, etc. For some people,consumerism itself has become a pastime, e.g., shopping at the mall, bargain hunting, or antiquing.

Business sector

Fast-movingconsumer goods (FMCG)

Financial services

Food and beverage

Government

Health & Medicine

Information technology

Leisure


22

viewpoints

Business sector

Media

Mobility

Retail

Asia rising Women’s power

Urbanisation

Rising mobility

Media spread

Cultural flows

Networked world

Electrification

Aging

Cultural multipolarityPopulation growth

Transparency

Migration

Changing families

Time pressure

Social freedom

Ethical Consumption

Monetization

Middle class growth

Consumerism


Popular media reinforce the idea of consumerism as a lifestyle and carry the advertising meant todraw consumers to products and services. Consumers in Malaysia now have more access to a mediawhere more people have more variety of sources for information and entertainment throughdifferent devices. Apart from traditional newspapers, magazines and television, sharing informationthrough social media has become a trend. Some consumers prefer smartphones for their desirablefeatures and advance ability in term of media accessibility.

As people embrace consumerism, expectations about transportation change. Personal mobility is aprime component of consumer life in developed countries. The model of personal car ownershipand leisure travel has now been passed on to developing countries and has become theaspirational model for developing countries’s emerging consumer class.

In Malaysia, a family without a car is a rarity. Even students of driving age from middle and uppermiddle class families have their own cars to travel from their residents to colleges or universities.

Formal retail outlets such as hypermarkets and supermarkets that provide one-stop shopping arecommon in developed countries are making inroads into developing countries. The old fashionedsundry shops and street vendors wil soon be things of the past.

Relationships to other TrendsConsumerism interacts with many other trends. The diagram below shows these relationships its closely intertwined and driven by other trendsincluding the rise of middle class, monetization, media spread, ethical shopping, etc.

Source: INNOVARO: Top 20 Trends Consumerism


23

viewpoints

Relationships to Other Top 20 Trends

Other Trend

Middle-classgrowth

Monetization

Ethicalconsumption

Social freedom

Time pressure

Asia rising

Women’s power

Urbanization

Relationship toconsumerism

Driver

Mutuallyreinforcing

Outcome

Mutuallyreinforcing

Mutuallyreinforcing

Mutuallyreinforcing

Driver

Mutuallyreinforcing

Relationship description

Over the last century the emergence oflarge middle-income groups in developedcountries societies has gone hand-in-handwith the creation of modern consumerism.Rising middle classes are now helpingspread consumerism to developingcountries.

Monetization gives consumers new optionsfor consumerist identities and pursuits. Therise of consuming classes provides theincentive for businesses to monetize dailyactivities.

Ethical consumption is a specific form ofconsumerism in which people integratepersonal values into their purchasingchoices. Rather than focusing solely onstandard variables such as price and quality,consumers integrate ethical, religious,political, and other beliefs into theirpurchasing decisions, enhancing the tiebetween consumption and identity.

Rising freedom gives people moreeconomic and social room to engage inconsumer lifestyles. At the same time, thenew choices available in consumeristsocieties let people express their socialfreedom as they buy products that helpdefine and differentiate them from theirfellow citizens (e.g., sport cars, hip-hopmusic, organic

Consumerism increases options and theneed to support one’s expenditure withwork, boosting time pressure. At the sametime, the purchase of consumer goods(such as prepared foods) can free up time.

The rise of Asia is creating new demands forconsumer goods and services. At the sametime, the lure of consumer-focused lifestylesis helping drive the rise of Asian economies.

As their position in society improves, women’seconomic options and resources increase. Thismeans that they are able to more directlydrive and direct consumer spending.

Cities expose people to the range of consumerlife, and offer economic opportunities that canboost people’s income, driving consumerspending. At the same time the allure ofconsumer life can draw people in search ofmodern lifestyles to the cities.

Change in the future

Much of future growth in consumerism willbe driven by the expansion of the globalmiddle class in developing countries suchas China, India, Brazil, Russia, and Mexico.

Time-consuming household activities aremonetized in consumer societies, includingfood preparation and childcare. As incomesrise, more and more of consumer lifestyleswill be monetized, e.g., exercise, dogwalking, and shopping.

Developed countries consumers will likelylead the rise in ethical consumption. Asconsumers in developing countries learnmore about ethical consumption, theirchoices may also be shaped by these ideasand will demand products that meet theirdistinct ethical criteria.

Consumer goods will be used more andmore as a way for people in developingcountries to define themselves and expresstheir growing freedom. Countries that areopening up will help spread modernconsumerism further around the world.

Consumers in developing countries will paymore attention to time. They willincreasingly seek products and services toalleviate their rising time pressure.

Asia’s budding consumers will not make thesame choices that people in developedcountries do. Their styles, preferences, andconsumption patterns will contribute to themix of global consumer options – and insome cases influence the choices ofdeveloped countries consumers.

Women’s rising economic and social statuswill be expressed through consumptionchoices, and used to pursue new identityoptions.

The future growth of cities, especially indeveloping countries, will exposeconsumers to a wider variety of consumeroptions than ever before.


24

viewpoints

Other Trend

Rising mobility

Media spread

Cultural flows

Networkedworld

Electrification

Relationship toconsumerism

Outcome

Mutuallyreinforcing

Driver

Outcome

Driver

References1. Top 20 Consumerism2. Malaysian Demographic and Economic Trends3. Malaysian Retail Trends4. Malaysia Consumer Life5. Malaysia may be developed nation by 2018, says minister6. Strong ringgit to give Malaysians better purchasing power7. Low Carbon Green Growth Roadmap for Asia and the Pacific8. April CPI up 1.7% on higher food prices

9. MITI confident services sector to contribute 70% of GDPby 2015

10. Malaysia among top 3 in economic impact of Internet study11.Human Development Report 201312.Nutrition Research in Malaysia13.SKMM Handphone Survey 201114. World Economic Forum : Engaging Tomorrow’s Consumer15.World Economic Forum : Consumer Industry Emerging

Trends and Issues

16. ‘Car prices will be cut in stages’17.Retail and Consumer World by PwC18.Charging forward PwC’s 2012 electric vehicle survey 19.Household Use of the Internet Survey 201120.Greater KL To Host 10 Million People, Greener Buildings

In 2020, Says Raja Nong Chik21.Household Expenditure Trends, Department of Statistics

Malaysia

Source : Social Technologies Analysis.

Relationship description

Upgrading personal transportation is aprimary goal for many as their incomes rise,whether that means a motorized scooter fora teen in Vietnam or a minivan for a youngfamily in Mexico.

Media content drives consumerism andnew consumers seek to acquire the radios,TVs, satellite dishes, and other devices thatenable media spread.

Cultural flows expose people in emergingeconomies to the idea of consumer cultureand, in general, give people new consumeridentities to aspire to.

As consumerism spreads, people gain accessto network devices and services.

Electrification enables many new forms ofconsumption, from appliances to mediadevices and new kinds of food.

Change in the future

Consumer spending will spur demand formobility products and services, from carsand traffic management systems to airplanes.

It will become easier to reach consumers inthe future as more are linked to modernmedia streams. But as consumers gain theability to personalize their media, messageswill need to be more closely focused onspecific consumer identities.

Developed countries cultural exports willfind increasing competition from risingpower of developing countries in shapingglobal consumerism.

Nodes in the networked world will increaseas consumerism spreads. Developedcountries will connect in new ways, andmuch of developing countries will connectfor the first time.

Electrification will increase the total pool ofconsumers, and open new opportunities forserving bottom-of-the-pyramid consumers.

NON-COMMuNICABLEDISEASES (NCDS):

IS IT A FuTuREWITHOuT HOPE?

BY

Ani Suzila [email protected]


25

viewpoints


26

viewpoints

News about the death of a 36 years old friend due to heart attack really shocked me. He is young,cheerful, and athletic. He has not shown any symptom of illness, either physically, emotionally ormentally. The news really made me ponder, and scrolling down my Facebook newsfeeds made it evenworst with news so many drastic and tragic fatalities.

One has to accept that death does not consider age or fitness level. It is inevitable. And one cannot fully relate health symptoms to death as statistics have shownthat the death cases caused by NCDs are on the rise for all ages all over the world irrespective of the wealth status of the nations. (Figure 1, World Bank)

Figure 1 Projected deaths by major cause and World Bank income group, all ages, 2005

Lower middleincome countries

Note: in this fact sheet, we use low, middle and high-income categories as defined by the wold Bank, Cointries are grouped based on their 2009 grossnational income. See World Health Statistic 2011 for more information.

Neonatalinfections

Lowerrespiratoryinfections

Diamhoeldiseases

HIV/AIDS Ischaemicheartdisease

Malaria Strokeand othercerebrovasculardisease

Tuberculosis

Birthasphyxiaandbirth trauma

Prematuarityand lowbirthweight

163 of 100018 13 13 10 8 8 7 5 5 4

Middle-incomecountries

Ischaemicheartdisease

Strokeand othercerebrovasculardisease

Chronicobstructivepulmonarydisease


Diamhoeldiseases

HIV/AIDS Roadtrafficaccident

Diabetismellitus

Tuberculosis

677 of 100093 86 49 36 30 18 17 16 14

Hypertensiveheart disease

15

High-incomecountries

Ischaemicheartdisease

Strokeand othercerebrovasculardisease

Trachea,bronchus,lung cancers

Alzheimerand otherdementias

159 of 100025 14 9 7


6

Chronicobstructivepulmonarydisease

6

Colon andrectumcancers

5

Diabetismellitus

4

Hypertensiveheart disease

4

BreastCancer

3

The leading threat:Non-communicable diseases (NCDs) have beenidentified as the leading cause of morbidity andmortality globally. World Health Organization(WHO) projected that 64 million people will dieof chronic diseases by 2015. As the common riskfactors to these chronic diseases that cause death

in men and women from all parts of the world, areunhealthy diets, physical inactivity, tobacco and alcoholintake, obesity and environmental carcinogens, societyis blaming it on modernization, urbanization andglobalization. (Table 1, World Health Statistics2008 shows a comparison of leadingcause of deaths in 2004 and theprojected cause of deaths in 2030.)

Source: World health Statistic 2011

The sedentary lifestylesafforded throughurbanization,modernization andglobalization are the maincause of this new socalled lifestyle diseases.

BEWARE:HEART ATTACK

JUST AHEAD

What is NCD?

NCD refers to all type of diseases that usually notinfectious. However, some NCDs such ascardiovascular (heart) diseases, stroke, cancer,diabetes, respiratory diseases, and obesity butcan be genetic or hereditary. There are also NCDsof mental and neurological disorders which havenot been highlighted although cases ofSchizophrenia, Alzheimer and depression are alsorising globally.

NCDs can be prevented by controlling the riskfactors such as practicing healthy diet and regularphysical fitness activities, but there are cases ofapparently fit people also falling prey to them.One good example is Yuvraj Singh, the 30 year-oldcricket player whose death has been caused bya rare form of disease called germ cell seminoma.

Although the risk factor is sedentary lifestyle, NCDsare not only prevalent amongst the rich. Accordingto the World Bank, NCDs are going to be the maincause of death in poor developing nations by 2015.

Data from WHO 2008 shows that 48% of NCDdeaths are linked to cardiovascular illness (17million deaths); cancer, 21% (7.6 million deaths);respiratory diseases, 4.2 million; and diabetes, 1.3million worldwide. 80% of these deaths occuredin low and middle income countries.

Disease or injury Deaths Rank(%)

Ischaemic heart disease 12.2 1

Carebrovascular disease 9. 2

Lower respiratory infections 7.0 3

Chronic obstructive pulmonary disease 5.1 4

Diarrhoeal diases 3.6 5

HIV/AIDS 3.5 6

Tuberculosis 2.5 7

Trachea, bronchus, lung cancers 2.3 8

Road Traffic accidents 2.2 9

Prematurity and low birth weight 2.0 10

Neonatal infections andother* 1.9 11

Diabetes mellitus 1.9 12

Malaria 1.7 13

Hypertensive heart disease 1.7 14

Birth asphyria and birth trauma 1.5 15

Self-inflicted injuries 1.4 16

Stomach cancer 1.4 17

Cirrhosis of the liver 1.3 18

Nephritis and nephrosis 1.3 19

Colon and rectum cancers 1.1 20

Violence 1.0 22

Breast cancer 0.9 23

Oesophagus cancer 0.9 24

Alzheimer and other dementias 0.8 25

Rank Deaths Disease or injury(%)

1 14.2 Ischaemic heart disease

2 12.1 Cerebrovascular disease

3 8.6 Chronic obstructive pulmunary disease

4 3.8 Lower respiratory infections

5 3.6 Road traffic accidents

6 3.4 Trachea, bronchus, lung cancers

7 3.3 Diabetes mellitus

8 2.1 Hypertensive heart disease

9 1.9 Stomach cancer

10 1.8 HIV/AIDS

11 1.6 Nephirtis and nephrosis

12 1.5 Self-inflicted injuries

13 1.4 Liver cancer

14 1.4 Colon and rectum cancers

15 1.3 Oesophagus cancer

16 1.2 Violence

17 1.2 Alzheimer and other dementias

18 1.2 Cirrhosis of the liver

19 1.1 Breast cancer

20 1.0 Tuberculosis

21 1.0 Neonatal infactions and other*

22 0.9 Prematurity and low birth weight

23 0.9 Diarrhoeal diseases

29 0.7 Birth asphyxia and birth trauma

41 0.4 Malaria

Table 1 Leading Causes Of Death, 2004 and 2030 Compared

2004 2030

* Comprises servere a neonatal infections and other, noninfectious causes arising in the prinatal period

Source: World Health Statistics 2008 ( www.who.int/whosis/whatstat/2008/en/index.html)


27

viewpoints


28

viewpoints

Table 2 World Health Statistics 2008,Mortality and burden of disease

Malaysia’s scenario

Malaysia is also being hit by the rising wave ofpremature deaths caused by NCDs. Researchdata, including from the Malaysian NationalHealth & Morbidity Surveys (NHMS), has shownincreases in NCDs cases from 2006 to 2011 (Referto graph). Heart diseases are top 5 principalcauses of death of Malaysians aged 15-64 yearsold. (Department of Statistics, Malaysia).

Rising obesity cases amongst children in Malaysiafor the past few decades is also alarming. Theprevalence of ‘at risk of overweight’ is 12.5%(male) and 11.7% (female) among school childrenaged 13-17 years. Childhood obesity usuallyoccurs in a social landscape that is awash in low-nutrition, and high-calorie food.

In developing countries, middle-aged adults areseen to be more vulnerable to chronic diseasessuch as heart attacks and strokes. The number of

deaths at earlier ages caused by these diseases islarger in developing countries compared to indeveloped countries. This trend affects thesecountries economic and social development, it islike robbing the nations of its citizens during theirmost productive years.

Table 3 Prevalence of NCD Risk Factors in Malaysia (1996-2006)

2005 2005 1990 2000 2006 1990 2000 2006

Liberia 1200 ... 36 64 63 1 8 7 955 485 169 270Libyan, Arab Jamaiyica 97 ... 5 2 1 ... ... ... 650 411 79 55Lithuana 11 <10 5 10 7 0 0 0 640 391 161 136Luxembourg 12 <50 2 1 1 0 0 0 406 177 134 51Madagascar 510 16 38 40 4 5 0 0 0 837 430 147 112Malawi 1100 605 9 23 21 6 104 90 835 430 147 112Malaysia 62 16 21 16 14 0 2 3 625 274 139 50

Mali 970 81 79 66 63 1 6 7 909 458 166 145Mata 8 <50 1 1 1 0 0 0 429 214 124 24Marshall Islands ... ... 68 47 28 . .. ... ... 997 526 125 62Mauritania 820 <50 62 72 67 0 3 4 984 451 158 138Mauritius 15 <10 4 3 3 0 0 0 701 434 79 42Mexico 60 8 10 4 2 0 0 0 603 163 88 58Micronesia (Federated States of) ... ... 33 19 12 ... ... ... 782 410 93 39Monaco ... ... 0 0 0 ... ... ... 325 115 120 41Mongolia 45 <10 52 36 15 0 0 0 988 488 306 96

Maternalmortalityratiod

(per 100 000live births

Female HIV/AIDS

e

Non-

commuricab

le

Cardio-vascu

lar

Canc

er

Injurie

s

TB among HIV-negetivepeoplef

1990 2000 2006

Maternal Mortality Maternal Mortality

TB among HIV-positivepeopleg

Cause-specific mortality rate(per 100 000 population)

Age-standerdized mortality ratesby cause h, i

(per 100 000 population)

2002

NHMS II MANS MyNCDS-1 NHMS III(1996) (2003) (2005) (2006)

Age group > 18 years > 18 years 25-65 years > 18 years

Smoking 24.8% N.A. 25.5% 21.5%

Physically inactive 88.4% 85.6% 60.1% 43.7%

Unhealthy Diet N.A. N.A. 72.8 N.A.

Overweight 16.6% 27.4% 30.9% 29.1%(BMI > 25 & >30 kg/m2)

Obesity (BMI > 25 & >30 kg/m2) 4.4% 12.7% 16.3% 14.0%

Hypercholesterolaemia N.A. N.A. 53.5% 20.6%

In 2006, there is an estimated 2.8 million Malaysians age 18 years and above are current smokers, 5.5 million physically inactive,3.6 million overweight and 1.7 million Malaysians obese.

Source: World Health Statistics 2008

Source: Malaysian National Health & Morbidity Survey (NHMS)

Cabinet Committee for A HealthPromoting Environment

Main TOR: To determine policies that creates a living environment whichsupports positive behavioural changes of the population towards healthyeating and active living

Preventive mechanismAs sedentary lifestyles and new dietary habitscontribute to the increase of chronic diseases andpremature deaths, preventive measures such asgood and healthy diet, regular medical checkupand health screening, and regular exercisebecome necessary. In Malaysia, the governmentis playing the leading role in effort to combatthese diseases. The Ministry of Health hasdeveloped a plan known as National StrategicPlan for NCDs (NSP-NCD). NSP-NCD waspresented and approved by the Cabinet ofMalaysia on 17 December 2010. The NSP-NCDprovides the framework for strengthening NCDprevention and control programs in Malaysia.

There are seven strategies outlined in NSP-NCD:

1. Prevention and promotion 2. Clinical management3. Increasing patient compliance4. Action with NGOs, Professional Bodies & other stakeholders5. Monitoring, Research and Surveillance6. Capacity Building7. Policy and Regulatory interventions

Malaysia adopted the ‘whole of government’ and‘whole of society’ approach in implementing thestrategies. The idea is to get cross ministriesinvolvement, both in creating policies and legislations,to create a health promoting environment.

Admissions to MOH Hospitals due to CirculatoryDiseases & Cancer: Projections by 2020

Circulatory diseases Maliganant neoplasmas

200,000

180,000

160,000

140,000

120,000

1000,000

80,000

60,000

40,000

20,000

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020

Projected, Circulatory diseases Projected, Cancer

y= 130995e0.0208x

R2=0.7959

y= 53166e0.0523x

R2=0.0716

1. Minister of Health

2. Minister of Education

3. Minister of Information, Communication,Arts & Culture

4. Minister of Rural & Regional Development

5. Minister of Agriculture and Agro-based Industry

6. Minister of Youth & Sports

7. Minister of Human Resource

8. Minister of Domestic Trade, Co-operatives andConsumerism

9. Minister of Housing and Local Governments

10. Minister of Women, Family and Social Affairs

Source: Ministry of Health, Malaysia

Figure 2 Admissions to MOH Hospitals due to Circulatory Diseases & Cancer: Projections by 2020


29

viewpoints


30

viewpoints

Defeated conquest or triumph?The main focus of NSP-NCD is to improve medicalcare and services along with many other interventionprograms, including education, training, awarenesscampaigns and counseling of the general public.

Apart from helping to improve and promote healthyliving habits and lifestyles, NSP-NCD also implementsmeasures to reduce the risk factors of NDCs such asincreasing the price of tobacco and unhealthy foodcontent, reducing the cost of healthy food and

restricting the marketing of unhealthy foods forchildren, protect populations from exposure tosecond-hand smoke and numerous other initiatives.

Economic and social lossThe economic impact of NCDs is very high, notonly for the effected individuals and their families,but the society and nation at large. Globally, in2010 the direct costs (diagnosis, treatment andcare) and indirect costs (loss of productivity andincome) for cardiovascular diseases alone were$863 million, and it is projected to increase by 22percent to $1.05 billion by the year 2030. At the2011 UN High Level Meeting on NCDs, the WorldEconomic Forum projected that NCDs couldresult in a cumulative output loss of US$ 30trillion over the next two decades. (figure3)

It is hard to put a price tag on fighting thesediseases. However, the World Economic Forumhas identified NCDs as the second most severe

threat to the global economy after wealthinequality between the rich and the poor. NCDshave forced many breadwinners of the families toquit their jobs, whilst many women are unable tocontinue to work as they have to look after the sick.

Where does it lead?It is hoped that emerging technologies will beable improve the mortality and mobility rate ofhumankind. Continuous innovation and integrationin medical, engineering, information technologyand researches to build a good infrastructure incombating NCDs are necessary. At the same time,people need to adhere to the lifestyle changeswithin and outside health services.

Dr. Ray Kurzweil, inventor, businessman andauthor, forecasted that by 2045 we will bedominated by nonbiological intelligence (amerger between biological and machine

intelligence). Soon technology can be used toreprogram genes away from cancer. However, theimportance of maintaining healthy lifestyle is verysignificant.

References:1. WHO,Preventing Chronic Diseases a vital investment ,Geneva 20052. World Economic Forum and Harvard School of PublicHealth, September 2011 WHO, World Health Statistics 2008(http://www.who.int/whosis/whostat/EN_WHS08_Full.pdf )

3. The Non-Communicable Diseases (NDC) Division, Ministryof Health Malaysia4. The Malaysian Association for the study of obesity (MASO)

5. The report, Public Policy and the Challenge of Chronic Non-communicable Diseases, is available at http://web.worldbank.org.

6. BMJ Publishing Group Ltd 2007

7. Non Communicable Diseases - A Universal Scourgehttp://www.sooperarticles.com/health-fitness-articles/diseases-articles/non-communicable-diseases-universal-scourge-1041834.html#ixzz2RqAcn78J

8. Action Plan for the Global Strategy for the Prevention andControl of Noncommunicable Diseases (NCD Action Plan).

9. Non-communicable diseases pose rising threat to poornations Geneva, John Zarocostas

10. IT growth and global change: A conversation with RayKurzweil : McKinsey Quarterly (January 2011)

11. Huffpost Healthy Living, Katherine Warren, LauraMacherelli, July 2011

In developing countries,middle-aged adults areseen to be morevulnerable to chronicdiseases such as heartattacks and strokes

Some NCDs such ascardiovascular (heart)diseases, stroke, cancer,diabetes, respiratorydiseases, and obesitybut can be geneticor hereditary

45

40

50

35

30

25

20

15

10

5

02011 2013 2015 2017 2019 2021 2023 2025 2027 2029

lost

out

put,

trill

ions

(201

0 US

$)

High income

Total, world

Upper -middle income

Lower -middle income

Low income

Total, low and middle income countries

Figure 3 Output losses will speed up over time (breakdown of NCD cost by disease, based on EPIC model)

Source: World Economic Forum ( www.who.int/whosis/whatstat/2008/en/index.html)

BY

Natrah Mohd Emran [email protected]

FAMILY & HOME:THE NEXT DECADE

Apart from affordable price, future homebuyers will definitely look for added

values in availability of technology devicesand systems in their houses.

According to Google’s executive chairman, EricSchmidt, in the house of the future people are ‘not lost,never lonely, never bored’. He sees new technology asoffering the possibility of ‘a life of knowledge andentertainment – a potpourri for all of us to choose from.1

Based on his statement, it could be imagined that in thenext decade home would be the heart of daily routineswithout necessarily leaving the house to get thingsdone as Facebook, Twitter, YouTube, instant messaging,

video conferencing, web meetings and many othercollaborations and social media platforms would becomepart of peoples’ everyday lives around the world.

From the porch to the kitchen and from the hall to thebedroom of future houses would be equipped withdevices that are not only more efficient than anythingwe have now, but also provide greater connectivitybetween people and machines, allowing them to ‘talk’seamlessly to each other.

Changes in demographic and family set-ups, shifting ofhabits, economic constraints, and aging familymembers are among the drivers of change towardsinnovation of new technologies. The following diagram

(Diagram 1) listed 10 technology trajectories that arerelevant to the evolution of home and family life overthe next decade (Diagram 1).2

Home sweet home and it is getting sweeter! Outside forces and introduction of new technologies haveinfluenced and changed the dynamics of family and home. Housing developers include moderntechnologies and facilities to encourage sales. House owners are getting accustomed to new devices,systems and services.

Apart from affordableprice, future home buyerswill definitely look foradded values in availabilityof technology devices andsystems in their houses.

31


viewpoints

Diagram 1 10 Key Technology Trajectories influencing future home

Key Technology Trajectories

Ten technology trajectories wereidentified in this research series:

• Adaptive Environments• Cloud Intelligence• Collaboration Economy• Contextual Reality• Cutting the Cable• Information Fusion• Interface Anywhere, Any way• Manufacturing 3.0• Personal Analytics• Socially Networked Stuff

Of the 10, several are particularlyrelevant to the evolution of home andfamily life over the next decade.

Cloud Intelligence

Cloud-based services willbring advanced decision-support into homes, offeringpersonalized, contextualizedassistance as families goabout their lives.

InterfaceAnywhere, Any Way

Intuitive interfaces willbecome the dominant formof interaction with IT. Peoplewill use gestures, touch,verbal commands/ andother novel input/ outputinterfaces to control devicesand home systems

Information Fusion

Many household systemswill have the ability to makecomplex information andpatterns user-friendly andaccessible to residents viavisualization and other easy-to-grasp presentation forms.

SociallyNetworked Stuff

Ordinary home products,from HVAC systems to

toasters and toothpastetubes, will be networked-

able to sense andcommunicate with each

other, family members, andthe broader digital

infrastructure. They willdisplay alerts, make

suggestions, etc.

Cutting the cable

Millennials and Generations Zare coming of age ina world where networking is inincreasingly ubiquitous. Theywill expect their homes to beplatforms thatfaciliate their anywhere,anytime IT-infused lifestyles.

More aware and adaptive homeWith the advancement of new materials andembedded sensors, homes and home systems couldbecome far more functional, adaptive and responsive.As flexible displays finally reach commercialisation,new interfaces will make home technology moreubiquitous – touch screen surfaces, voice controlledappliances, eye-movement tracking or even emotion

analysis that monitors what the user wants wouldbe available soon. These will make home the centreof almost all activities – work, education andentertainment. Indirectly, this will influence andchange the house layouts. There is no necessity fordedicated home offices or entertainment room, butinstead a more flexible and adaptive rooms – anyroom. Subsequently, people will tend to spent moretime at home and become more reliant on ‘datainsurance’ to protect families’ crucial information.

As missing out is not an option, cost of these newdevices will be the main considerations for homebuyers. The economic standings of home ownersplay an important role in determining the type oftechnology devices and facilities in their homes. Up-market houses would be equipped with state-of-the-art technology whilst cheaper houses would beequipped with cheaper products. As for olderhouses/homes, cost of products and installationwould be the determining factor.

Adaptive Environments

Advances in materials will makehomes “smart”. Everyday objects,surfaces and coatings will adaptto changing conditions orconsumer needs-becoming selfcleaning, changing function,displaying different colours, etc.

Source: Innovaro. 2011

$$$$


32

viewpoints

New roles of tech- savvy generation More than 60% of the Malaysian population arebelow the age of 34. This group, known as the‘digital natives, encompasses two generations:the Millennials (born in 1979-1998) and the Gen Z(born from 1999 onwards)3. This group; especiallythe Gen Z, are more likely to engage with multipledevices or media simultaneously.

Today, kids as young as pre-schoolers engrossedwith smart phones and tablet computers are acommon sight. As these Gen Z move into theirteens and 20s, they will have substantial demandfor virtual products – avatar, virtual currency, and3D printing, etc. They would also be demanding forafter-market customisations and modifications ofthe smart systems to match their environmentand needs.

Digital DIY home – upgrading is inour handIn future, more DIY-enabled devices will be built. Lifeat home would be more engaging, convenient andfun (or otherwise?). Without leaving homes, familiescould be connected with the outside world as theycan gain ideas and share information, almostinstantly from anywhere and anything; be it socialnetworks (e.g. other consumers, virtual agents) or thesmart devices itself.

Consumers would be expecting productscustomisations and modifications to fit theirpersonal needs and necessities. A power to controlgiven by products’ manufacturers would enableconsumers to make more informed decisions onfamily issues and home systems. For example, asmart meter with real-time reading and able toprovide analysis on energy consumption based onspecific characteristic of a home will assist familymembers to be more aware on their monthlyenergy consumption and can work together topractice more energy efficient routines.

Future houses wouldbe equipped with devicesthat provide greaterconnectivity betweenpeople and machines,allowing them to ‘talk’seamlessly to each other.

Diagram 1 User age distribution on Facebook in Malaysia

ConclusionBy 2020, most people would be living in morefunctional and adaptive homes, with personallycustomised and modified home systems, and bettercommunication methods and interactions betweenfamily members. However, while technologiesprovide new capabilities and experiences, there arealso various uncertainties and questions that needto be seriously considered – privacy, financial constrainand the essential human values.

While in the local context, as Malaysia aims to be adevelop nation by 2020 with USD15,000 income percapita, are we ready for the change? How fast will wereact to introduction of more advanced tools? Howmuch are we willing to pay? How would these factorseffect the investment and advancement of hometechnologies? After all, home is where the heart is.

Tech usage reshaping family dynamicsCommunication; either directly or indirectly, is vitalin human development. It is a natural process forhumans to access the outside world on a daily basis.Constant connectivity expands the relationshipbetween parents and children, brothers and sisters,nieces, in laws etc.

As relationships increasingly ‘go digital’, the impacts arebeing translated into transformative future technology.Evolution of digital entertainment; for example, maycontribute to tighten up family bonding throughinteresting activities and games played together.

However, technologies may also create personal‘technology bubbles’ where family members cocoonthemselves at home without communicating withone another, but privately communicate with othersat different places (‘alone together’ is the term usedby the MIT). Everyone is in their own world but yetthey all globally connected.

Socialbakers’ statistic on Malaysia Facebook usersshows that 72% users are aged between 18 to 34.(And yes, they are the Millennial and Gen Z.) Anotherstatistic by Google, Ipsos and the Mobile MarketingAssociation (MMA) shows that 97% are using smartphones at home, and 44% are using smart phoneonline multiple times per day!

USER AGE DISTRIBUTIONON FACEBOOK IN MALAYSIA3,279,401

993,758

298,12799,375

0 695,630

695,6303,776,280

13-1516-1718-2425-3435-4445-5455-6465+

Source: www.socialbakers.com


33

viewpoints

References1. Nexpected! Technology behind the future home2. INNOVARO, 20113. INNOVARO, 2011

Book Club

Scenario planning is the principles, methods, and techniques for looking forward into the future and trying to anticipateand influence what is to come next. This book provides students and line managers in organizations with the meansto create better scenarios and to use them to create winning business strategies. The purpose is to shed new light onscenarios and scenario-like thinking in organizations for managers at every level within a company. The book coversscenarios such as: economic outlooks; political environments; acquisitions; downsizing, and more.

Strategic Foresight:

A New Lookat Scenarios

ISBN-10: 0230611729ISBN-13: 978-0230611726Author: Alfred MarcusPublisher: Palgrave Macmillan


34

NEW MEGATRENDS

ISBN 10: 1137008083ISBN 13: 9781137008084Author : Sarwant SinghPublisher: Palgrave Macmillan

New Mega Trends predicts the tentrends that will make the greatestimpact to business – and our lives - inthe future and offers practical advice onhow to profit from them.

Based upon extensive research by one of theworld's largest market research companies andtested with some of the largest Fortune 100companies, New Mega Trends identifies the tenmost important global trends that will redefineour world by 2020:

E-mobilityUrbanizationHealth, wellness and well-beingSocial trendsNew battlefieldsVirtual connected worldInnovating to zeroValue for money business modelsSmart is the new GreenFrom planes to trains

Looking at each of these trends in depth, Singhnot only identifies and evaluates the emergingtrends, but also translates these into opportunitiesfor everyday business and personal life.

New Mega Trends offers a vivid picture of howour working and personal lives will be changedin the years to come, and with an understandingof immediate opportunities and threats toeveryday business and personal life.

Foresight has emerged as a key instrument for the developmentand implementation of research and innovation policy. The mainfocus of activity has been at the national level. Governmentshave sought to set priorities, to build networks between scienceand industry and, in some cases, to change their research systemand administrative culture. Foresight has been used as a set oftechnical tools, or as a way to encourage more structured debatewith wider participation leading to the shared understanding oflong-term issues. In this comprehensive and critical Handbook,cross-cutting analytical chapters explore the emergence andpositioning of foresight, common approaches and methods,organisational issues, and the scope for policy transfer andevaluation. Leading experts and practitioners contributechapters analysing experiences in France, Germany, the UnitedKingdom, the USA, Japan, China, Latin America, small Europeannations, Nordic countries and selected developing countries. Thebook concludes with consideration of the future of foresightitself. This fascinating Handbook will appeal equally to thosewishing to apply foresight to their policy or strategy-makingactivities, and to those studying the theory and practice offoresight. The Handbook will be vital reading for policymakersconsidering, commissioning, or using foresight, companies eagerto use public foresight, as well as academics and researchers inforesight, futures and STI policy and management communities.

The Handbook of

TechnologyForesightISBN : 1848448104, 9781848448100Authors : Luke Georghiou, Ian Miles,Rafael PopperPublisher: Edward Elgar Pub, 2009

Book Club

YOUTH-CONSUMERISM

What are the type of activitiesthat are most popular amongst youth?

Source from : Youth Survey, Social Environment, Lifestyles And Values, GOETHE Institute

Youth are spending more of their leisure times on entertainment rather thangetting involve in healthy activities

Five activities that are most liked by young Malaysians

GENERATION VETERAN

YEAR OF BIRTH

THE YOUTH ASDEFINED BY UNITEDNATIONS ( Age 15-24)

X Y Z

2009

1994

1989

1964

1964

ALSO KNOWN AS THE MILLENNIALGENERATION OR MILLENNIALS), GENERATIONNEXT, NEXT GENERATION, ECHO BOOMERS

lGEN- HAVE NEVERKNOWN A WORLDWITHOUT INTERNET

?

Watching TV

Listening Music

Surfing the internet

Reading magazines or newspapers

Taking a walk

Activities with family members

Exercising

Activities

Percentage (%)0 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

75.0

61.7

52.3

47.0

39.9

36.1

32.3

• Digitalize society

• Technologically Adept

• Enterprising

• Environmentalist


Youths are the leaders, movers and shakers of the future. They should be the key indicator to the state of future nation. Their characteristic and behavior will determine tomorrow’s future - will there be shifts in economy,political, social, culture and family value

Youth characteristics:

ALPHA


36

Virtual shopping:the convenient retail therapy

Source : PayPal on the survey ‘PayPal Skip the Queues Survey 2012’

Source : www.ourmobileplanet.comBrow

sed i

nter

net

Onlin

e sho

pping

/On

line B

ankin

g

Job s

earc

h

Prod

uct S

earc

h

Gene

ral S

earc

h

Read

New

s

7969

30

5965

54

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100% How Malaysians usetheir smartphones

0 10% 20% 30% 40%

trouble finding a parking lot

the long queuesat checkout counters

the battle with crowds

Willingness to wait 5-10 minutes in line at a retail store.

Problems

Percentage (%)50% 60% 70% 80% 90% 100%

67

65

50

40

Digitized society towardsknowledge, creative &innovative lifestyles

The top pet peeves for shopping in malls:

Surfing Internet is one of the most popular activities among the youth. 2012 was the year for mobile commerce as more Malaysians turned to their mobile devices to do their shopping. Malaysian shoppers used online and mobile shopping to get back36 hours of their precious time to get involve in other activities, including spending time with family and friends

YOUTH-CONSUMERISM

What are the type of activitiesthat are most popular amongst youth?

Source from : Youth Survey, Social Environment, Lifestyles And Values, GOETHE Institute

Youth are spending more of their leisure times on entertainment rather thangetting involve in healthy activities

Five activities that are most liked by young Malaysians

GENERATION VETERAN

YEAR OF BIRTH

THE YOUTH ASDEFINED BY UNITEDNATIONS ( Age 15-24)

X Y Z

2009

1994

1989

1964

1964

ALSO KNOWN AS THE MILLENNIALGENERATION OR MILLENNIALS), GENERATIONNEXT, NEXT GENERATION, ECHO BOOMERS

lGEN- HAVE NEVERKNOWN A WORLDWITHOUT INTERNET

?

Watching TV

Listening Music

Surfing the internet

Reading magazines or newspapers

Taking a walk

Activities with family members

Exercising

Activities

Percentage (%)0 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

75.0

61.7

52.3

47.0

39.9

36.1

32.3

• Digitalize society

• Technologically Adept

• Enterprising



Youths are the leaders, movers and shakers of the future. They should be the key indicator to the state of future nation. Their characteristic and behavior will determine tomorrow’s future - will there be shifts in economy,political, social, culture and family value

Youth characteristics:

ALPHA


37

A survey was conducted among parents that give gadgets to their children in the United Kingdom.The Daily Mail reported some of the issues raised by the survey participants as:�

�Smart phones and tablets have become parts of everyone’s live. Even babies are not spared.Questions posed by Babies.co.uk in a survey showed:

Issues

regret giving their children games consoles, mobile phones and

computers

yearn to take the gadgets back

annoyed about the amount of time their children spend in front of a

computer or watching TV instead of enjoying traditional activities

try to limit the time youngstersspend using devices or watching

TV each day

kids have their own TV in bedrooms

blame the gadgets for reducingthe amount of quality time

the family has together

admit that they are giving the gadget to their children for an easy life

Percentage (%)

33.3

34.0

67.0

73.0

40.0

66.7

43.0

Baby & Gadget

Yes

• Do you let your baby play with your tablet/smart phone?

NoYesNoMaybe

• Do you think letting your baby use a smart phone/tablet helps them learn?

45%

55%

15%

50%35%

Today, kids are more exposed to technology and various gadgets become past of their everyday lives. Technology has become the way of life and young parents seems to fall prey to this. Reports fromDaily Mail, UK and Babies.co.uk reveals the upcoming trend in bringing up children


38

*Results polled from over 1000 respondents.

Conclusion on Baby & Gadget:• How about the future of the next generation will be as the babies are more exposed to the technologies nowadays? • Are they will be more expert?• And how the nation will develop as technologies will become more advance among the young generation?

YesNo

YesNo

Once a weekTwice a weekUnder 1 hour a dayUnder 2 hours a dayUnder 3 hours a dayMore hours a day

Maybe

YesNo

• Does letting your baby play with a smart phone/ tablet too much disconnect them from their relationship with you?

• When a baby plays on a smart phone/tablet does it negatively impact his real world social and communication skills?

• How often do your baby play your smart phone/ tablet (if you allow it)?

• Does the youth of today spend too much time on smart devices?

18%

31%

51%

52%

48%

14%23%

12%

30%

9%

6%

• Easier to make children stay in one place

• Stimulate sense and imagination

• Promote listening ability, learning of sounds and speaking ability

• Develops innovative thinking, investigative skills, strategic thinking

• Increases children’s computer literacy

• Develops good eye, hand and mental coordination

• Encourages quick mathematical and engineering skills

• Unaided utilization of gadgets

• Tends to keep children out of touch of reality

• Affects concentration and focus in school works

Advantages Disadvantages

Positive and negative impacts of giving electronic devices and gadgets to children

Source: Babies.co.uk

19%

81%


39

40


41


60s RISKS

Women Men

-#1 killer of women over 60.

HEART DISEASE

75% Of strokes occur after 65.

STROKE

Most colorectal cancer inwomen occurs after 60.

COLORECTAL CANCER

1 in 15 men ages 60-69 willdevelop prostate cancer.

PROSTATE CANCER

20% of colon cancer diagnosedbetween ages 60-64.

75% of strokes occur after age 65.

24% of colon cancers diagnosedbetween ages 65-70.

COLON CANCER

STROKE

1 in 2 women over 60 Suffer a fracture due toOsteoporosis.

OSTEOPOROSIS

The following shouldbe done every 3 years:

All of the followingshould be doneannually:

Colorectal screening.

Cholesterol testingCoronary screeningProstate exam

TESTS

Whether in your 20s or well into your 70s, prevention is the key to

sustaining health and vitality. Follow this simple guide to mantain

good health and peace if mind from youth well into your golden years.

Prevent Your Way to Healthy

60s The risk of Type 2 diabetes decreases for both menand woman after 60, while the risk for heartdisease and many cancers increase sharply.

SOURCES: http://www.cancer.gov, http://www.labelstoneline.org,http://wwwcmed.umichedu, http://www.diabetes.org, http://women.webmd.com,http://www.melanomafoundation, http://rex.nicnih.gov

TESTS

Bone density test every

2-3 years

Colorectal screening

every 3 years

Colonoscopy screening

every 5 years.

The following should be

continued annually:

Mammogram

Pelvic exam

Pap and smear at

physician’s disreation

Coronary screening.

42


As a strategic policymaker or stakeholder, you can help map outa desired future for Malaysia

This is an invitation by myForesight® to build a collective future.Do you find this magazine thought-provoking? Do you think wecould have done better? Perhaps you would like us to covera specific angle in the study of Foresight.

Or maybe, you would like to contribute articles to myForesight®

magazine? Send your feedback and articles to [email protected] Website: www.myforesight.my

We look foward to hearing from you.

myForesight® team

MAP THE FuTuRE

myforesight - health & lifestyle

Documents