Abstract
Introduction
Money might not buy happiness, but it can often buy your health. While many healthcare treatments have the potential to solve medical problems, high costs and limited accessibility prevent many from receiving the care that they want and need. In the market for orthotic shoe insoles, options include over-the-counter insoles that lack personalization and often require multiple purchases over time, or custom insoles that can cost up to $800 and lack adaptability (RN, n.d.). This poses a clear financial burden for the more than 50% of people with foot pain in need of a more affordable yet effective shoe insole (Shoe Insoles and Orthotics Statistics, n.d.). Thus, the motivation for the technical project was to design and develop a modifiable insole that provides a more adaptable option to meet the individual needs of each user. Financial burdens of health conditions are not limited to the medical device markets. Celiac Disease (CD) is an autoimmune disorder triggered by the ingestion of dietary gluten, with the only currently available treatment consisting of a strict, lifelong gluten-free diet. CD is associated with high costs for expensive gluten-free foods and healthcare costs for diagnosis and treatment. However, the costs of CD are not merely economic, as the burdens of this disease extend to social and psychological implications as well. Maintenance of a gluten-free diet and management of symptoms have been associated with increased reports of mental health disorders and social isolation (Alkhiari, n.d.). Both the market for shoe insoles and the socioeconomic costs of CD emphasize the need to understand how medical conditions can impact more than one’s physical health and wellbeing. Engineering solutions to these problems and understanding how the accessibility and affordability of treatments impact health outcomes is essential, as technology is only helpful if those in need can actually use it.
STS Research Project
In my STS research, I conducted an extensive literature review to investigate differences in costs for individuals with Celiac Disease. The economic costs of maintaining a gluten-free diet included an overall 183% increase in gluten-free food prices compared to regular foods, with online venues showing the most drastic differences in cost (Lee et al., 2019). Additionally, my research revealed that not only is gluten-free food more expensive, but it is also less available to consumers in many stores (Soler & Borzykowski, 2025). In addition to the aforementioned economic burdens, CD also proved to have substantial impacts on the social well-being of affected individuals, with CD patients reporting increased social isolation, caution in social settings, and increased rates of mental health disorders (Alkhiari, n.d.). These factors contributed to reduced adherence to the gluten-free diet, which stands as the only treatment for CD and is necessary for affected individuals to maintain their long-term health and manage symptoms. In reviewing these sources, the need for change became clear. 1% of individuals worldwide are affected by CD, with the incidence of the disease increasing over time (Singh et al., 2018). Understanding the economic and social dimensions of this disease can allow for improved support for individuals with CD. In addition to changing societal perceptions of CD, policy changes can allow for economic relief and restaurant training programs to reduce the burden of CD and improve patient experiences.
Technical Project
The technical portion of my thesis produced a novel shoe insole that can be adapted to meet an individual’s unique needs. My Capstone team 3D printed our design using thermoplastic polyurethane (TPU). This device included TPU tubing that connected from hollowed air pockets to an outside valve where air could be passed through using a bike or other accessible pump. The valves on the ends of the tubes were ball valves that were 3D printed using a resin printer. Five Tekscan Flexiforce A301 pressure sensors were placed along the surface of the insole where the foot makes contact. Non-inverting op amp circuits were built for each sensor in order to amplify the signal from the sensors to match human body weight recordings. The designed device provides a way to adjust the level of comfort and support of a shoe insole using an air pump. Further work can build upon this design by reducing its size and weight to improve the overall portability of the device. Additionally, further testing on the duration of use of the device can allow for a better understanding of its ability to withstand high loads. This device can help address the need for an accessible shoe insole option to meet the unique needs of each user.
Conclusion
The synthesis of my technical and STS projects highlights the need for engineers to consider the economic and social repercussions of technological developments. Both projects emphasize the importance of creating treatments that are accessible and effective for individuals in need. Looking at these two distinct topics provided insight on both the device market and the experiences of patients with autoimmune disorders to see the ethical significance of biomedical engineering in action.
Acknowledgements
I want to thank my Capstone team, Olivia, Cecilia, Hannah, and Christian, for being such diligent and collaborative team members. I also want to thank our Capstone advisor, Dr. Shawn Russell, and Hailey Wrona for their guidance throughout the duration of our project and for providing materials and insight. Finally, I want to thank Dr. Richard Jacques, who has provided me with the proper direction to complete my STS portfolio and guided my understanding of what it means to be an ethical engineer.
References
Alkhiari, R. (n.d.). Psychiatric and Neurological Manifestations of Celiac Disease in Adults. Cureus, 15(3), e35712. https://doi.org/10.7759/cureus.35712
Lee, A. R., Wolf, R. L., Lebwohl, B., Ciaccio, E. J., & Green, P. H. R. (2019). Persistent Economic Burden of the Gluten Free Diet. Nutrients, 11(2), 399. https://doi.org/10.3390/nu11020399
RN, M. A., MSN. (n.d.). How Much Do Custom Orthotics Cost? GoodRx. Retrieved November 2, 2025, from https://www.goodrx.com/conditions/musculoskeletal/custom-orthotics-cost
Shoe Insoles and Orthotics Statistics. (n.d.). RunRepeat - Athletic Shoe Reviews. Retrieved November 6, 2025, from https://runrepeat.com/shoe-insoles-and-orthotics-statistics
Singh, P., Arora, A., Strand, T. A., Leffler, D. A., Catassi, C., Green, P. H., Kelly, C. P., Ahuja, V., & Makharia, G. K. (2018). Global Prevalence of Celiac Disease: Systematic Review and Meta-analysis. Clinical Gastroenterology and Hepatology: The Official Clinical Practice Journal of the American Gastroenterological Association, 16(6), 823-836.e2. https://doi.org/10.1016/j.cgh.2017.06.037
Soler, L., & Borzykowski, N. (2025). The cost of being gluten-free: A hedonic pricing analysis of food products for celiac patients. Health Economics Review, 15, 87. https://doi.org/10.1186/s13561-025-00677-w
