Kory Kochersperger ENGL 115 6.23.20 Speech 4: Persuasive Speech Should Philadelphia subsidize gym/fitness memberships for low-income citizens? I. Introduction A. Attention Getter: "We are losing ground in the battle against cardio vascular disease.” Said by Dr Sadiya Kahn, an assistant professor of cardiology at Northwestern University’s Feinberg School of Medicine. There are plenty of metrics to choose from, but they all paint the same picture. Over one third of US adults are obese, increasing the risk of several leading causes of preventable deaths including: heart disease, stroke, type 2 diabetes, and specific types of cancer. While speaking of diabetes, the Philadelphia Department of Public Health explains diabetes diagnosis has increased more than 50% over the past 15 years, which falls directly in-line with national trends. The United States continues to be sicker and sicker, year over year. The city of Philadelphia not only falls inside the bell curve of ever-increasing chronic disease, in some aspects it’s actually leading the way. Norma Padron is associate director for Main Line Health Center for Population Health Research as Lankenau Hospital. She wrote an article for PhillyMag in 2017 called “The Hard Truth Behind Philadelphia Health Statistics” tying together direct evidence that health and wellness is succinctly a socioeconomic problem. Padron explains, “According to the Robert Wood Johnson Foundation’s County Health Rankings, Montgomery County stands first among Pennsylvania counties in the socioeconomic factors that determine health, whereas Philadelphia ranks 67th out of 67. These counties are separated by a single street: City Avenue. We can statistically prove the United States is sick, and fat, both of those on an upward trajectory. And we can prove Philadelphia is no different. B. Term Topic Question & Preview: Should Philadelphia subsidize gym/fitness memberships for low-income citizens? Yes, we should try it. At a time when cities and communities are re-examining budgets and re-assessing where their values and tax dollars align, 2020 seems like the right time for this kind of program. As we’re seeing a transition away from extensive and continued money for police, we need to strongly consider programs for those with a shallow voice. The lowincome populations with the least education, the worst health-habits, yet the most in need of some help. So today we’ll touch on how this program already exists in different capacities, mostly within the private sector. We’ll also take a look at why it’s not only a morally good idea, (an effort to serve the health of the people) but also logistically, the potential for success. II. Body A. The idea at hand. 1. Understanding the terms and the problem. We have a health problem. And poor people have it most in amount, and most in severity. We use a wide-spanning, umbrella term called chronic disease to indicate a host of diagnosis including: heart disease, obesity, asthma, diabetes, stroke, some cancers. We lump them together because their prognoses are generally all the same: ultimately incurable, though preventable. Further, if detected early many of these can be stopped or reversed with non-medical prescriptions in the form of: healthy whole foods, and significantly increased exercise. 2. Dig a bit deeper. Obesity rates are higher in women. Obesity rates are higher in middle-aged adults (45-65yr) Obesity rates are nearly 2x higher in non-Hispanic black women, than white women. And the most important piece of data we see from the Philadelphia Department of Public Health is: Adults with lower income, and those with a high school education or less have significantly higher rates of obesity. And we see this holding true on a sliding scale, the poorer you are the higher the odds you’re obese. 3. What’s the fallout? With no prevention, it’s pretty obvious what happens next. People with chronic disease account for 81% of all hospital admissions. When that fails, (ultimately it will, there is no cure) seven out of ten deaths in the United States are due to chronic disease, killing more than 1.7 million Americans year over year. B. A piece of the “solution”. Answering the “why it happens” question is heavy, and multi-faceted. Our mission here today is much more direct. If increased exercise is undoubtedly one of the ways to fight off chronic disease, and poor people have the highest rates of chronic disease, then how do we increase access and remover barriers of entry. Our proposal is to cut cost from their equation. a. It begins with an online database, geo-locating you to your nearest fitness facilities. b. The city absorbs the costs of membership and in return there is an attendance policy. If you check-in fourteen or more times in a month, no costs. c. In 2013, the Department of Labor published a 72-page study on four private sector companies, and their wellness program initiatives. Programs were set up similarly to the one we’ve proposed. Gym attendance was the catalyst for re-imbursement to employees whom participated. d. Philadelphia is in the back-of-the-pack when it comes to health/obesity in the United States, but they know there’s a problem, and they’re trying. The city has partnered with The Food Trust to increase availability and affordability of healthy food via Farmer’s Markets in low income neighborhoods. So, we know they’re accepting to the idea of combating the crisis, potentially with city dollars. e. Similarly, the city has partnered with Philly Powered Campaign to promote physical activity and exercise. C. Benefits // Drawbacks 1. Benefits A) Much like a police force or a fire department is tasked to protect the residents and communities they serve, the idea of protecting those same people from health conditions that result in misery, loss of function, and death shouldn’t seem too farfetched. B) Increased health/wellness is correlated to better productivity, fewer sick days, and over time, perhaps less pressure on our hospitals and healthcare systems. C) Better relations within broader communities. The proposal is similar to something like college scholarships for low-income or minority students. A more inclusive pool of community inhabitants in pursuit of the same thing, (health) leads to better communication, and better understanding of each other. D) Employment opportunities for counselors to educate and assist on a person-to-person level, employment for tech fields to build and maintain the website. E) As with any forward-thinking program the alternative is simply the preceding status quo. Our proposal isn’t mandatory, there’s no penalty for non-compliance. Our goal is simply to change the lives we can reach. We educate those who are willing, we provide the funds, and the details (gym schedules, class schedules, best methods of travel) and begin the “trick down effect” where participants begin to teach the people of their inner-circle, and we slowly grow the field. To not examine the idea, is to leave things just as they are, with Philadelphia being one of the sickest major cities in our country. 1) Drawbacks A) Money is king. Philadelphia is notorious for budget problems, and unless money is diverted, this will obviously be a hard sell. B) Past case-studies show that wellness incentives are usually met with lukewarm response. On top of that, the data suggests that those who do participate are usually already the fittest, and most motivated. C) Public outcry comes in varied forms, but it will inevitably appear. We would need to define who qualifies and who doesn’t, which will leave people just outside of that curve, and they’ll want an explanation why. Some conservative minded people may reasonably claim this as simple government overreach. It’s not the city’s job to tell people how to live. D) The logistical complexities are too immense for the program to gain any traction, meaning that free gym memberships don’t solely put bodies in gyms. Low income communities have more hurdles to jump. Jerilyn Cox, a registered nurse at Whitman-Walker Health in Washington DC explained it well, “You’re less likely to go out to a recreational facility, or gym if you have to take multiple steps, like figure out what hours you can go depending on your work schedule, and what bus line or metro train you have to take to get there and back.” III. Conclusion A) Review The battle in the United States against chronic disease is complicated and needs to be approached from many, many angles. One thing is certain: low income communities, and minority cultures suffer from its affects the worst. With our proposal we are not trying to solve the whole problem at once, rather just one sub-section of it. Science says that exercise can increase lean muscle tissue, decrease bodyfat, and lower blood pressure. We believe positive results are best achieved when people are in an environment of similar-thinking individuals. The city of Philadelphia’s health statistics are a snapshot of those of the United States, in some instances worse than the mean. Our program is to incentivize low-income people to exercise more by paying for their memberships to health facilities. These are our communities; we all live here. These are our neighbors and their longevity, health, and well-being should concern us. B) Appeal to Action The action could come from either side. We can go to the gyms and companies themselves, or go to the city’s representatives. The results we want will only happen when both sides see the value. But the time is ripe. Our communities seem tired of the same old asset allocation. Political change takes a long time, unless the people demand their voices heard. We take our proposal to city council, to the folks who run our city.
