Where’d the $2500 come from?

June 17, 2017

(This article was originally published at Statistical Modeling, Causal Inference, and Social Science, and syndicated at StatsBlogs.)

Brad Buchsbaum writes:

Sometimes I read the New York Times “Well” articles on science and health. It’s a mixed bag, sometimes it’s quite good and sometimes not. I came across this yesterday:

What’s the Value of Exercise? $2,500

For people still struggling to make time for exercise, a new study offers a strong incentive: You’ll save $2,500 a year.

The savings, a result of reduced medical costs, don’t require much effort to accrue — just 30 minutes of walking five days a week is enough.

The findings come from an analysis of 26,239 men and women, published today in the Journal of the American Heart Association. . . .

I [Buchsbaum] thought: I wonder where the number came from? So I tracked down the paper referred to in the article (which was unhelpfully not linked or properly named).

I was horrified to find that the $2500 figure appears to be nowhere in the paper (see table 2). Moreover, the closest number I could find ($1900) was based on a regression model without covarying age, sex, ethnicity, income, or anything else. Of course older people exercise less and spend more on healthcare!

I sent the following email (see below) to the NYTimes author, but she has not responded.

At any rate, I thought this example of very high-profile science-blogging to be particularly egregious, so I thought I’d bring it to your attention.

The research article is Economic Impact of Moderate-Vigorous Physical Activity Among Those With and Without Established Cardiovascular Disease: 2012 Medical Expenditure Panel Survey, by Javier Valero-Elizondo, Joseph Salami, Chukwuemeka Osondu, Oluseye Ogunmoroti, Alejandro Arrieta, Erica Spatz, Adnan Younus, Jamal Rana, Salim Virani, Ron Blankstein, Michael Blaha, Emir Veledar, and Khurram Nasir.

And here’s Buchsbaum’s letter to Gretchen Reynolds, the author of that news article:

I very much enjoy your health articles for the New York Times. Sometimes I try and find the paper and examine the data, just for my own benefit.

After perusing the paper, I’m was not quite sure where the $2500 figure came from. In table 2 (see attached paper), the unadjusted expenditures are reported over all subjects.

non-optimal PA: $5397, optimal PA: $3443 for a difference of $1900.

This is close to $2500 but your number is higher.

However, remember, this is an *unadjusted model*. It does not account for age, sex, family income, race/ethnicity, insurance type, geographical location or comorbidity.

In other words, it’s a virtually useless model.

Lets look at Model 3, which does account for the above factors.

non-optimal PA: $4867, optimal PA: $4153 for a difference of $714

So $714 closer to the mark.

BUT, this includes ALL subjects, including those with cardiovascular disease (CVD).

If you look at people without CVD then the estimates depend on the cardiovascular risk profile (CRF). If you have an average or optimal profile then the difference is around $430 or $493. If you have a “poor” profile, then the difference is around $1060 (although the 95% confidence intervals overlapped, meaning the effect was not reliable).

What is my conclusion?

I’m afraid the title of your article is misleading since it is larger (by $600) than the $1900 estimate based on the meaningless unadjusted model! Even if the title was “What’s the Value of Exercise? $700”, it would still be misleading, because it implicitly assumes a causal relationship between exercise and expenditure.

Remember also that the adjusted variables are only the measures the authors happened to record. There are dozens of potentially other mediating variables which are related to both physical exercise and health expenditures. Including these other adjusting factors might further reduce the estimates.

Best Regards,

It’s just a news article so some oversimplification is perhaps unavoidable. But I do wonder where the $2500 number came from. I’m guessing it’s from some press release but I don’t know.

Also, I’m surprised the reporter didn’t respond to the email. But maybe New York Times reporters get too many emails to respond to, or even read. I should also emphasize that I did not read that news article or the scientific paper in detail, so I’m not endorsing (or disagreeing with) Buchsbaum’s claim. Here I’m just interested the general challenge of tracking down numbers like that $2500 that have no apparent source.

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