Keeping Rush Limbaugh Honest

Today’s post is in response to a video http://www.msnbc.msn.com/id/21134540/vp/31332672#31332672
that I viewed courtesy of a face book friend. He sent me the clip as he correctly assumed it would get my attention. The clip is of a TV show host responding to something that Rush Limbaugh said on his radio show. To paraphrase, Mr. Limbaugh said that people who exercise so much, exercise nuts I believe he called them, were likely to blame for the rising costs of health care in this country. The reason? He suggested that all of their physical activity, of which he mostly named group sports, resulted in a significant amount of injuries and emergency room visits.

First of all, I have only once gone to the emergency room with an injury fitting that distinction and it was from a ballet class mishap and I only went because my sister insisted. I believe it was a torn tendon and it was not emergent but painful.

We have spoken a lot lately about calorie reduction for weight loss and physical activity for disease prevention. There is a causal link between lack of physical activity and disease and vice versa (meaning exercise and weight control also prevent disease). People who are physically fit and of a normal weight are much less likely to require prescription medications and the frequent physician visits to monitor the progress and side effects so there associated.

Yes, I do have pulled muscles from time to time for which I might see my primary care doctor, massage therapist and or physical therapist; however, I do NOT take medicines. I do not have any chronic disease for which I need disease management.

Though we already know that Mr. Limbaugh is in err, we can back it up with some fact checking of our own. In fact, he should have looked at the CDC’s Advance Data documents himself where he could easily deduct the cause of emergency room visits.

Here are some results from the National Hospital Ambulatory Medical Care Survey (NHAMCS). The survey was conducted from December 29, 2003, through December 26, 2004. I appreciate that this data is five years old (though the report is only three years old) but it includes a review of over 110 million emergency department or ED visits and will certainly show if Mr. Limbaugh’s assertion holds any weight. You can review this very detailed report and conduct your own data queries at http://www.cdc.gov/nchs/data/ad/ad372.pdf.

Though the entire report is fascinating, the bottom line is this, Rush Limbaugh is ignorant. I enjoyed writing that sentence. The truth is that the plurality of ED visits is related to abdominal pain, chest pain, and fever. The report does note musculoskeletal complaints but later breaks down injuries and we can make a cleaner assumption from that data.

For example and by category:

Injury and Poisoning make up 26% of the ED visits and 20 % of that 26% is for fractures, sprains and strains, open wounds, superficial injury, contusions with intact skin. To be extra extra safe, we can add 1.4 % for “other” injuries. So 21.4 percent of 26 percent is 5.5%.

When the report breaks it down to the top twenty diagnosis, however, bruising is on the top, I am referring to the contusions with intact skin. In very close range, only .1 % apart follow abdominal pain, open wounds (non head), chest pain and then respiratory infection. That makes the report a little confusing however, if it were broken down by cost of care, I feel fairly certain that evaluating and treating some bruises is a lot less expensive then working up chest and abdominal pain.

The report goes even further however and categorizes injuries by intent and mechanism. In review of that table it appears that I significantly over estimated which injuries were related to exercise because only 4.3% of unintentional injuries were said to be caused by overexertion and strenuous movements with an additional 1.1 % due to non traffic “pedal cycle” accidents. This would take us down to 5 percent of 26 percent of ED visits related to sports and or exercise. APPROXIMATELY! So 1.3% of ED visits are the cause of the health care crisis.. yes.. that makes sense. (!)

In conclusion, with an ever increasing overweight, diabetic, hypertensive population, we would do well to not only encourage physical activity but to legislate the promotion of it.

The report that I referenced today is cited below:

McCaig LF, Nawar EN. National Hospital Ambulatory Medical Care Survey: 2004 emergency department summary. Advance data from vital and health statistics; no 372. Hyattsville, MD: National Center for Health Statistics 2006.

Well, don't just sit there! Move IT