Battery usage and background activity

Is the battery usage and activity by app reported in Settings -> Battery accurate and reliable? Specifically, I'm wondering how background activity can accumulate for an for an app that has its Settings -> General -> Background App Refresh disabled.

About every year I have a problem with unexplained battery drain on an iPhone. This has happened over multiple generations of hardware and software. I've been relatively lucky that it has seldom been directly related to a new iOS or app version, i.e. I don't usually suffer from the crippling battery drain that gets widely publicized.

When this problem flares up, my phone's battery will be down below 10% at a time of night when it has historically been at ~40%. I then investigate in Settings -> Battery to see what's going on. Battery capacity has been around 90%, so I could understand losing ~10% runtime in a year-old battery, but it doesn't explain a sudden drop of 30% capacity.

I usually find some app(s) with excessive usage. This year I noticed, after a few days of having the problem, that background activity was high for Weather Channel, Barstool, and Chive. Over the last 10 days, the bar graphs for background activity show about 16 hours per day. All three were disabled for background app refresh. Then I tried force quitting them. The next day, Weather Channel was still high for background activity. So I uninstalled it. I checked app store reviews, and sure enough there are many recent reports of excessive battery drain.

How is it possible to keep accumulating background activity despite that app being disabled for background app refresh? I really don't understand why quitting Weather Channel wasn't enough and I had to uninstall it to stop battery usage. Assuming the reported usage and activity is correct, I don't understand how iOS allows an app to do this.
Battery usage and background activity
 
 
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