health numeracy; health literacy; cognition


Background and Objective. Existing research concludes that measures of general numeracy can be used to predict individuals’ ability to assess health risks. We posit that the domain in which questions are posed affects the ability to perform mathematical tasks, raising the possibility of a separate construct of ‘‘health numeracy’’ that is distinct from general numeracy. The objective was to determine whether older adults’ ability to perform simple math depends on domain. Methods. Community-based participants completed 4 math questions posed in 3 different domains: a health domain, a financial domain, and a pure math domain. Participants were 962 individuals aged 55 and older, representative of the community-dwelling US population over age 54. Results. We found that respondents performed significantly worse when questions were posed in the health domain (54% correct) than in either the pure math domain (66% correct) or the financial domain (63% correct). Our experimental measure of numeracy consisted of only 4 questions, and it is possible that the apparent effect of domain is specific to the mathematical tasks that these questions require. Conclusions. These results suggest that health numeracy is strongly related to general numeracy but that the 2 constructs may not be the same. Further research is needed into how different aspects of general numeracy and health numeracy translate into actual medical decisions.


Original Citation: Levy, Helen, Peter A. Ubel, Amanda J. Dillard, David R. Weir, and Angela Fagerlin. "Health Numeracy: The Importance of Domain in Assessing Numeracy." Medical Decision Making