Health numeracy refers to the patient’s ability to locate, comprehend, and communicate clinical and public health information. It goes beyond general literacy, focusing on numbers and quantitative reasoning in healthcare.
Why Health Numeracy Matters
Poor understanding of medical numbers affects patients’ ability to make decisions, manage chronic conditions, and understand probabilities of medical outcomes. Research shows adults reporting poor health often have the lowest numeracy skills.
- Decision-Making: Understanding risks and benefits of treatment requires interpreting probabilities and percentages.
- Medication Management: Correctly calculating doses, timing, and frequency relies on basic numeracy.
- Risk Perception: Patients often misinterpret numerical data, leading to overestimation or underestimation of personal health risks.
Levels of Health Numeracy
Health numeracy has several skill levels that can be classified for practical use in patient care.
1. Basic level
- Recognizing numbers and understanding simple quantitative information without calculations.
- Examples: Reading prescription instructions, identifying appointment times, counting daily medication pills.
2. Computational level
- Ability to count, quantify, and perform simple manipulations of numbers.
- Examples: Calculating net carbohydrates from a nutritional label or estimating fees on a sliding scale.
3. Analytical level
- Requires higher-level understanding; for example, including inference, proportions, percentages, and comparisons.
- Examples: Interpreting cholesterol levels, understanding basic health graphs, or comparing insurance plan benefits.
4. Statistical level
- Involves understanding probability, biostatistics, and interpreting complex quantitative data.
- Examples: Estimating treatment success rates, understanding absolute versus relative risk, and interpreting clinical trial results.
Techniques to Improve Understanding Medical Numbers
Effective communication of numbers is essential to prevent patient confusion or misinterpretation:
- Use Absolute Numbers: For instance, say “3 out of 100 people” instead of “3%,” which is easier for patients to visualize.
- Consistent Denominators: Moreover, when comparing risks, keep the total population size and timeframe consistent.
- Visual Aids: Use icon arrays, bar graphs, or AI-generated crowd images to show quantities and probabilities.
- Contextual Analogies: Additionally, relate numbers to everyday experiences, such as comparing 100 people to residents of an apartment building.
Challenges in Communicating Numbers
Even with these strategies, numerical information can confuse or “offend” patients if not presented clearly. Observations show patients react differently to statistics:
- Some feel overwhelmed and disengage completely.
- Others actively interpret and question the numbers, showing strong engagement.
- Meanwhile, many fall in a grey zone, unsure whether information is meaningful or presented understandably.
Tailoring communication to patient understanding minimizes offense and maximizes benefit.
Practical Examples of Health Numeracy in Action
- Risk Communication: For example, present colon cancer screening as “2 out of 100 lives saved” rather than abstract percentages.
- Medication Understanding: Similarly, explain “2 out of 10 people get side effects, while 8 out of 10 do not,” instead of relative risk.
- Interactive Tools: Tools that allow patients to compare multiple complication rates, visually highlighting differences in risk.
Building a Health Numerate Society
Encouraging health numeracy involves education, accessible resources, and careful communication strategies:
- Incorporate numeracy education in school and adult learning programs.
- Use simple, clear language and visuals in patient education materials.
- Assess patient understanding using the teach-back method, asking patients to explain numbers in their own words.
- Support research on health numeracy outcomes and intervention effectiveness.
Conclusion
Understanding numbers in healthcare is a crucial, often overlooked, component of patient empowerment. Helping patients understand and act on numerical health information enhances decision-making, reduces errors, and improves outcomes.
- Using clear numbers, visual aids, and interactive tools improves patient comprehension.
- Recognizing the multiple levels of health numeracy ensures materials and communication strategies are appropriately tailored.
- Investing in health numeracy education supports a more informed, healthier population.
References
- Golbeck, A., Ahlersschmidt, C., Paschal, A., & Dismuke, S. (2005). A definition and operational framework for health numeracy. American Journal of Preventive Medicine, 29(4), 375–376. link
- Understanding Literacy & numeracy. (2024, October 16). Health Literacy. link
- AHRQ SHARE Approach: Communicating Numbers link
- Stone, J. (2002). What should we say to patients with symptoms unexplained by disease? The “number needed to offend.” BMJ, 325(7378), 1449–1450. Link
