General performance on a numeracy scale among highly educated samples

Med Decis Making. 2001 Jan-Feb;21(1):37-44. doi: 10.1177/0272989X0102100105.


Background: Numeracy, how facile people are with basic probability and mathematical concepts, is associated with how people perceive health risks. Performance on simple numeracy problems has been poor among populations with little as well as more formal education. Here, we examine how highly educated participants performed on a general and an expanded numeracy scale. The latter was designed within the context of health risks.

Method: A total of 463 men and women aged 40 and older completed a 3-item general and an expanded 7-item numeracy scale. The expanded scale assessed how well people 1) differentiate and perform simple mathematical operations on risk magnitudes using percentages and proportions, 2) convert percentages to proportions, 3) convert proportions to percentages, and 4) convert probabilities to proportions.

Results: On average, 18% and 32% of participants correctly answered all of the general and expanded numeracy scale items, respectively. Approximately 16% to 20% incorrectly answered the most straightforward questions pertaining to risk magnitudes (e.g., Which represents the larger risk: 1%, 5%, or 10%?). A factor analysis revealed that the general and expanded risk numeracy items tapped the construct of global numeracy.

Conclusions: These results suggest that even highly educated participants have difficulty with relatively simple numeracy questions, thus replicating in part earlier studies. The implication is that usual strategies for communicating numerical risk may be flawed. Methods and consequences of communicating health risk information tailored to a person's level of numeracy should be explored further.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / epidemiology
  • Breast Neoplasms / prevention & control
  • Colorectal Neoplasms / epidemiology
  • Colorectal Neoplasms / prevention & control
  • Decision Theory
  • Educational Status
  • Female
  • Health Behavior*
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Mass Screening / statistics & numerical data
  • Middle Aged
  • Probability Learning*
  • Problem Solving*
  • Risk Assessment*
  • United States