Assessing Health Numeracy Among Community-Dwelling Older Adults

Faculty of Health Sciences, University of Western Ontario, Ontario, Canada.
Journal of Health Communication (Impact Factor: 1.61). 10/2007; 12(7):651-65. DOI: 10.1080/10810730701619919
Source: PubMed


Quantitative information occupies a central role within health care decision making. Despite this, numeracy has attracted little research attention. Therefore, the purpose of this study was to (1) describe the health numeracy skill of a nonclinical, Canadian community-based senior population and (2) determine the relationship between health numeracy skill and prose health literacy, education, and math anxiety in this population. A convenience sample of 140 men and women, 50 + years, completed a questionnaire assessing demographic details, math anxiety, functional health literacy (Shortened Test of Functional Health Literacy for Adults STOFHLA), general context numeracy, and health context numeracy skills. Most participants had adequate functional health literacy (prose and numeracy) as measured by the STOFHLA, poorer general context numeracy skill, higher health context numeracy skill, and moderate math anxiety. Approximately 36% of the variation in general context numeracy scores and 26% of the variation in health context numeracy scores were explained by prose health literacy skill (STOFHLA), math anxiety, and attained education. This research offers an initial assessment of health numeracy skills as measured by three existing numeracy scales among a group of independently functioning older Canadian adults. This work highlights the need for clarification of the numeracy concept and refinement of health numeracy assessment instruments. Moreover, identifying patients' numeracy strengths and weaknesses will enable the development of focused numeracy interventions and may contribute to moving individuals further along the continuum of health literacy proficiency.

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    • "Aspects of health information and decision-making using numbers and numerical constructs (such as balancing the risks and benefits of different medical procedures, and understanding and taking medication correctly) differ from those aspects of health information transmitted via words (such as a description of diseases and treatments). Within this context there is an increasing recognition of the importance of numeracy as a 'stand-alone' risk factor for poor health (Rothman et al., 2006; Ancker and Kaufman, 2007; Donelle et al., 2007; Peters et al., 2007). In their systematic review Berkman et al. (2011) reviewed the small number of published studies exploring numeracy and health including accuracy of risk perception, knowledge, skills taking medication, and disease prevalence and severity. "
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    ABSTRACT: The relative contributions of functional literacy and functional numeracy to health disparities remain poorly understood in developed world contexts. We seek to unpack their distinctive contributions and to examine how these contributions are framed by place-based deprivation and rurality. We present a multilevel logistic analysis of the 2011 Skills for Life Survey (SfLS), a representative governmental survey of adults aged 16-65 in England. Outcome measures were self-assessed health status and the presence of self-reported long-term health conditions. Exposure variables were functional literacy (FL) and functional numeracy (FN). Age, sex, individual socio-economic status, ethnicity, whether English was a first language, non-UK birthplaces, housing tenure and geography were included as potential confounders and mediators. Geography was measured as area-based deprivation and urban/rural status. FL and FN were both independently associated with self-assessed health status, though the association attenuated after taking account of confounders and mediators. For long-term conditions, the association with FN remained significant following inclusion of confounders and mediators whilst FL attenuated to non-significance. Rurality did not influence these associations. Area deprivation was a significant factor in attenuating the association between FL and self-assessed health status. Policy makers and health professionals will need to be aware of the distinctive impact of FN as well as FL when combating health inequalities, promoting health and managing long-term conditions.
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