Medical College of Wisconsin
CTSICores SearchResearch InformaticsREDCap

A framework for health numeracy: how patients use quantitative skills in health care. J Health Commun 2008 Jul-Aug;13(5):501-17 PMID: 18661390 PMCID: PMC4162627

Pubmed ID





Our objective of this study is to develop a conceptual framework for the construct of health numeracy based on patient perceptions, using a cross-sectional, qualitative design. Interested participants (n=59) meeting eligibility criteria (age 40-74, English speaking) were assigned to one of six focus groups stratified by gender and educational level (low, medium, high). Fifty-three percent were male, and 47% were female. Sixty-one percent were white non-Hispanic, and 39% were of minority race or ethnicity. Participants were randomly selected from three primary care sites associated with an academic medical center. Focus group discussions were held in May 2004 and focused on how numbers are used in the health care setting. Data were presented from clinical trials to further explore how quantitative information is used in health communication and decision making. Focus groups were audio and videotaped; verbatim transcripts were prepared and analyzed. A framework of health numeracy was developed to reflect the themes that emerged. Three broad conceptual domains for health numeracy were identified: primary numeric skills, applied health numeracy, and interpretive health numeracy. Across domains, results suggested that numeracy contains an emotional component, with both positive and negative affect reflected in patient numeracy statements. We conclude that health numeracy is a multifaceted construct that includes applied and interpretive components and is influenced by patient affect.

Author List

Schapira MM, Fletcher KE, Gilligan MA, King TK, Laud PW, Matthews BA, Neuner JM, Hayes E


Kathlyn E. Fletcher MD Professor in the Medicine department at Medical College of Wisconsin
Purushottam W. Laud PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Joan Neuner MD, MPH Associate Professor in the Medicine department at Medical College of Wisconsin


2-s2.0-48249111804   31 Citations

MESH terms used to index this publication - Major topics in bold

Attitude to Health
Data Interpretation, Statistical
Decision Making
Focus Groups
Information Dissemination
Middle Aged
Patient Education as Topic
Primary Health Care
jenkins-FCD Prod-321 98992d628744e349846c2f62ac68f241d7e1ea70