Demographic disparities in numeracy among emergency department patients: Evidence from two multicenter studies

ObjectiveTo estimate the prevalence and demographic disparities in limited numeracy among emergency department (ED) patients.MethodsWe performed two cross-sectional studies of ED patients with sub-critical illness in 2000–2001 and 2006. We enrolled 959 adult patients from 28 EDs in 17 US states and measured numeracy based on four validated questions.ResultsRates of correct responses for individual numeracy questions ranged from 15% to 68%; only 11% of participants answered all questions correctly. Several demographic characteristics were independently associated with frequency of correct answers, including age (OR 0.92 [95% confidence interval (CI), 0.87–0.97] per ↑5 years), race/ethnicity (compared to whites: OR 0.35 for blacks [95%CI, 0.20–0.63]; and OR 0.36 for Hispanics [95%CI, 0.19–0.69]), education (OR 4.74 [95%CI, 2.01–11.14] for high school graduates vs. not), health insurance (OR 1.70 [95%CI, 1.06–2.71] for those with private insurance vs. not), and income (OR 1.13 [95%CI, 1.05–1.22] per ↑$10,000).ConclusionWe found a higher prevalence of limited numeracy among ED patients compared to the general population. Significant demographic disparities are consistent with previous observations for general health literacy.Practice implicationsGreater understanding of the high prevalence of limited numeracy may guide healthcare providers to simplify messages and communicate health information more effectively.