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Research piece

Numeracy and managing your Health

20 Jul 2018

Research shows that many people do not have adequate numeracy skills to look after their health.



There are many numeracy skills that people need to look after their health. People need numeracy skills to manage their diets, make and keep medical appointments, measure medicine doses, or simply work out a routine for taking tablets throughout a day.

Currently 43% of the UK population lack adequate literacy skills to understand food labels, medicinal instructions, and information given by the NHS in leaflets and online. Even more concerning is that 61% do not have the numeracy-specific health literacy skills needed to maintain their health (Rowlands et al., 2015).

For example, Cancer Research UK recently found that 46% of people got the answer wrong when asked whether a risk of 1 in 100, 1 in 10, or 1 in 1000 resulted in more chance of their getting a disease (Smith et al., 2014). They also found that those with poor numeracy skills were less likely to take a bowel cancer screening test. 

Health literacy

People with specific chronic health conditions are at particular risk if they have poor numeracy skills. Poor numeracy affects patients’ abilities to self-manage many chronic healthcare conditions, such as asthma, diabetes, chronic kidney disease, and blood pressure (Apter et al., 2006; Cavanaugh et al., 2008; Fraser et al., 2013; Estrada et al., 2004). Crucially, research suggests that people with lower health literacy are more likely to make emergency care visits, suggesting that poor numeracy affects people’s abilities to self-manage their care. 

Health literacy-2

But everyone needs numeracy to protect their health. Research show that people with poor numeracy are less able to monitor their diets, take regular exercise, give up smoking, and interpret food labels (Von Wagner et al. 2007; Rothman et al., 2006). 

More recently, research has found that patients need an understanding of numeracy to make informed decisions on when, where, and how to be treated (Protheroe et al., 2009; Von Wagner et al., 2009). 

Read the full research (pdf)


Apter A, et al. 2006. Asthma numeracy skills and health literacy. Journal of Asthma. 43:705-710.

Cavanaugh et al. 2008. Association of numeracy and diabetes control. Annals of Internal Medicine. 148(10): 737-46.

Estrada CA, Martin-Hryneiwicz M, Peek BT, Collins C, Byrd JC. 2004. Literacy and numeracy skills and anticoagulation control. The American Journal of the Medical Sciences. 328(2): 88-93. 

Fraser SDS, Roderick PJ, Casey M, Taal MW, Ming Yuen H, Nutbeam D. 2013. Prevalence and associations of limited health literacy in chronic kidney disease: a systematic review. Nephrology, Dialysis, Transplantation. 28(2): 129-7. 

Griffey RT, Kennedy SK, McGownan L, Goodman M, Kaphingt KA. 2014. Is low health literacy associated with increased emergency department utilization and recidivism. Academic Emergency Medicine. 21(10): 1109-1115. 

Protheroe J, Nutbeam D, Rowlands G. 2009. Health Literacy: A necessity for increasing participation in healthcare. British Journal of General Practice. 59(567): 721-723.

Rothman RL et al. 2006. Patient understanding of food labels: The role of literacy and numeracy. American Journal of Preventative Medicine. 31(5): 391-398. 

Rowlands G, Protheroe J, Winkley J, Richardson M, Rudd R. 2014. Defining and describing the mismatch between population health literacy and numeracy and health system complexity, an observational study. (Submitted to the BMC Public Health for peer review).

Smith SG, Kobayashi LC, Wolf MS, RaineR, Wardle J, on Wagner C. 2014. The associations between objective numeracy and colorectal cancer screening knowledge, attitudes and defensive processing in a deprived community sample. Journal of Health Psychology. [ONLINE] [Accessed 20 December 2014].

Von Wagner C, Knight K, Steptoe A, Wardle J. 2007. Functional health literacy and health-promoting behaviour in a national sample of British adults. Journal of Epidemiology and Community Health. 61(12): 1086-1090. 

Von Wagner C, Semmler C, Good C, Wardle J. 2009. Health literacy and self-efficacy for participating in colorectal cancer screening: The role of information processing. Patient Education and Counseling. 75(3): 352-357.