Math predictors of numeric health and non-health decision-making problems

Abstract

People frequently encounter numeric information in medical and health contexts. In this paper, we investigated the math factors that are associated with decision-making accuracy in health and non-health contexts. This is an important endeavor given that there is relatively little cross-talk between math cognition researchers and those studying health decision making. Ninety adults (M = 37 years; 86% White; 51% male) answered hypothetical health decision-making problems, and 93 adults (M = 36 years; 75% White; 42% males) answered a non-health decision-making problem. All participants were recruited from an online panel. Each participant completed a battery of tasks involving objective math skills (e.g., whole number and fraction estimation, comparison, arithmetic fluency, objective numeracy, etc.) and subjective ratings of their math attitudes, anxiety, and subjective numeracy. In separate regression models, we identified which objective and subjective math measures were associated with health and non-health decision-making accuracy. Magnitude comparison accuracy, multi-step arithmetic accuracy, and math anxiety accounted for significant variance in health decision-making accuracy, whereas attention to math, as illustrated in open-ended strategy reports, was the only significant predictor of non-health decision-making accuracy. Importantly, reliable and valid measures from the math cognition literature were more strongly related to health decision-making accuracy than were commonly used subjective and objective measures of numeracy. These results have a practical implication: Understanding the math factors that are associated with health decision-making performance could inform future interventions to enhance comprehension of numeric health information.

Number lines can be more effective at facilitating adults’ performance on health-related ratio problems than risk ladders and icon arrays.

“…Subjective math ability is also relevant to the present study because it can explain additional variance in performance on health-related ratio problems over and above objective math skills. For instance, anxiety and negative attitudes about math could impact performance on health-related ratio problems by leading people to avoid thinking deeply about numbers (e.g., Sidney, Thalluri, et al, 2019; Thompson et al, 2021). Moreover, math anxiety has been found to predict health-related math problem-solving performance (Thompson et al, 2021) as well as people’s confidence in their own health-related problem-solving performance (Scheibe et al, 2022) even when accounting for objective math skills.…”

Leveraging Math Cognition to Combat Health Innumeracy

“…Mathematically, percentages involve use of a common unit ("by the 100," from the definition of percent as per (by) cent ( 100)), which facilitates the process of comparing relative quantities. Even though percentages are a relational construct, they perceptually look like whole numbers (Sidney et al, 2021;Thompson et al, 2021) because they convey "multiples" of a common unit (i.e., 100 iterations of the unit, 1/100). This feature of percentages enables individuals to effectively apply their knowledge about natural numbers when processing LEVERAGING MATH COGNITION ratios.…”

“…Future research should assess whether number lines help people make mathematically accurate health decisions in real-world, personalized risk contexts, too. LEVERAGING MATH COGNITION Thompson et al (2021) Note. Procedural knowledge about how to calculate and compare case-fatality rates was conveyed in a step-by-step worked example by Thompson and colleagues (2021).…”

Leveraging Math Cognition to Combat Health Innumeracy

“…Studies in math cognition have conducted analyses of the open-ended strategy reports in which children and adults describe how they estimated and compared fraction magnitudes. It is common for people to explicitly mention in their strategy reports that they focused on numerators in isolation (Fazio et al, 2017;Sidney, Thalluri et al, 2019;Siegler et al, 2011;Thompson et al, 2021). People also focused on just numerators early in the COVID-19 pandemic when the news media and politicians claimed that the seasonal flu was more common than COVID-19 because the absolute number of flu deaths were greater than the absolute number of COVID-19 deaths Netburn, 2020;Scheibe et al, 2021;Thompson et al, 2020Thompson et al, , 2021.…”

“…It is common for people to explicitly mention in their strategy reports that they focused on numerators in isolation (Fazio et al, 2017;Sidney, Thalluri et al, 2019;Siegler et al, 2011;Thompson et al, 2021). People also focused on just numerators early in the COVID-19 pandemic when the news media and politicians claimed that the seasonal flu was more common than COVID-19 because the absolute number of flu deaths were greater than the absolute number of COVID-19 deaths Netburn, 2020;Scheibe et al, 2021;Thompson et al, 2020Thompson et al, , 2021. This misunderstanding of case-fatality rates likely influenced people's beliefs that COVID-19 was less of a threat than the seasonal flu.…”