title: Demographic disparities in numeracy among emergency department patients: evidence from two multicenter studies.
abstract: OBJECTIVE
  To estimate the prevalence and demographic disparities in limited numeracy among emergency department (ED) patients.
  
  
  METHODS
  We 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.
  
  
  RESULTS
  Rates 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 (upward arrow) 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 (upward arrow) $10,000).
  
  
  CONCLUSIONS
  We 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.
  
  
  CONCLUSIONS
  Greater understanding of the high prevalence of limited numeracy may guide healthcare providers to simplify messages and communicate health information more effectively.
authors.affiliation: Division of Emergency Medicine, University of Colorado Denver School of Medicine, Aurora, CO 80045, USA. adit.ginde@uchsc.edu
authors.forename: Adit A
authors.initials: AA
authors.lastname: Ginde
authors.forename: Sunday
authors.initials: S
authors.lastname: Clark
authors.forename: Joshua N
authors.initials: JN
authors.lastname: Goldstein
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Camargo
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000193:education* / Q000706:statistics & numerical data; D000704:Analysis of Variance; D001249:Asthma / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004522:Educational Status; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006301:Health Services Needs and Demand; D006630:Hispanic or Latino / Q000193:education* / Q000706:statistics & numerical data; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D007297:Inpatients / Q000193:education* / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008433:Mathematics; D008875:Middle Aged; D010353:Patient Education as Topic; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D044465:White People / Q000193:education* / Q000706:statistics & numerical data