title: Socioeconomic status, statistical confidence, and patient-provider communication: an analysis of the Health Information National Trends Survey (HINTS 2007).
abstract: The increasing trend of exposing patients seeking health advice to numerical information has the potential to adversely impact patient-provider relationships especially among individuals with low literacy and numeracy skills. We used the HINTS 2007 to provide the first large scale study linking statistical confidence (as a marker of subjective numeracy) to demographic variables and a health-related outcome (in this case the quality of patient-provider interactions). A cohort of 7,674 individuals answered sociodemographic questions, a question on how confident they were in understanding medical statistics, a question on preferences for words or numbers in risk communication, and a measure of patient-provider interaction quality. Over thirty-seven percent (37.4%) of individuals lacked confidence in their ability to understand medical statistics. This was particularly prevalent among the elderly, low income, low education, and non-White ethnic minority groups. Individuals who lacked statistical confidence demonstrated clear preferences for having risk-based information presented with words rather than numbers and were 67% more likely to experience a poor patient-provider interaction, after controlling for gender, ethnicity, insurance status, the presence of a regular health care professional, and the language of the telephone interview. We will discuss the implications of our findings for health care professionals.
authors.affiliation: Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, United Kingdom.
authors.forename: Samuel G
authors.initials: SG
authors.lastname: Smith
authors.forename: Michael S
authors.initials: MS
authors.lastname: Wolf
authors.forename: Christian
authors.initials: C
authors.lastname: von Wagner
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001294:Attitude to Health / Q000208:ethnology; D015331:Cohort Studies; D003142:Communication; D003710:Demography; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D057220:Health Literacy; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D008913:Minority Groups / Q000523:psychology / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D012923:Social Class; D013223:Statistics as Topic; D014481:United States; D055815:Young Adult