Socioeconomic status, statistical confidence, and patient-provider communication: an analysis of the Health Information National Trends Survey (HINTS 2007).

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.