ABCs or 123s? The independent contributions of literacy and numeracy skills on health task performance among older adults

Samuel G. Smith, Laura M. Curtis, Rachel O'Conor, Alex D. Federman, Michael S. Wolf

Research output: Contribution to journalArticlepeer-review

29 Scopus citations


Objective: To investigate the relationship between literacy and numeracy and their association with health task performance. Methods: Older adults (n= 304) completed commonly used measures of literacy and numeracy. Single factor literacy and numeracy scores were calculated and used to predict performance on an established set of health self-management tasks, including: (i) responding to spoken information; (ii) comprehension of print and (iii) multimedia information; and (iv) organizing and dosing medication. Total and sub-scale scores were calculated. Results: Literacy and numeracy measures were highly correlated (rs = 0.68; ps < 0.001). In multivariable models adjusted for age, gender, race, education, and comorbidity, lower literacy (β= 0.44, p<. 0.001) and numeracy (β= 0.44, p<. 0.001) were independently associated with worse overall task performance and all sub-scales (literacy range, β= 0.23-0.45, ps < 0.001; numeracy range, β= 0.31-0.41, ps < 0.001). Multivariable analyses with both constructs entered explained more variance in overall health task performance compared with separate literacy and numeracy models (8.2% and 10% respectively, ps < 0.001). Conclusion: Literacy and numeracy were highly correlated, but independent predictors of health task performance. These skill sets are complementary and both are important for health self-management. Practice implications: Self-management interventions may be more effective if they consider both literacy and numeracy skills rather than focusing on one specific ability.

Original languageEnglish
Pages (from-to)991-997
Number of pages7
JournalPatient Education and Counseling
Issue number8
StatePublished - 1 Aug 2015


  • Health communication
  • Health literacy
  • Numeracy
  • Patient education


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