Correlating reading comprehension and health numeracy among adults with low literacy

Objective: Using the Test of Functional Health Literacy for Adults (TOFHLA), a pilot study was conducted to assess whether reading comprehension and numeracy scores sufficiently correlate in health contexts among adults with low literacy skills. Methods: The TOFHLA was administered to 144 adults with low literacy enrolled in a health literacy program prior to the start of coursework. Raw scores for reading and numeracy were calculated. Weighted numeracy scores were calculated and compared to raw reading comprehension scores. Results: Among 143 participants, 20% (n = 28) had a higher numeracy score than reading comprehension score, while an additional 20% scored lower in numeracy than in reading comprehension. Conclusion: This study found that reading comprehension and numeracy skill in the context of understanding health information do not necessarily correlate for specific disadvantaged groups. This finding calls attention to the need to further examine numeracy as a construct which is conceptually separate from reading comprehension, and highlights the importance of including a numerate component in health literacy evaluations. Practice implications: The results of this study have important implications for medical decision-makers, health educators, and health promoters working with traditional methods of assessing health literacy. (C) 2010 Elsevier Ireland Ltd. All rights reserved.