Leveraging Math Cognition to Combat Health Innumeracy

Rational numbers (i.e., fractions, percentages, decimals, and whole-number frequencies) are notoriously difficult mathematical constructs. Yet, correctly interpreting rational numbers is imperative for understanding health statistics, such as gauging the likelihood of side effects from a medication. Several pernicious biases impact health decision making involving rational numbers. In our novel developmental framework, the natural number bias--a tendency to misapply knowledge about natural numbers to all numbers--is the mechanism underlying other biases that shape health decision making. Natural number bias occurs when people automatically process natural-number magnitudes and disregard ratio magnitudes. Math cognition researchers have identified individual differences and environmental factors underlying natural number bias and devised ways to teach people how to avoid these biases. Although effective interventions from other areas of research can help adults evaluate numerical health information, they circumvent the core issue: people’s penchant to automatically process natural number magnitudes and disregard ratio magnitudes. We describe the origins of natural number bias and how researchers may harness the bias to improve rational number understanding and ameliorate innumeracy in real-world contexts, including health. We recommend modifications to formal math education to help children learn the connections among natural and rational numbers. Additionally, we call on researchers to consider individual differences people bring to health decision-making contexts, and how measures from math cognition might identify those who would benefit most from support when interpreting health statistics. Investigating innumeracy with an interdisciplinary lens could advance understanding of innumeracy in theoretically meaningful and practical ways.