Better Risk Literacy = Better Decisions

September 21st, 2017

Studies have suggested a correlation between good decision-making and intelligence, but scientist Edward Cokely and his colleagues have found there is a much better predictor of whether people will make decisions that benefit them, regardless of their intelligence level: their understanding of risk and statistical concepts. Understanding how probability works has been found to predict the quality of decision-making in a wide range of areas, from using credit cards responsibly to participating in high-stakes medical screenings. Cokely’s studies also show that when you teach people about probability, they make better decisions, some of which might even save their lives.

To illustrate, Cokely points to an example: a study of how people decide whether to go to the hospital when they are having possible symptoms of a heart attack. With today’s medicine, “if you get to the hospital quickly during a heart attack, you will probably live, and if you get there within an hour of a heart attack, you have much better odds of full recovery,” Cokely explains. But interventions that teach people to recognize the signs of heart attack have typically failed to increase the number of patients getting to the hospital in time. A recent study by Cokely and colleagues Dafina Petrova and Rocio Garcia-Retamero recently found that statistical numeracy was a big factor: patients with low numeracy skills were about four times less likely to go to the hospital within the critical first hour than those with high numeracy. The researchers speculate that people with low numeracy may underestimate the probability that they could be having a heart attack and may fail to deliberate much about the serious consequences of delay (e.g., death and major disability). (They conducted the study in Spain, which has universal health access, to rule out the possibility that cost or access were factors in patients’ decisions.)

Cokely, who is a Presidential Research Professor and associate professor of psychology at the University of Oklahoma and the National Institute for Risk & Resilience, is one of the first people to tease out why numeracy is so important for decision-making. He has learned that it’s not about the ability to do mathematical calculations per se, but more about the process of integrating our personal values with our risk assessments. “Statistics is the language of risk and science,” he explains. To make good decisions, you have to know how likely an outcome is given multiple factors, and you also need to integrate that information together with your personal values, responsibilities, and other cost-benefit information so that you can truly feel what’s at stake, and why.

Informed by these findings, which are based on tens of thousands of participants from multiple countries, Cokely’s lab is working to empower decision-makers, be they practicing surgeons or typical young adults at-risk for HIV infection. They have found that among people with low numeracy skills, decision-making quality can be dramatically improved by the use of transparent risk communications, like brochures with graphs and other visual aids that can help people see the otherwise-abstract concept of probability. But to generalize decision-making quality beyond a single topic, people need training in broader risk literacy skills, so Cokely and his colleagues are building online “intelligent” tutorial platforms designed to improve understanding of probability. Results of recent studies with diverse young adult decision makers suggest these programs can make a big improvement in both graph understanding and risk literacy skills more generally.

Beyond understanding the risks and trade-offs, math education is an important part of skilled and adaptive decision making. “There is math that is for certainty, like algebra, and there is math for uncertainty, like statistics. [U.S. schools] do a pretty good job training people in the former but have not focused nearly as extensively on the latter.” A major collection of economic data compiled by another lab suggests that if U.S. residents had the same numeracy level of Canadian citizens, the economic impact would be hundreds of trillions of dollars,“ in part because more skilled decision makers would be less likely to get tricked by scams, bad deals, or dangerous treatments, and because they would be more likely to make all kinds of good decisions about health, finances, public policy, relationships, and other things that really drive social and economic prosperity.

Cokely believes his findings offer a powerful message about the ability to equip people with the knowledge to make good decisions for themselves. He says that the goal for his lab and the program more generally is “to profoundly reduce global decision-making vulnerability.” That is ambitious, but with data coming in from Cokely and his collaborators all over the world, it seems like we may be on our way.

Edward Cokely is a recipient of the Federation of Associations in Behavioral & Brain Sciences (FABBS) Foundation Early Career Impact Award, to be presented during the annual meeting of the Society for Judgment and Decision Making in Vancouver, British Columbia.