Jim Craigmyle / Corbis

Key Concepts

• Statistical illiteracy is rooted not in intellectual deficits but in the doctor-patient relationship, the illusion of certainty in medicine, and the practice of presenting health information in opaque forms that erroneously suggest big benefits and small harms from interventions.
• Without understanding the numbers, citizens are susceptible to political and commercial manipulation of their anxieties and hopes. The result can be serious damage to physical health and emotional well-being.
• People need to understand the difference between absolute and relative risks and how to use natural frequencies to infer the true chances of disease from a positive test result. Individuals also should know to trust mortality rates over five-year survival statistics when evaluating screening tests.
• To boost statistical literacy, we also recommend introducing young children to statistical thinking and teaching statistics in school as a way of solving real-world predicaments rather than as a purely mathematical discipline.

In a 2007 campaign advertisement, former New York City mayor Rudy Giuliani said, “I had prostate cancer, five, six years ago. My chances of surviving prostate cancer—and thank God, I was cured of it—in the United States? Eighty-two percent. My chances of surviving prostate cancer in England? Only 44 percent under socialized medicine.” Giuliani used these statistics to argue that he was lucky to be living in New York and not in York. This statement was big news. As we will explain, it was also a big mistake.

In 1938 in World Brain (Methuen & Co.), English writer H. G. Wells predicted that for an educated citizenship in a modern democracy, statis­tical thinking would be as indispensable as reading and writing. At the beginning of the 21st century, nearly everyone living in an industrial society has been taught reading and writing but not statistical thinking—how to understand information about risks and uncertainties in our technological world. That lack of understanding is shared by many ­physicians, journalists and politicians such as Giuliani who, as a result, spread misconceptions to the public.

If your institution has site license access, enter here.