Monday, June 18, 2012

Are You Sometimes Confused by Written Medical Instructions?

Now, imagine what it would be like if you were sick, scared and 
had only third grade reading skills. Your doctor tells you, "You've got to follow these instructions exactly, or you could die." 

About 200 recent studies have shown the reading difficulty of 
most health related materials FAR exceeds the average reading 
abilities of the American adult. One of the biggest silent health problems today is the gap between health materials and reading 
skills. In the United States, the average reading level is eighth grade. In 1992, the Educational Testing Service determined that half U.S. adults read at between first and eight grade level. That is about 148 million people. It gets worse. One quarter of Americans read BELOW FOURTH GRADE level, meaning 74 million people would struggle with even the simplest, most well written health materials. 

Does it matter? Do you remember the anthrax scare, when someone 
was putting deadly white powder into our mail system? During that terrorist scare, the U.S. post office mailed millions of post cards to Americans. The post cards told people how to protect themselves from the deadly infection. They gave instructions on how to handle and report suspicious mail. These post cards were written at between ninth and eleventh grade reading level. 

More than half the people who got that mailing could not read it 
well enough to protect themselves and others. Does it matter? Do 
148 million people matter? Will it matter the next time the 
terrorists strike? 

Do you remember the mailing the Surgeon General sent out 
explaining how to avoid contracting HIV? He made every effort to 
see that it was written in clear, simple language. He got 
criticism for just how plain talking it was in places. A later 
evaluation of that document showed that it was written at between 
seventh and ninth grade level. Half the people receiving it read 
at a level BELOW what was required to read it. No wonder the 
infection keeps spreading. 

Think about it. For millions of people, the problem is not just 
the tiny print on prescription bottles. The problem is the words 
themselves. What does "take on an empty stomach" mean exactly? 
When should you "take four times a day"? Perhaps your doctor 
explained to you at the office. Do you remember what the doctor 
said a week later? 

Have you ever read the instructions for testing and assessing 
blood sugar levels? Have you ever tried to fill out a Medicare 
form? Do you struggle with letters from your health insurance 

Only 45% of asthmatics with literacy problems knew that they 
should stay away from things they are allergic to even if they 
WERE taking asthma medication. 89% of the people reading at high 
school level were clear about the same information. It's not a 
matter of intelligence. It's a matter of a missing skill which 
well-educated health providers presume is present in their 
readers when they sit down to write. 

There are two parts to the problem: the writer and the reader. 
Recently, the public health community has begun efforts to raise 
awareness. They are alerting the medical providers to the impact 
of health literacy issues. Some fledgling efforts are underway to 
provide clearer, simpler materials for the public. People are 
finding alternatives to reading for presenting the same 

There is a long way to go. Sign up now with your local literacy 
program as a volunteer. 

Drop in on your elderly neighbor and help her learn to read the 
specialized health material so critical in her life. (You may 
want to ask her about her life first, to save embarrassment when 
you learn you're talking to a retired English teacher). Start 
with all those ridiculously obscure materials her doctor sent 
home with her about glaucoma. You can go on to that Medicare form she needs to send in tomorrow. 
Do you want to know what eighth grade reading level is? You just 
read 700 words of it. 74 million Americans reading at below 
fourth grade level could have found it too hard for them to 
understand.The information contained in this article is for educational purposes only and is not intended to medically diagnose, treat or cure any disease. Consult a health care practitioner before beginning any health care program.

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