Can Patients Understand You?
Health Literacy Definition

Imagine you have an acoustic neuroma (also known as a vestibular schwannoma), developing in your Schwann cells.

Or imagine you are choosing a new health plan. You can choose one with a high deductible, which covers emergency out-of-network visits, though the in-network coverage is limited to certain providers. You can choose a 3-tier or 4-tier drug plan, which will impact your out-of-pocket, but not your premium.

Although these statements are completely accurate and provide lots of information, they’re not readable. Most Americans don’t know what most of the terms above mean. That’s why we need to write health content for readability, not just accuracy.

What is Health Literacy?

The average American reads at a 7th to 8th grade level. That means they have the same vocabulary and ability to process written information as a typical 7th grader or 8th grader.

But health literacy is a little different. Someone with an 11th grader’s vocabulary and reading comprehension level might still struggle to understand health terminology. Only 12% of Americans are considered proficient in health literacy, meaning they can easily complete tasks such as comprehending an employee's share of health insurance costs for a year.

We can hope health care will become less complicated, or that people will become more educated. In the meantime, it’s our job as health care providers, system designers, and content strategists to improve the readability of our websites, apps, portals, and email correspondence. That’s a hard job, since many terms are either in Latin, or specifically written for legal compliance.

How do you Write Readably?

Readability takes a few forms for health care communicators.

The first step is to become familiar with the basic tools such as:

All of these tools employ algorithms to determine the grade level of the writing. You copy a paragraph or a page of content, and find out its grade level. The tools typically gauge sentence length, word length, use of passive voice, and adverbs to determine how complex the page is.

But this isn’t enough for health care – if a page is deemed complicated because there are many words with three or four syllables, we can’t necessarily fix it. So we can’t stop there.

The second step is to see how the page reads when you remove all those problematic words. If the page is now a 6th grade reading level (a grade lower than average), then you’ve made a good start. But if the page is still high with the health care-specific words missing, you can do more editing.

The third step is to make up for those complicated health care terms. Anywhere that you removed a word, when you put it back in make sure you explain what it is. This is really important – if complexity is required for legal reasons or accuracy, that’s no excuse for not helping people understand what they’re seeing.

The fourth and final step is to consider ways to communicate beyond words. Add infographics and images. Use bulleted lists and tables to show how things connect.

We work in a complicated field, and sometimes it’s hard to connect with the people we want to help. Readability is one step in that direction.

Contributed by
Marli Mesibov
Job Title
VP, Content Strategy