Understanding Health Literacy: What Is It and Why Does It Matter?

A healthcare professional is reviewing a patient education pamphlet with a patient

Health literacy directly impacts one’s ability to make informed health decisions. Health-related information that is too difficult to understand can have a significant impact on health outcomes. Several resources are available to assist healthcare providers in developing easy-to-understand patient education materials, thereby improving patient comprehension and health outcomes.

What is Health Literacy?

Health literacy is defined as the degree to which individuals have the capacity to obtain, cognitively process, and understand health information to make informed health-related decisions.2 Low health literacy is a significant problem in the United States. Most written health-related information provided at the point of care is too complex for the average American patient to understand.5

It is important to understand that health literacy affects all of us. Problems that limit health literacy are often caused by unfamiliar medical terminology and complex numerical information. Providing patient education materials that are easy to read and understand will benefit both patients and healthcare providers.

The Problem with Patient Education Materials

The reading and comprehension skills of the average patient are often overlooked during the development of written patient education materials. A mismatch exists between the readability (i.e., grade level required to understand text) of patient education materials, and the reading comprehension skills of the average American adult.

Results from the 2003 National Assessment of Adult Literacy Survey (NAALS) found the average American adult reads between the 8th and 9th grade reading level, whereas most patient education materials are written at, or above, the 10th grade reading level.3 The gap is even greater for older adults.

Assessing Readability of Patient Education Materials

National organizations such as the American Medical Association (AMA) and National Institutes of Health (NIH) recommend developing patient education materials that are written at, or below, the 6th grade reading level”.6 Readability metrics make it easy to assess the grade level of patient education materials.

For example, Online-Utility.org offers a free online readability calculator embedded with several validated readability metrics, including the Simple Measure of Gobbledygook (SMOG), Gunning Fog Index (GFI), and the Flesch-Kincaid Grade Level (FKGL) formula. To assess readability, copy and paste any 100 word writing sample into the text box. The calculator will provide the grade level required to read and understand the text, as well as identify complex words and sentences that should be revised.

Developing Easy-to-Understand Patient Education Materials

Evidence-based guidelines for developing easy-to-understand patient education materials have been developed by several national organizations. For example, the Pfizer Principles for Clear Health Communication provide guidelines for sharing written health information. 1

To develop patient education materials that are accessible to the largest audience, Pfizer recommends writing that is clear, concise, and incorporates plain language. Additionally, healthcare providers can seek opportunities for continuing education to promote health literacy in the patients they serve.

Online Health Literacy Resources

Several resources for promoting health literacy are readily available online. Utilizing these resources to develop easy-to-understand patient education materials may improve comprehension and compliance in patients with low health literacy.

Agency for Healthcare Research and Quality: Health Literacy

American Medical Association: Health Literacy- A Manual for Clinicians

Centers for Disease Control: Simply Put: A Guide for Creating Easy-to-Understand Materials

NIH: How to Write Easy-to-Read Health Materials

Pfizer Principles for Clear Health Communication

MedBridge’s Patient Education resources are suitable for patients of all health literacy levels. With easy-to-understand, plain language explanations, you patients will appreciate the ease with which they are able to digest new information. Video-based resources often include 3D graphics and hands-on demonstrations.

For added support and understanding, consider watching the videos with your patients. This will provide an additional opportunity for education as you can answer any questions they have. They can then refer back to the assigned videos at any time using the online patient portal or the MedBridge GO app.

  1. Doak, L. G., & Doak, C. C. (2008). Pfizer Principles for Clear Health Communication (2nd Ed.). Retrieved from https://cdn.pfizer.com/pfizercom/health/PfizerPrinciples.pdf
  2. Institute of Medicine (US) Committee on Health Literacy, Nielsen-Bohlman, L., Panzer, A. M., & Kindig, D. A. (Eds.). (2004). Health Literacy: A Prescription to End Confusion. National Academies Press (US).
  3. Kutner, M., Greenberg, E., & Jin, C. (2006). The health literacy of America’s adults: Results from the 2003 National Assessment of Adult Literacy. Washington, DC: U.S. Department of Education, National Center for Education Statistics.
  4. National Institutes of Health [NIH]. (2014). How to write easy-to-read health materials. Retrieved from https://medlineplus.gov/etr.html
  5. Stossel, L. M., Segar, N., Gliatto, P., Fallar, R., & Karani, R. (2012). Readability of patient education materials available at the point of care. Journal of general internal medicine27(9), 1165–1170. https://doi.org/10.1007/s11606-012-2046-0/PMC3514986/
  6. Weiss, B. D. (2007). Health Literacy: A Manual for Clinicians. Chicago, IL: American Medical Association Foundation and American Medical Association.