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’vegot to follow these instructions exactly, or you could die.”

About 200 recent studies have shown the reading difficulty ofmost health related materials FAR exceeds the average readingabilities of the American adult. One of the biggest silent healthproblems today is the gap between health materials and readingskills.

In the United States, the average reading level is eighth grade.In 1992, the Educational Testing Service determined that halfU.S. adults read at between first and eight grade level. That isabout 148 million people. It gets worse. One quarter of Americansread BELOW FOURTH GRADE level, meaning 74 million people wouldstruggle with even the simplest, most well written healthmaterials.

Does it matter? Do you remember the anthrax scare, when someonewas putting deadly white powder into our mail system?

During that terrorist scare, the U.S. post office mailed millionsof post cards to Americans. The post cards told people how toprotect themselves from the deadly infection. They gaveinstructions on how to handle and report suspicious mail. Thesepost cards were written at between ninth and eleventh gradereading level.

More than half the people who got that mailing could not read itwell enough to protect themselves and others. Does it matter? Do148 million people matter? Will it matter the next time theterrorists strike?

Do you remember the mailing the Surgeon General sent outexplaining how to avoid contracting HIV? He made every effort tosee that it was written in clear, simple language. He gotcriticism for just how plain talking it was in places. A laterevaluation of that document showed that it was written at betweenseventh and ninth grade level. Half the people receiving it readat a level BELOW what was required to read it. No wonder theinfection keeps spreading.

Think about it. For millions of people, the problem is not justthe tiny print on prescription bottles. The problem is the wordsthemselves. What does “take on an empty stomach” mean exactly?When should you “take four times a day”? Perhaps your doctorexplained to you at the office. Do you remember what the doctorsaid a week later?

Have you ever read the instructions for testing and assessingblood sugar levels? Have you ever tried to fill out a Medicareform? Do you struggle with letters from your health insuranceprovider?

Only 45% of asthmatics with literacy problems knew that theyshould stay away from things they are allergic to even if theyWERE taking asthma medication. 89% of the people reading at highschool level were clear about the same information. It’s not amatter of intelligence. It’s a matter of a missing skill whichwell-educated health providers presume is present in theirreaders 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 raiseawareness. They are alerting the medical providers to the impactof health literacy issues. Some fledgling efforts are underway toprovide clearer, simpler materials for the public. People arefinding alternatives to reading for presenting the sameinformation.

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

Drop in on your elderly neighbor and help her learn to read thespecialized health material so critical in her life. (You maywant to ask her about her life first, to save embarrassment whenyou learn you’re talking to a retired English teacher). Startwith all those ridiculously obscure materials her doctor senthome with her about glaucoma. You can go on to that Medicare formshe needs to send in tomorrow.

Do you want to know what eighth grade reading level is? You justread 700 words of it. 74 million Americans reading at belowfourth grade level could have found it too hard for them tounderstand. 

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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Author: Piyawut Sutthiruk

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