This guide provides practical support for writing health information in plain language. It includes tips, readability tools and data to help you make the case for health-literacy friendly materials.

Why this matters

Everyone should have access to evidence-based health information to enable them to make informed decisions about their health. Complex or jargon-heavy materials make information harder for people to understand. This can lead to increased hospital visits, failing to take medicines correctly and a lack of trust in healthcare.[1]

Starting with plain language can also help you tackle other health information challenges. For example, translated materials and accessible formats are easier to create when you are starting from a resource which is easy to understand. Consumer research carried out by PIF in early 2020 showed the public rated information which was easy to understand as a key criteria for health information, second only to being evidence-based.

Keep it simple

  • Put the information people most need or want to know at the beginning
  • Aim for a target reading age of 9-11
  • Keep sentences short
  • If you have to use a complex word explain it straight away or use a glossary

 

Check understanding

  • Engage your target audience to ensure language is easy to understand and tone is correct
  • Ask other members of your team to review
  • Work with different reviewers at different stages of the project

 

Consider different formats

  • Look at different ways of presenting the information
  • Make use of tools like infographics or short animations alongside text
  • Think about how to present potentially complex information, for example risk, clearly

 

This guide supports the following PIF TICK criteria:

  • 6.0 Health inequalities: Information is written to meet health and digital literacy, language and accessibility needs of the target audience.
  • 7.0 Content and design: Information is clearly communicated, easy to access and navigate.

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2. Data on literacy challenges

It is important to remember general literacy and health literacy are not the same thing. Someone can have high literacy in their everyday life but still have low health literacy. Health literacy is situational and complex, combining traditional literacy, information literacy and numeracy. It also increasingly requires digital literacy and media literacy.

However, data on literacy and numeracy levels can help us to understand the scale of the challenge.

 

OECD Survey of Adult Skills

The OECD Survey of Adult skills took place in 39 countries over three phases from 2011 to 2017[6]. It found one in six adults in England and Northern Ireland (16.4%) have ‘very poor literacy skills’ at or below Level 1. One in four

(24.5%) are at or below Level 1 in numeracy. A 2019 OECD report put the mean literacy and numeracy skills in England at Level 2.

The tables below show the three lowest OECD skills levels for literacy and numeracy. It is worth noting 1% could not provide enough information to be assigned scores due to language difficulties or disabilities. That means one in 100 people are below ‘Below Level 1’.

 

"43% of adults do not have adequate literacy to understand health information. This drops to 61% when numeracy skills are also needed."

– Rowlands, G. et al (2015)

 

Three lowest OECD skills levels for literacy

Below level 1

Can read brief texts on familiar topics and locate one piece of specific information. Only basic vocabulary knowledge is required.

No requirement to understand the structure of sentences or paragraphs.

Level 1

Can read relatively short texts to locate one piece of information identical to or synonymous with information in the question. 

Ability to recognise basic vocabulary, determine the meaning of sentences and read short paragraphs.

Level 2Can make matches between text and information. Can paraphrase or make low-level inferences.

Three lowest OECD skills levels for numeracy

Below level 1Can carry out simple processes in concrete, familiar contexts where the mathematics content is explicit with little or no text or distractors. For example, basic arithmetic with whole numbers or money.
Level 1Can carry out basic processes in common, concrete contexts where the mathematical content is explicit, with little text and minimal distractors. For example, counting, understanding simple percentages like 50% and identifying elements of simple or common graphical representations.
Level 2Can carry out two or more steps involving calculation with whole numbers and common decimals, percents and fractions. For example, simple measurement and spatial representation, estimation and interpretation of relatively simple data and statistics in texts, tables and graphs.

Health and Digital Literacy Charter

At PIF we believe health-literate information is not ‘dumbing down’ it helps ‘level up’. Our 2019/20 Health and Digital Literacy Survey showed some progress – 60% of organisations are now providing information for those with low literacy or numeracy compared to 35% in 2013. However, more work needs to be done.

In 2020, we launched our Health and Digital Literacy Charter asking health information providers across the UK to show their commitment to health and digital literacy.

Sign the Health and Digital Literacy Charter and see who has signed it here.