Updated Jun. 2012
Plain Language = Better Health Care
- by Maria Mindlin
Low Health Literacy
Research conducted by the National Adult Literacy Survey estimates “90 million Americans – half of all adults – may struggle with low health literacy.” Older adults, minorities, immigrants, and people with low income are especially at risk for low health literacy. 
Low health literacy has both human and financial costs. According to the Harvard School of Public Health, there is a strong correlation between patients with low health literacy and:
- poorer overall health,
- misunderstood treatment explanations, and
- inability to follow medical regimens. 
Look how plain language made the Universal Protocol understandable for a greater number of patients:
Original Text - 12th grade
This brochure includes tips that can help you prevent errors in your surgery and make sure that you have the correct procedure performed at the correct place, or site, on your body.
Plain Language - 6th grade
Mistakes sometimes happen during surgery. Doctors may do the wrong surgery or operate on the wrong part of your body. Or they operate on the wrong person. 
There are financial costs to government and hospitals when patients do not understand. The American Medical Association reports that “[I]ndividuals with low health literacy incur medical expenses that are up to four times greater than patients with adequate literacy skills, costing the health care system billions of dollars every year for unnecessary doctor visits and hospital stays.” 
Plain Language Solution
Click to enlarge
Using plain language to make sure patients can read and understand printed information is part of the solution.
Here are the basic readability features that make this form easy to read:
- A short, easy title that says what your document is about.
- Familiar words, active voice, and appropriate reading grade level work best. WIC (Women, Infants and Children) produces its materials at the 3rd–5th grade level. Other DHCS branches set goals of 5th–7th grade.
- Bullets and subheads: Bullets break up the text and make major points stand out. (Use 5 or fewer bullets.) Subheads followed by short paragraphs break up the text so readers can quickly find what they need.
- Font type: San serif system fonts – such as Arial – are best. Unlike serif fonts, they stand up fairly well to photocopy, faxing, online display, and low-resolution printing.
- Translation: Plain language documents have less text and more white space — they are an ideal platform for translation into other languages, which often expand by 25%.
References and Notes
 Center for Health Care Strategies, Fact Sheet #2
 Harvard School of Public Health, Health Literacy: A prescription to end confusion
 From Transcend’s adaptation of the Universal Protocol to Prevent Wrong Site, Wrong Procedure and Wrong Person Surgery
 Health Literacy Studies, American Medical Association
For more information on Readability and Plain Language call Transcend at 530.756.5834.
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