A new study accepted for publication in the British Journal of General Practice asserts that the majority of general practice websites contain content well above the recommended reading level for online content.

The study analyzed 3,823 pages of content scraped from 813 Scottish general practice websites.  Analysis showed that 2,942 pages (77.1%) had a reading age surpassing the recommended level for "Plain English."

Another recent study analyzing COVID-19 content across websites in 15 countries reinforced this disparity.  This study, available on the Journal of the American Medical Association website found that, "official information about COVID-19 exceeded the recommended reading level, exhibited complex syntax, and used technical terminology.”

According to the U.S. Department of Education, 54% of U.S. adults 16-74 years old or about 130 million people, lack proficiency in literacy, reading below the equivalent of a sixth-grade level.  

Both the American Medical Association and the National Institutes of Health recommend that the readability of patient education materials should be no greater than a sixth-grade reading level. Recommendations in the United Kingdom are consistent with this benchmark, which define "Plain English" as comprehensible to a 9 to 14 year old.

Similar Findings from Imaginary Landscape

We've found similar issues throughout our 20 years of hospital web development.  This is often the result of a blurring between patient conditions and healthcare specialties.  For instance a search for information about childhood cancer is met by content about pediatric oncology.  Similarly, a person suffering gas pains may not know that guidance is found under the heading gastroenterology.  The desire to present leading-edge expertise often overlooks the importance of being plainspoken.

The most common objection to less complicated language is imprecision, especially in a healthcare context.  Physicians and related specialists can sometimes bristle at the perceived vagueness of plainspoken terms, preferring the precision of clinical descriptions.  In our experience, this is the main culprit that ratchets up the readability level.

It can be difficult to challenge medical professionals on linguistics.  Luckily, by their very nature, they appreciate data, analysis and study.  We've found success in providing research to supplement our assertions, often materials published in journals that require the same peer-reviewed rigor as the journals that publish their own research. 

The Centers for Disease Control and Prevention published a guide addressing this issue called, “Simply Put, A guide for creating easy-to-understand materials.”  In it, the CDC provides comprehensive guidelines, tips and examples to make health-related content more readable.  It is a must-read for anyone responsible for producing or editing health content.

There is certainly a time and place for demonstrating expertise and precision with more clinical content.  Indeed, the web has allowed people to delve deeply into specialized information about conditions and treatments by providing direct access to journal articles and related research.  However, if your goal is to reach and communicate with a broader audience, a more plainspoken approach is appropriate.