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Many Americans may not comprehend COVID-19 information as agencies fail to meet health literacy guidelines, study says

The U.S. Centers for Disease Control and Prevention, the White House and state health departments failed to meet guidelines when communicating vital information about COVID-19 to the public, according to a study released Tuesday.

The CDC, the American Medical Association and the National Institutes of Health all recommend that medical information for the public be written at no higher than an eighth-grade reading level. 

But after studying 137 federal and state web pages, Dartmouth College researchers found that public information about the coronavirus averaged just over an 11th-grade reading level.

The study worries public health experts, who reference previous research highlighting health inequities among vulnerable communities impacted most by the coronavirus pandemic. 

“How public information is presented can influence understanding of medical recommendations,” said Joseph Dexter, senior author of the study and a fellow at Dartmouth’s Neukom Institute for Computational Science. “During a pandemic, it is vital that potentially lifesaving guidance be accessible to all audiences.”

Although states are not required to follow these guidelines, experts say it’s important for everyone to understand health information, especially as the 2003 National Assessment of Adult Literacy found that only 12% of American adults exhibit proficient health literacy. 

Researchers discovered that all 50 U.S. states provided information above the recommended eighth-grade reading level. Nine of the 10 states with the highest illiteracy rates had websites written above a 10th-grade level.

“The differences between eight-grade and 11th-grade reading levels are crucial,” Dexter said. “Text written at a higher grade level can place greater demands on the reader and cause people to miss key information.”

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Dexter worries that placing this greater demand on the public could also force people to turn to less trustworthy sources for unreliable, yet more digestible information.

“Information about COVID-19 can be complex, contradictory, and sometimes false,” Dexter said.

But the study found that health literacy isn’t just a U.S. problem.

Researchers also reviewed 18 international websites, three public health agencies and 15 official government websites, and discovered that the pages exceeded the U.S. national eighth-grade guideline by at least one measure. This included a dozen pages from the World Health Organization website. 

“WHO coordinates a major effort to redirect anyone searching for information about COVID-19 to reliable sources,” said Vishala Mishra, the paper's co-author and a researcher at Madras Medical College. “Therefore, it becomes especially relevant for governments and health agencies … to provide more accessible health information that matches the public’s health literacy.”

Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT. 

Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.

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