Nearly half of adults in England don’t understand health information material, study indicates

BMJ 2012; 345 doi: (Published 07 December 2012) Cite this as: BMJ 2012;345:e8364
  1. Susan Mayor
  1. 1London

Nearly half of adults in England are unable to understand standard health information material—such as instructions on how to calculate the dosage of paracetamol for a child—well enough to act on it, indicate results from a study reported this week.

Researchers extrapolated results for levels of literacy and numeracy collected in interviews with more than 6000 people aged 16-65 years to assess understanding of 64 items of information on health and safety. The data came from a nationally representative sample taking part in the Skills for Life survey,1 conducted by the Department for Business, Innovation and Skills, and were applied to a wide range of materials commonly used to promote health and manage illness, including health screening leaflets, letters from GPs, and road safety information.

The results showed that 43% of people would be unable to understand and act on the information This figure was based on the proportion of people whose literacy and numeracy scores were below the level of reading and maths skills that a panel of 50 health and safety professionals had assigned to the information materials.

The leader of the research group, Gill Rowlands, professor of health disparities at London South Bank University and a GP in Stockwell, London, said, “Health literacy skills are needed to understand and use information in ways that promote and safeguard good health. The results of our study mean that the health information material we are currently using can’t be effectively used by half of the people we are giving it to.

“This is a huge wasted opportunity for people being able to manage their own health better and being able to use health services effectively. We need to develop solutions to ensure that health information is more easily understood.”

Analysis of individual items of health information indicated that 43% of adults of working age would be unable to understand instructions provided with paracetamol explaining how to use a child’s age and weight to calculate a dose. The same proportion lacked the numeracy and literacy needed to effectively understand instructions for fitting a child’s car seat. And half (49%) of people would lack the reading and maths skills to understand and follow instructions provided in a bowel cancer screening kit for collecting a faecal sample.

The findings showed that information requiring maths skills is particularly difficult for people, with nearly two thirds (61%) lacking the skills to understand information that requires numeracy as well as literacy. More than three quarters of people (78%) would not have the levels of literacy and numeracy needed to calculate their body mass index from a chart.

Results from the study were presented to a group of MPs and healthcare organisations this week. An expert group, including health and safety professionals and representatives from the Department of Health, is analysing the findings to recommend ways to develop health information that most people can understand and act on.

The study was supported by an educational grant from MSD, but the company had no input into the research.


Cite this as: BMJ 2012;345:e8364