Information about COVID-19 offered by the U.S. Centers for Disease Control and Prevention, the White House, and state health departments failed to meet recommendations for communicating with the public, according to a Dartmouth study.
The review of written web content during the onset of COVID-19 demonstrates that official information about the virus might have been too complex for a general audience. On average, government sources communicated about three grades higher than the reading level recommended by existing guidelines for clear communication.
The research, which also analyzed international health web pages, appears as a research letter in JAMA Network Open, a medical journal published by the American Medical Association.
“How public health information is presented can influence understanding of medical recommendations,” said Joseph Dexter, a fellow at Dartmouth’s Neukom Institute for Computational Science and senior author on the study. “During a pandemic it is vital that potentially lifesaving guidance be accessible to all audiences.”
After studying 137 web pages from federal and state sources, the team found that communications about COVID-19 averaged just over an 11th-grade reading level.
According to the study, information shared by the CDC and other U.S. sources during the onset of COVID-19 exceeded recommendations on the number of words in a sentence, word size, and the use of difficult terms related to public health.
Even though states are not required to follow the federal regulations, they might still benefit from complying with the guidelines. All 50 U.S. states provided information above the eighth-grade level. Nine of the 10 states with the highest illiteracy rates had websites written above a 10th-grade level.
Previous research has found that only 12 percent of American adults exhibit proficient health literacy.
“The differences between eighth-grade and 11th-grade reading levels are crucial. Text written at a higher grade level can place greater demands on the reader and cause people to miss key information,” said Dexter.
According to the study, exceeding readability standards may have a greater effect on vulnerable communities with lower health literacy, potentially worsening the impacts of the pandemic.
Beyond the U.S., the study reviewed 18 international websites, including three public health agencies and 15 official government sites.
Almost all of the international pages scored above the eighth-grade level by five different assessments. All of the pages, including those from the World Health Organization, exceeded the U.S. national eighth-grade guideline by at least one measure.
Direct to Full Text Research Article: Comparison of Readability of Official Public Health Information About COVID-19 on Websites of International Agencies and the Governments of 15 Countries (via JAMA Open)