Speaking of communication

Literacy is a minor, but persistant issue in the US. According to the National Adult Literacy Survey, in 1992, about half of all adult Americans had difficulty reading and using written material.

One place where limited literacy has measurable consequences is healthcare. People with low literacy skills tend to be sicker. Part of the problem seems to be that they do not follow the direction of their doctors because they don't understand it.

Now this is not a new problem, and the AMA has been involved with it for a while.

But what bothers me is that a key recommendation from many "experts" in health literacy is that materials written for patients be written at the 6th grade reading level according to the Fry test. Here are the recommendations from the AMA:

Text construction
• Write at or below the 6th grade level.
• Use one- or two-syllable words.
• Use short paragraphs.
• Use active voice.

The Fry test pushes you to write short words and short sentences on the assumption that these are easier to read. But there is no evidence that short words are necissarily easier to read. And requiring short sentences means writers often leave out optional grammatical words (like that) and all the nice little linking words that tie the thoughts in your sentences together. What you end up with is a staccatto paragraph with no context or relationship between sentences. I would imagine that type of sentence is much harder to read.

Of course no linguists were consulted in making up these recommendations.