WHO EPI-WIN webinar: Communicating risks and evidence in a Public Health Emergency (5) Health literacy

20 September, 2021

[Note from HIFA moderator (Neil): Our thanks to Richard Fitton for representing HIFA at the event on 14 September. Here is his fourth summary/observation. A recording of the webinar is now available here: https://www.youtube.com/watch?v=za0t0B-jP1Q ]

Literacy levels in high income countries.

The presenters at the webinar answered questions about communicating risk and evidence with people with low numeracy and literacy. Findings had shown that written materials helped retention and undwerstanding and pictures and illustrations could do more so,

How big is the incidence of low literacy and numeracy in the 7.9 billion people on the planet, now? Presumably, extrapolating from the USA *** a High Income Country analysis of national literacy, 3.45 billion people - half or more of the world's population - would have lower level literacy and would benefit from pictorial illustrative information?

*** America was one of the first country to have universal primary school education. The 1992 National Adult Literacy Survey The National Adult Literacy Survey (NALS) conducted by the US Department of Education in 1992 tested a stratified national random sample of some 26,000 adults. The NALS results were reported by dividing the literacy skills of subjects into five levels of difficulty according to their ability to use and understand text and numbers (Table 1).


Level 1 22% of tested adults were at the lowest level of literacy skill, termed NALS level 1, individuals can only perform basic tasks such as signing their name or finding a word or fact in a short written article. Individuals at NALS level 1 are often considered “functionally illiterate.” Although they can perform some reading and writing tasks, their limited literacy skills prevent full functioning in today’s society. Individuals in NALS

Level 2 27.5% of tested adults were at level 2 - have somewhat more advanced skills but are still substantially limited in their ability to read and understand text. They are considered marginally literate.

Levels 3 - 31.5%, 4 -16%, and 5 - 3% have sufficient literacy skills to permit full functioning in society. Those at NALS level 5, the most advanced literacy level, have well developed literacy skills that enable them to perform complex tasks, such as writing lengthy documents and extracting data from tables and graphs (Table 1)


HIFA profile: Richard Fitton is a retired family doctor - GP, British Medical Association. Professional interests: Health literacy, patient partnership of trust and implementation of healthcare with professionals, family and public involvement in the prevention of modern lifestyle diseases, patients using access to professional records to overcome confidentiality barriers to care, patients as part of the policing of the use of their patient data.

Email address: richardpeterfitton7 AT gmail.com