Rudd and colleagues (2000) also showed that several studies examined patient education materials designed for specific ethnic groups. A substantial number of studies report on both readability and comprehension assessments of these documents, deeming most of them inappropriate (Austin et al., 1995; Delp and Jones, 1996; Jolly et al., 1993, 1995; Logan et al., 1996; Powers, 1988; Spandorfer et al., 1995; Williams et al., 1996). Hosey and colleagues (1990) used the Wide Range Achievement Test to measure the reading ability of a group of American Indian diabetic patients and found that although many patients scored at a reading grade level of 5, the diabetes education materials scored at a mean reading grade level of 10. Guidry, Fagan, and Walker (1998) note that less than half of the cancer education materials specifically targeting African Americans reflected the culture of African Americans and that few were written at a reading grade level for those with low literacy skills.

Finding 4-2 More than 300 studies indicate that health-related materials far exceed the average reading ability of U.S. adults.

Popular Sources of Health Information

News Media. The news media is a large part of America’s health information revolution. More than a dozen exclusively health-related magazines are easily available at grocery stores and major bookstore chains every month in America. Magazines aimed at women, men, children, parents, and mothers are also widely available and carry numerous articles on a wide variety of health issues. Several of America’s largest newspapers, reaching millions of people each day, carry health sections dedicated to health news. These health sections are read by people at all literacy levels. Three quarters of newspaper readers with NALS Level 1 literacy skills reported reading the home, fashion, health, or reviews sections, while 85 percent of newspaper readers with NALS Level 5 skills read these sections (health data alone was not available) (Kirsch et al., 1993). The major broadcast and cable networks have health journalists and health reporting. There are multiple cable channels dedicated to health topics and other channels dedicated to women’s issues such as Oxygen, that cover health as a major focus. Some of broadcast TV’s most popular shows—Oprah and more recently a spin-off called Dr. Phil, regularly carry health information and advice. Health news, such as SARS, heart disease, obesity, antibiotic resistance, and smallpox vaccination has been a centerpiece in newspaper headlines dozens of times in 2002–2003 alone.

Advertising and Marketing. Advertising is also a prominent source of health information. Scott-Levin, a drug market research firm in Newtown, Pennsylvania, reports that while all visits to physician’s offices rose 2 percent in



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