Here’s something to think about before you send your next message to your community: about half of your audience may not be able to read it. According to the Program for the International Assessment of Adult Competencies (PIAAC), one of the world’s largest literacy studies, over half of U.S. adults read at basic levels or below.

As disaster health professionals of all kinds know, disaster health and safety information tends to be complicated with lots of caveats and can require people to run through a pretty challenging set of tasks. They need to synthesize information, draw complex conclusions and integrate information. According to the PIAAC study, only 13 percent of U.S. adults read well enough to do those things.

Consider the study’s findings in light of risk communications literature. Risk communications studies show that in high-concern high-stress situations, the ability to process information – including written material – plummets.

Low-literacy rates + a high-stress situation = a monumental communication challenge.

To protect health, especially in disasters and other public health emergencies, the audience has to understand what we are trying to say well enough to take action. To communicate effectively and connect people with low literacy skills to critical information, we need to remember the basics:

1. Team up with community groups. Talk with community organizations already working with low literacy populations to understand literacy levels in your community. Enlist community groups as focus groups to be sure your materials will be understood by people in your community, particularly those with limited reading proficiency.
2. Put your content to the test. Test materials using a reading level measurement tool. Free online tools, such as the SMOG Readability Calculator, can check the reading level and provide suggestions to change the reading level. Don’t waste a lot of space on background information; just explain why taking action matters. Consider the common instructions on an airplane: put the mask on yourself before helping your child. Why? You’ll pass out in seconds, and your toddler can’t put the mask on you.
3. Use infographics. Simple infographics illustrate your point making the message easier to understand. Crafting great infographics may require training and graphic design software but, first, try leveraging the creativity and enthusiasm of students or instructors at the community college or a local arts society. Graphic design or art students, instructors or enthusiasts may be willing to volunteer their time to create infographics in exchange for the ‘by-line’ or work with you for a lower cost than you would pay for training and software. Plus, involving community members helps spread the word about the topic.
4. Use video. Be sure to test the reading level of the script and visually demonstrate your point. If your agency or organization doesn’t have professional video production capability or the funds to hire a crew, fear not. Check out the Disaster Public Service Announcement Library developed by CDC and ASPR for simple videos on a variety of emergency topics. Smart phones also offer basic video capability, and that “reality TV” look can still be effective in emergencies. Or, again, reach out in advance to students, teachers and community organizations for help producing videos.
5. Use word-of-mouth. While social media stands out as the go-to, modern form of word-of-mouth, don’t discount the old-school method. Community meetings, information fairs, door-to-door canvassing, and speak engagements at worship services are effective in high-concern situations, even when your target audience includes the most avid readers. Add a COIN to your communication plan: a Communication Outreach Information Network of trusted people in the community willing to carry important emergency health messaging to hard-to-reach populations.

The global literacy study shows that people literacy is a challenge in every country and every language surveyed. Which means in the United States, we need to consider more than just limited English proficiency; we need to use the same techniques in all the languages spoken – or read – in our communities.