Shared meanings or missed opportunities? The implications of functional health literacy for social marketing interventions

Social marketing is being hailed as a key tool to help address the myriad health and overall population well-being issues facing societies. While there is considerable evidence of the success of some specific social marketing interventions, a factor often overlooked is that literacy problems within a considerable proportion of the population means that information provided as part of interventions may not be readily comprehended by all members of the target population. The substantial personal and social consequences of low functional literacy levels have been well documented, particularly within the health sector, for over 25 years, yet information material continues to be produced that is written at a level well above people’s average reading ability. The barrier is largely invisible as people with low literacy levels will go to great lengths to avoid acknowledging their problem, due to feelings of shame and the desire to avoid potential embarrassment. There is an ethical responsibility for social marketers, and others involved in designing health promotion interventions to improve information provision and comprehension. Without this, considerable numbers of people will be unable to benefit from interventions and may even be at risk due to a lack of understanding of the issues involved. A study of the readability of a range of printed and Internet UK health information sources is reported. We suggest that even though the problems associated with low levels of health literacy have been recognized for at least 25 years, UK health information material is still written at a level well beyond the ability of certain sections of the population to understand it. The results of a readability analysis conducted to verify this proposition are discussed. We conclude the paper with a recommendation for further research in the area and for immediate improvement to social marketing-related activity.