October is National Health Literacy Month. This is the month when health educators work to make sure that their students can access and understand information that will help them make good decisions for their own health and the health of their families. Doctors are reminded to provide readable brochures to their patients and classroom teachers are asked to make sure that their classrooms provide positive learning environments.
There’s another environment that may matter more.
We know that more than 80 percent of American adults look for health information online. This makes Google the top source of health information in America.
How good is Dr. Google?
So how is that information? A great deal of research has been done on that question, typically in specific healthcare fields. Reading through these reports tells us two things:
- Online health information tends to be hard to read. While the NIH and AMA’s recommendation for patient education reading levels is that information should be written at a sixth grade level to make sure that most people will be able to read it, study after study finds average reading levels of 10th grade or higher (sometimes much higher) in health information available to patients.
- Online health information tends to be inaccurate. Studies often judge less than half of the available information to be accurate. What’s more, as one JAMA study baldly stated, “Websites with higher accuracy were more difficult to read than websites with lower accuracy.” Often, personal blog posts are easiest to read (but least accurate) and academic and government sites are found to be most accurate — and hardest to read.
A few studies have followed up on ordinary patients and consumers who read the health information that is readily available online. These studies find that people believe what they read (or watch). They will tend to choose information that is easier and more enjoyable to consume, even if it’s not very accurate, and they repeated false information when interviewed later. They didn’t usually do much fact-checking. Subjects in these studies accepted health information from product review sites even though the average level of accuracy at these sites was just over 8%.
Helping people learn to use the internet well and to make good evaluations of how legit a website is are good goals for Health Literacy Month, but those of us who publish health information can also help.
“In the absence of quality control on the Internet…”
Google tries to show the best quality and most trustworthy sources for all queries, and they get help from doctors when it comes to health information. But the results referenced above — showing that only about half of the search results lead to accurate information — come from Google as it now exists. The algorithm obviously doesn’t provide the most accurate health information. There’s also the problem of higher accuracy being associated with sites that are harder to read. While these websites may be directed toward doctors rather than patients, patients may have limited choices… and less accurate options overall.
But Google has to choose from what’s available. The blog post below, one we wrote for one of our clients, shows up in Google’s quick answer area because it is both accurate and readable. Sometimes people ask questions that don’t have an answer like that already on the web.
How can you help?
One suggestion we see a lot is that health professionals should make recommendations for their patients — tell them which websites to use. In our experience, doctors may be more likely to recommend the harder-to-read websites. They are generally quite comfortable reading websites that measure grade 15 on readability tools, and they don’t have a clear idea of the average American’s reading level. The government tells us the average American adult reads at an 8th grade level. We also hear doctors saying “Stay off of Google,” advice that their patients clearly don’t follow.
The lack of quality control on the internet shifts the responsibility for good health care information to publishers. Health care professionals should offer patient education information on their websites. Accurate, readable answers are actually not available for all your patients’ questions. What’s more, your patients can’t always tell what’s accurate. Being able to send your patients to your blog gives you and your patients confidence in the information they find when they look for health information online.
“Dr. Google” isn’t going away. Helping to provide accurate, readable health information online is one of the best things we can do to advance the cause of health literacy.