Recommended Reading Grade Level for Patient Communication
Patient education materials should be written at a 6th grade reading level, as recommended by the National Institutes of Health (NIH) and American Medical Association (AMA). 1, 2, 3
The Evidence-Based Standard
The 6th grade reading level represents the gold standard for patient-facing health information, though some sources cite a range of 4th to 7th grade as acceptable 3, 4. This recommendation exists because:
- The average American adult reads at approximately a 7th to 8th grade level 2, 4
- Over 50% of patients now seek medical information from online sources 1
- Materials written above this level create barriers to health literacy and informed decision-making
Practical Implementation Guidelines
To achieve appropriate readability, use these specific writing techniques 5:
- Words: Use familiar words of 1-2 syllables; avoid or explain medical/technical terms
- Sentences: Keep sentences to 15 words or less
- Paragraphs: Limit paragraphs to 10 lines or less
- Voice: Use active voice in present tense
- Language: Write as if speaking directly to patients, not to other healthcare professionals
The Reality Gap
Current patient materials consistently fail to meet this standard. Research across multiple specialties reveals:
- Most materials are written at 10th to 14th grade levels 1, 6, 3, 4, 7
- 95.3% of clinical letters exceed recommended readability levels 8
- The problem is worsening over time, with readability declining by 0.64 grade levels annually in some specialties 8
Common Pitfalls to Avoid
Do not assume higher education requires more complex language. Interestingly, even patients with postgraduate education often prefer simpler content at the 8th-12th grade level 9. Only bachelor's degree holders consistently preferred more complex postgraduate-level content, while both less educated and highly educated patients favored simpler materials 9.
When you cannot tailor content to individual education levels, aim for 8th-12th grade reading level as the most effective balance between clarity and comprehensiveness 9.
Supplemental Strategies
Beyond text simplification: