If you know my work, you know that I think a lot about, what I call, the Simplicity Complex – examining the upsides and the downsides of simplifying (often over-simplifying) the language used to communicate about health. The most persistent recommendation from researchers and practitioners in the field of health literacy – simplify the words….and sentences in your message.
What if the complexity of health information, science, society and its disparities, in the first half of the 21st century, requires more than simple representations of science, medicine and decision making?
Lately, I’m becoming less subdued in my criticism of all things simplified. Chalk it up to the inability of millions to understand ( as we intended it) the simple message - "Wear a Mask"!
Here’s the most current example of the ubiquitous advice from people working in health literacy to SIMPLIFY.
This particular online influencer in health literacy has been fairly liberal in dispensing advice to “stop saying “hypertension”, or “cardiovascular health”, or “novel virus” or “contraception”….You get the idea.
Given Covid and all the talk about “transmission” they’ve reprised (brought back again) an old post about why you should substitute simpler words for more complicated words.
In their crosshairs this time, the word, “transmit.”
They say the word is “straight out of a sci-fi novel or ham radio how-to. And the related noun, “transmission,” is more hot rod than Hot Zone.”(Forgive my low movie/media literacy here. I don’t even get what the the second sentence is alluding to.)
Their evidence, witness the unruly sentence:
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They claim that there is no reason to use the verb “transmitted” when the world is full of simple words like “spread” or “pass.”
No reason indeed? Well …….I can think of a few.
Reason #1:
While it’s true that “spread” or “pass” might be easier to read in an isolated sentence, a near universal reading/listening strategy we all use is “skipping and guessing.” (Check out Jean Berko-Gleasons’ fun linguistic Wugs experiments with (1958). By 4 or 5 years old kids begin to work with words they don’t know. That’s how we become active readers and listeners, and how we figure out what new words mean.
Reason #2
As language users we comprehend written and spoken language, in large measure, as a result of things we do across sentences/utterances (Olson, 1977 , 1994 ; van Dijk, 1977 ;van Dijk, 2001 ), not what we read in isolated sentences.
Reason #3
We use a wide range of skills to decode and make meaning, including expectations for the message and the topic, our motivation, the context, our past experience, language comprehension and trust in the messenger, just to name a few. Are we really saying that these things aren’t at work in the lives of less able readers?
Reason #4
Reading and linguist research shows that words, ambiguous in isolation, are decodable when they appear embedded in rich context. A primary reason—decoding is an active process that engages the reader.
In a previous post, “We are not all in this together: public understanding of health and science in the time of COVID” I tried to put forth reasons why we should really stop and think about what we’re doing when we routinely gatekeep every bit of health information and remove any “complexity” in favor of simple words, simple thoughts. The downsides are many. Here are three top of my mind.
Routinely targeting more complex words and replacing them with simple words:
- assumes that readers/listeners can’t figure things out - become more active, confident readers who, all the research shows, are more engaged with the information and thus learn more from it;
- is communication by subtraction. It distills out basic health and science concepts that are fundamental to being health literate
- takes the focus ( and responsibility) off writing well constructed, cohesive sentences that support each other and assist the reader to make meaning.
The blogger's advice concludes (in bold):
"When writing about infectious diseases, skip “transmit” and use “spread” or “pass” instead! (When writing about radios, aliens, or cars, it’s up to you.)"
The way that I see it, boundless simplification of health messages is an undertow we should be very wary of. If after 30 years, we don’t stop to interrogate this popular strategy we run the real risk of recapitulating inequity and denying access of many to the information commons.
The goal should be to develop new ways to clarify and communicate health information and advance public health and science literacy.
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