Reading grade levels and health behaviors of parents at child clinics.

OBJECTIVES: Recent reports suggest alarmingly low levels of literacy among adults in the U.S., but these are not expressed in grade levels. Assessment of the epidemiology of reading grade levels is necessary for development of patient education materials written at appropriate levels. METHODS: We measured demographics, reading ability and self-described health behaviors of 646 parents at two private, two university, two indigent and six public child-related clinics in a midwestern city using a bilingual oral interview and the Wide Range Achievement Test. RESULTS: Parents were 59% white, 92% female, with mean age 28 years, mean years of school 12.1 and mean reading grade 8.7. Parents tended to read four to five grades below their highest completed school grade. Analysis of self-reported health behaviors showed that 69% had no private insurance, 31% smoked cigarettes, 35% had body mass index greater than 27, and 46% of parous mothers had never breast-fed. Prevalence odds ratios showed that all adverse health risks except obesity were associated with low reading ability. CONCLUSIONS: These findings have important implications for public health professionals working in clinical care, health education and agency policy. Persons with low literacy levels appear to be at particularly high risk for adverse health behaviors. Education materials and teaching vocabulary should be appropriate for client reading grade levels.