"Low health literacy" sounds like a reading problem. Mostly it isn't. Nearly 9 out of 10 English-speaking adults in the US struggle to some degree with health information, and most of those adults can read a lease, a text message, or a news article without any trouble at all.
What breaks down is denser material, delivered once, usually in writing, often while a patient is scared, in pain, or halfway out the door. Low health literacy means someone cannot reliably find, understand, or act on the health information handed to them: a discharge summary, a medication label, a set of post-surgical instructions read aloud in the last two minutes of a visit. It gets worse fast when English is not a patient's first language. The Agency for Healthcare Research and Quality puts the number of people in the US with limited English proficiency at nearly 25 million, about 8.6% of the population, and its own patient safety guide says that group is disproportionately harmed when a communication error happens. Jellypod exists for exactly this overlap: it turns a clinic's existing discharge summary, care plan, or handout into narrated audio, in the language a patient actually speaks, instead of asking a nurse to re-explain it or a translator to be booked days out.
What is low health literacy?
Low health literacy is the inability to find, understand, and use health information well enough to make informed decisions and follow instructions correctly. It is a functional skill, not an intelligence marker: someone who reads dense contracts for a living can still leave an oncology consult unable to explain their own treatment plan, because health information carries its own vocabulary, its own math (dosing, frequency, risk percentages), and its own stakes. The 2003 National Assessment of Adult Literacy, the last federal study to measure this directly, found only 12% of US adults score at a level rated proficient for health-related reading tasks, things like calculating a correct medication dose from a label or following multi-step discharge instructions. More than a third scored basic or below basic, the bottom two of four tiers.
Health literacy is also situational. Stress, pain, unfamiliar terminology, and a rushed pace all lower a patient's functional literacy in the moment, even for someone who would test as proficient on a calm afternoon. That is why one-time, one-format delivery, a single verbal explanation or a printed handout, keeps failing the same population twice: once on the reading level, once on the timing.
Why does health literacy affect patient outcomes?
Because it changes what happens after a patient leaves the room, not just how the visit felt. A 2015 study in BMJ Open followed 7,733 Medicare beneficiaries hospitalized for a heart attack in North Carolina and Illinois and found that, after adjusting for demographic and clinical factors, patients with above-basic health literacy had a 12% lower risk of 30-day readmission than patients scoring basic or below basic (p=0.03), and a 16% lower readmission rate overall (p < 0.01). Literacy did not change the diagnosis. It changed whether the patient understood the plan well enough to follow it once they were home, the same mechanism covered in what the research says about medication adherence.
That gap shows up earliest around exactly the moments a clinic already puts in writing: discharge instructions, medication labels, follow-up scheduling, the warning signs that mean "call us" versus "go to the ER." A patient who cannot parse those in the format they were given is not a patient being careless. They are a patient the format failed.
Is low health literacy only about reading level?
No, and treating it as a pure reading-level problem misses a large share of the population it is supposed to describe. Language is its own axis: the AHRQ patient safety guide notes that among patients who experience a medical error, those with limited English proficiency are more likely to be harmed, and the harm is more likely to be serious, with communication breakdown as the leading cause. A patient can be fully literate in their own language and still be functionally unable to read an English discharge summary, a different problem from low literacy that produces the identical outcome: information that does not transfer.
Digital access compounds it further. A patient portal message, an app notification, or a QR code linking to instructions assumes a baseline comfort with a screen and an account login that a meaningful share of patients, often the same patients already struggling with print, do not have. Low health literacy is really three overlapping gaps: reading level, language, and format access. A single printed handout in English addresses none of the last two at all.
Does audio actually help people with low health literacy understand more?
Yes, and the mechanism is specific enough to matter. A 2015 study in the Journal of Medical Internet Research by Meppelink, van Weert, Haven, and Smit tested colorectal cancer screening information across 231 adults aged 55 and older, split evenly between low and high health literacy, presented as spoken narration or written text, alone or paired with animation. Among the low health literacy group, spoken narration alone produced a recall score of 11.42 against 9.12 for written text (p=.03), and spoken narration paired with animation lifted that to 13.24. The detail that matters most: when the low health literacy group heard the spoken version, their recall matched the high health literacy group's (p=.12, no longer a significant gap). Written text never closed that gap in the same study. Spoken delivery did.
That is one controlled study on one condition, not a universal law, but it lines up with the wider pattern in patient education research: a 2019 meta-analysis of 51 studies found written discharge instructions recalled correctly 58% of the time against 67% for video, and a 2025 systematic review in BMC Medical Education found podcasts improved comprehension, retention, or engagement in a majority of the 21 studies it covered, detailed in what the research says about patient education handouts. Across Jellypod's own Health & Fitness podcasts, roughly one in four are already published primarily in a language other than English, a rate the platform did not design toward for that category specifically. Clinics and health educators simply chose to reach patients that way once producing a second language stopped requiring a translation vendor.
What does closing the gap actually look like?
Not a new department or a bigger budget. The source material a clinic already trusts, produced in a format more patients can use.
- Start from the document already in useUpload the discharge summary, care plan, or handout a clinician already wrote and approved. Jellypod drafts a script grounded in that exact document, not a generic explanation of the diagnosis.
- Review the script against the source before producing audioDosing, timing, and warning signs cannot be approximately right. Check every number against the source before moving to audio or video.
- Produce it in the languages patients actually speakThe same source document can generate audio written natively in 29 languages, rather than a line-by-line translation of the English script.
- Publish to a private feed for one patient, or a public one for general educationA specific care plan stays restricted to the patient it was written for. General guidance, like how a common medication works, can go out publicly for anyone to find.
A real example
Professor Kris Vanhaecht at KU Leuven uses Jellypod to make peer-reviewed medical research and patient safety material easier to reach. "It enables us to make podcasts of peer-reviewed medical papers that nobody, until now, was going to read," he said. The pattern holds at both ends of the health literacy spectrum: dense material that only ever existed in one written format reaches almost nobody, whether the audience is a patient managing a new diagnosis or a clinician trying to stay current.
Frequently asked questions
What is considered low health literacy?
Low health literacy describes someone who cannot reliably find, understand, or use health information well enough to make decisions and follow instructions correctly, such as reading a prescription label, understanding discharge steps, or knowing when a symptom needs urgent care. The 2003 National Assessment of Adult Literacy found more than a third of US adults score at the basic or below basic level for this kind of reading.
What causes low health literacy?
Reading level is one factor, but not the only one. Age, stress, unfamiliar medical vocabulary, limited English proficiency, and low comfort with digital tools all lower a patient's functional health literacy, sometimes independent of their general literacy. A patient fluent in reading their own language can still have low health literacy in a second language, and a patient's health literacy can drop temporarily under the stress of a new diagnosis even when it is normally high.
How do you communicate with patients who have low health literacy?
Plain language matters, but format matters just as much. Research consistently finds spoken and video explanations outperform written material for recall, and a 2015 study found spoken narration specifically closed the recall gap between low and high health literacy groups where written text did not. Pairing plain language with audio or video, in a patient's own language, addresses more of the problem than simplifying the wording of a printed handout alone.
Does low health literacy only affect older adults?
No, though age is a contributing factor. The National Assessment of Adult Literacy found health literacy scores are lower on average for adults 65 and older and for those with less formal education, but limited English proficiency and situational stress affect health literacy across every age group. A young, otherwise literate adult managing a new diagnosis can experience the same comprehension gap in the moment.
Can improving the format of patient materials really change outcomes, not just comprehension?
The strongest evidence connects comprehension to outcomes indirectly but consistently. A 2015 BMJ Open study tied higher health literacy to lower 30-day readmission after a heart attack, and CPAP adherence research found a 3-minute video moved adherence from 50% to 68.2% in three weeks. Neither study changed the medical plan itself, only whether the patient understood it well enough to follow it.
The short version
Low health literacy affects most US adults to some degree, and it is rarely a matter of intelligence. It is a mismatch between how health information gets delivered, mostly written, mostly once, mostly in English, and how much of the population that format actually reaches. Controlled research shows spoken delivery closes part of that gap in a way plain language alone does not, and producing it in a patient's own language closes another part entirely. See how Jellypod fits into health and medical content.