Leave no one behind: improving health and risk communication through attention to literacy.

Twice in recent times, the federal government mailed critical health-related information to every household in the United States. The mailings, the 1988 brochure Understanding AIDS and the 2001 postcard A Message to Americans, were designed to provide the general public with important information about needed action. This paper compares the development process undertaken for each mailing. The authors assess content and format in light of communication principles and the functional literacy skills of average adults. The authors, noting that the reading grade level of the postcard exceeds the reading ability of the average adult, recommend that plain language guidelines be combined with health and risk communication principles in all future efforts to alert the public.