How readable is this Zika information?

I was recently at a conference for applied linguists (AAAL) and I was talking with a small group about how the health literacy field has over-used readability formulas to help analyze and adjust the difficulty of written content.

I showed the following 2 paragraphs:  The first taken from a NYT article about Zika. The first paragraph’s readability grade level, using the Flesch Kincaid, is 12.6 grade.  The second paragraph is one I rewrote so that the readability score on the Flesch Kincaid was lower, 7.6.

I then said: The second paragraph is fundamentally just as difficult as the first.”  Please tell me why? 

Everyone was sort of stumped.  

So, a little help here.  Why are the two paragraphs comparable in difficulty?

flesch kincaid paragraphs


10 replies
  1. Naomi Gewirtzman
    Naomi Gewirtzman says:

    I like these examples because they demonstrate how simplifying text doesn’t always simplify the meaning. People (including myself) tend to think that by simplifying words/using synonyms/reorganizing sentences makes things more understandable to the general public, but that isn’t always true.

    Problems with example 1:
    -It’s one long sentence with lots of information
    -not everyone knows that there are different types of mosquitoes or that mosquitoes can transmit disease or how transmission even works
    -people may not know what a “carrier” is or truly understand what a virus is

    Problems with example 2:
    -as others stated, the use of the word future is confusing and could be alarming to people because “future” could mean anything
    -like the first example, the use of the word carrier or “carry” may be confusing
    -although the second sentence is explaining the first sentence, it could still leave the reader wondering “and then what?” or “how can i get it?” since it just talks about how the mosquito can get Zika and leaves out how humans can be affected

    When comparing the two examples, there are some similarities which make them difficult to understand. The wording is different in both, but they are both still confusing. If someone was reading these sentences and did not know a whole lot about Zika or the way mosquito-borne diseases spread, it could leave them wondering how it could affect them.
    I think that when it comes to creating health information, it is important to note that simplifying words may only be effective if their placement in the sentence is easy to understand. Long sentences can be confusing even when they contain simple words AND short sentences can be just as confusing if they use complicated words commonly used in scientific information.


  2. Juan Lopez
    Juan Lopez says:

    I agree with Chris that both paragraphs are just as confusing and somewhat misleading. While the 12.6 text appears more formally written, the 7.6 paragraph makes the same assumptions and leaves out the same key information. For example, both texts hypothesize that ‘American’ mosquitos could become carriers of the virus by way of biting a previously infected person. While this may come across as evident to public health practitioners or folks in the scientific community, the idea that a mosquito is carrying or delivering anything might go over a layperson’s head. As Maricel said, the ‘future’ implication in the 7.6 text could mean just about anything; what future? Tomorrow? Next year? In another lifetime? The conclusion that I draw from this wonderful example is that ‘dumbing’ down the writing will do little to cure the ills of poor health literacy. In my opinion, there are instances where you’re better off explaining something thoroughly rather than simplifying it and, in turn, leaving readers just as confused or ill-informed.

    • ChrisZ
      ChrisZ says:

      It’s good to hear from you Juan. I hadn’t thought much about “the future” phrase – but I agree with you and Maricel, it is so vague yet ominous.

      You might be interested in a series of short animated lessons I’m creating about readability formulas.

      Thanks again for you comments.

      [Please let me know if you have any problem accessing the link]

  3. Holly E. Jacobson
    Holly E. Jacobson says:

    in the 7.6 text, I find I have to pause when I get to “This…” after reading the first sentence, and then I have to read the first proposition again. The language is stilted, as Plain Language often is. I find it difficult to process.
    Part of the issue for me, as well, is that since I DO know a bit about contagious disease processes, I am looking for that information, so what I am bringing to the reading of both texts is going to be different, perhaps, from what someone else brings.
    Also, I feel that reading the 12.6 text and then 7.6 text may have had some kind of priming effect that made processing of 7.6 more confusing. I expected more information.
    Anyways, I think both are confusing (but they might be clearer embedded in more text), and that lack of cohesion makes texts with low readability as measured by formulae difficult to follow.

  4. liam
    liam says:

    The first thing I found confusing in the second paragraph was the word “future”. Saying “in the future” can have several meanings- in the near future? at a much later time? Individuals with limited literacy may not be able to figure it out. Also, if you want to educate people on something important that is happening now why use the word future to begin with?. Additionally, as mentioned by fellow classmates earlier, the term virus is not necessarily understood by everyone as it is scientific language, and there is no connection or explanation on what is the risk of getting bit by Zika virus which makes it difficult to understand what this message is all about. I feel that overall the message is not clear in both paragraphs; the specific information it may wish to convey is confusing and the action you want the audience to take is unclear.

    • Sarah
      Sarah says:

      I like this infographic! It’s one of the only Zika communications that also includes follow-up informaiton (“How to treat it” “People sick with Zika should…” All the communications I’ve seen about Zika focus on the prevention and avoidance and don’t answer the “now what?” question.

  5. says:


    Both paragraphs are difficult because a person would have to understand concepts of disease such as modes of transmission for infection and the interaction between host, agent and environment. Moreover, in both, the concept of a virus and how it translates to risk for something like Zika, is difficult to understand for those with poor scientific health literacy. I would also argue, both paragraphs expect the reader to make the geographic connection that traveling to endemic areas, can result in travelers becoming infected ( I.E a bite from infected mosquito, which transmits virus to bodily fluids) and sexual transmission or getting impregnated by a carrier (infected person) can potentially bring the virus to the U.S. While the readability levels are adjusted, they are both have a high science literacy level.


  6. Maricel Santos
    Maricel Santos says:

    Thanks, Christina, for sharing this at AAAL and on your blog.

    The writer of Text 2 tried to simplify the text by:

    (1) reducing the vocabulary: eliminate the technical word “carrier”; use only the word “mosquito” instead of “mosquito” then the word “insect”; drops the “Aedes” detail
    (2) breaking down the original long, complex sentence (which contained 2 relative clauses “If….” and “who…”) into 2 separate, shorter sentences: 1 simple, plus 1 complex.

    However, the important information — the process by which an Aedes mosquito can pass on Zika — is no clearer in the 2nd text.

    First, I think the phrase “in the future” adds more confusion. What does “in the future” mean? As in futuristic mosquitos, like the kind that fly around in the Star Wars world? That phrase immediately conveys to me that these events don’t yet occur, but in fact the risk affects mosquitos and people NOW.

    Second, after reading the 2nd text, I still want to know: do you mean all mosquitos can pass on Zika? (The answer according to the first text: no, only Aedes-type mosquitos).

    I think text 2 dilutes the important idea of being a “carrier”. Thus, I don’t think readers of Text #2 are any better informed than readers of Text #1.

    Why do we rely on texts to explain this stuff? Wouldn’t a a good graphic be more effective?

    • ChrisZ
      ChrisZ says:

      I simply love the example you’ve conjured up, Maricel, of the Star Wars mosquito! I missed that possibility and you’re right.
      I also think an Infographic is screaming out to be used here. However I see so many infographics that make things even more complicated, especially when they use numbers and insufficiently explanatory visuals together.
      I’ve appreciate hearing from people with examples of good, understandable Infographics. They don’t have to be about Zika to help our readers of this blog.

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