CHICAGO — A new study from Northwestern University found that 32.5 percent of middle-aged American adults, specifically those aged 35 to 64, have limited health literacy skills. The research included 1,000 adults in Chicago who were receiving care at Northwestern-affiliated hospitals and federally qualified health centers.
Limited health literacy was defined as the inability to consistently read prescription instructions correctly, understand medical forms, or recall details from doctor visits involving chronic condition diagnoses. Researchers found that lower health literacy was associated with lower income, less education, and unemployment. Participants with poorer health literacy skills had more chronic conditions, were prescribed more medications, and performed worse on cognitive testing.
Researchers evaluated health literacy through interviews and practical tasks. These tasks included interpreting prescription labels, recalling physician instructions from a clinical diagnostic video, and reviewing written care materials. Abigail Vogeley, a research fellow and doctoral student, said the study aims to reduce confusion rather than highlight deficits. "This work is not about pointing out what people can't do, but rather, can we confuse patients less?" Vogeley said.
Michael Wolf, a medical researcher and center director, said people lack guidance on managing care in midlife. "In midlife, there's no clear 'user manual' for engaging with health care. Our findings suggest we're not adequately preparing people to engage and manage their care," Wolf said.
Vogeley noted that while focus has typically been on older adults, health literacy is suboptimal in middle age. The study authors recommend simplifying patient health materials to use plain language at a sixth- to eighth-grade reading level. The study is scheduled for publication in the Journal of General Internal Medicine on June 10, 2026.
No independent assessment was available for this report.