Using Plain Language for Effective Health Communication

Governors are focused on improving the health and well-being of their constituents, and health communication is a tool that can support this. States and territories are exploring ways to increase accessibility of government communications through several strategies, including by making sure they're written in plain language - the practice of writing for an intended audience in a clear, understandable way.

Several different industries have focused on using plain language and this approach has more recently been formalized by both the federal government and state governments. The federal Plain Writing Act of 2010 defines plain language as "Writing that is clear, concise, well-organized, and follows other best practices appropriate to the subject or field and intended audience." By using plain language, states and territories can support more readers in understanding messages. A plain language style uses several specific approaches to convey information in a way that meets the goals of the writing. The strategies outlined in the Plain Writing Act of 2010 include:

• Reader-centered organization;
• "You" and other pronouns;
• Active rather than passive voice;
• Short sentences and paragraphs;
• Common, everyday words; and
• Easy-to-follow design features, such as lists, headers, and tables.

A plain language approach also has applications to health policy, as clear communications are at the heart of public health messaging. For example, state health departments may follow plain language guidelines when providing education on how to prevent the spread of communicable diseases. This approach can also play a role in improving health literacy, with a Medicaid agency, for example, using clear, concise language to share information about how Medicaid beneficiaries can use their health plan benefits. To better understand how this plain language approach applies to public health, the Centers for Disease Control and Prevention (CDC) developed a resource called "Everyday Words for Public Health Communication" to help reduce the amount of jargon in public health outreach.

States are also beginning to formalize an approach to using plain language in government communications. In July 2024, Maryland Governor Wes Moore established the Maryland Plain Language Initiative through executive order. This initiative aims to create standards to enhance communication between the state and its residents, with the goal of making printed and digital communications, services, and support easier to understand and use.

"This Executive Order is based on a simple idea: It shouldn't have to be so difficult for Marylanders to access the programs and services they need. Our administration's Plain Language Initiative will help ensure that every piece of writing that comes out of our administration - in print and online - is simple, accessible, and easy to read. This is what it looks like to leave no one behind."

The initiative is housed within the Maryland Digital Service in the Department of Information Technology, with the Maryland Department of Disabilities and the Governor's Office of Community Initiatives listed as partners in this work. The executive order specifies the Maryland Digital Service will:

• Assess Maryland's capacity, needs and resources to implement plain language standards best practices;
• Create the Maryland Plain Language Plan to improve accessibility of state agency written communications; and
• Consider designating a plain language contact in each state agency, develop a style guide and other resources, pilot projects to get public feedback to improve the initiative iteratively, develop a training plan for agencies and identify available resources to achieve the outline goals.

The Maryland Plain Language Initiative takes a human-centered whole of government approach to accessibility. The initiative includes all state agencies, advocacy organizations, community partners and members of the public. The initiative's goal of improving written communication with the public will also have implications for health-related communications.

The Idaho Department of Health and Welfare aims to use the plain language model in communications with the public. The department's 2024-2028 Strategic Plan includes a goal around strengthening trust and confidence by improving customer experience for stakeholders such as the public, department customers, legislators, healthcare providers and other partners. Plain language is mentioned as a tool to achieve this goal. The department has plans to use a readability tool to measure progress in better adhering to plain language standards for communications with Idahoans.

"Maintaining public trust and confidence in government is of paramount importance."

The adoption of plain language in state government has the potential to enhance the efficacy of state communications. This approach is also an innovative way to support health equity. The NGA Center supports Governors' health equity goals through the Health Equity Learning Network and will continue to track and highlight novel state health equity approaches. For more information on how Governors can use plain language as a strategy to address health equity, contact Anna Heard at [email protected].