Is Literacy the Overlooked Barrier to Hospital Accessibility?

When hospitals address accessibility, the focus often centres on physical features like ramps, lifts, or hearing loops. But there’s another barrier—less visible, more widespread—that quietly shapes how people experience care: literacy.

And not just reading words. It’s about understanding instructions, navigating complex systems, and making sense of clinical information while under stress.

Reading Doesn’t Guarantee Understanding

An individual might read every word on a sign or letter and still struggle to grasp its meaning. Health-related materials often contain jargon, abbreviations, and inconsistent formatting. Even fluent English speakers can find this overwhelming.

Now consider facing that same environment with low literacy skills, or with limited English proficiency (LEP), or while experiencing pain or anxiety. That’s not just inconvenient—it can be unsafe.

Most Australians Don’t Operate at High Literacy Levels

According to the OECD’s international survey of adult skills, around 44% of Australian adults operate at literacy levels 1 or 2. That means they may struggle with everyday texts, particularly if the information is dense, unfamiliar, or comes at a stressful time.

Here’s what those levels mean:

• Level 1: Can read short, simple texts but struggles with forms, signs, or instructions—especially if presented in unfamiliar ways.

• Level 2: Can handle slightly more complexity, but still has trouble integrating information or following multiple steps.

• Level 3: The minimum needed to function effectively in modern society—can read moderately dense material and act on it when clearly written.

• Level 4 and 5: Proficient users who can process, evaluate, and apply complex information across multiple sources.

Only about 15% of Australian adults reach Level 4 or 5. Yet many hospital environments are designed as if every user sits comfortably at these higher levels. Most don’t.

Hospitals Are Text-Heavy Environments

From entrance signs to floor directories, appointment letters to consent forms, hospitals are filled with written content. Much of it is densely formatted, overly technical—preferably in Latin—and delivered in a way that assumes calm, confident users who are fluent in both English and healthcare systems.

LEP and Literacy Are Different, But Overlapping

Limited English proficiency (LEP) affects people who may be literate in their own language but cannot easily read or understand English. Low literacy affects people who may struggle with reading and understanding in any language. Both groups are common in healthcare settings—and both are underserved by systems designed for confident English readers.

We need to design communication and wayfinding systems that support both. That means going beyond translation. It means designing for clarity at every level.

Translation Isn’t the Whole Solution

Providing materials in multiple languages is essential. But translating complicated English into equally complicated Arabic or Mandarin doesn’t improve access. It just moves the barrier sideways.

We need better structure. Plain language. Logical sequencing. Clear visual cues. Familiar icons. And messages designed for people who are stressed, tired, or unwell.

Wayfinding Helps People Navigate Without Reading

Good wayfinding supports orientation, movement, and decision-making—without relying on heavy reading. Icons, colour zones, consistent naming, and clear environmental cues all reduce the cognitive load.

One of the techniques we use in text-heavy environments like hospitals is a navigation system inspired by large airports. Instead of asking users to interpret complex departmental names, we assign locations a simple code—often a number or a combination of a letter and number—like a gate at an airport. Users don’t need to understand what happens at each destination; they just need to know that they’re headed to “G23” or “Zone B7.” Once they arrive, they check for confirmation, just like checking a gate number against a flight. This system is sequential, logical, and easy to follow—especially for people with reading difficulties or limited English proficiency.

When paired with patient-friendly signage and accessible communication materials, wayfinding becomes a tool that reduces stress and improves safety across the entire journey.

Clarity Enables Access

Accessibility is more than getting through the door. It means knowing where to go, what to do, and how to get help—all without needing to read at a high level. If we design for literacy levels most people don’t have, or for English proficiency many people lack, we leave too many behind.

At Humanics Collective, we design for understanding. Because care should be accessible—not just physically, but cognitively too.