Researchers have found that persons with poor literacy skills are more apt to misunderstand labels and those tightly folded up health information notes packaged with medications. This can lead to faulty use of medications. (Photo: Shutterstock/NTB scanpix)

Poor reading skills in Nordic countries link to poor health

Many residents of the Nordic countries cannot read and comprehend texts relating to their health.

In Norway residents have good access to universal health services and opportunities for advanced education, whether they are children of a fisherman or a lawyer.

But there are still social disparities in public health.

We know from reams of research papers and reports that those with the most education tend to have the best health and live longest.

A Nordic research project has now investigated the link between how well we read and how healthy we are.

The researchers find a strong connection in Norway, Sweden, Denmark and Finland.

“If you have poor reading skills rather than good ones, the risk of poor health triples,” says Kjersti Lundetræ. She is an associate professor at the University of Stavanger’s National Centre of Reading Education and Research.

More than education

Surprisingly, good reading skills — or the lack of them — does not link strongly to the length of a person’s education. The researchers in this study found that the ability to read a text unmasks something beyond educational level. Literacy plays an independent role exclusive of gender, age and level of education.

“This is the first time researchers in the Nordic countries have seen the link between literacy skills and health,” explains Lundetræ.

The study was made among 22,500 persons aged 16–65 in Norway, Sweden, Denmark and Finland.

The researchers used data from the Programme for the International Assessment of Adult Competencies (PIAAC), popularly called PISA for adults. It reveals adults’ skills in reading, writing and arithmetic.

The test also includes an interview in which, among other issues, the informants are asked how they perceive their own health.

All the Nordic countries

The share of the population that reports having poor health is quite alike in the four Nordic countries. Gender differences were minor. In all four countries the participants’ levels of education were pivotal to their perception of their own health.

Whereas 25 percent of those with low levels of education said their health was poor, only 10 percent of persons with high levels of education claimed the same.

Nearly 30 percent of the persons in Norway with the poorest reading skills say their health is poor. The share who thought this among the better educated was 10 percent.

Can be serious

Lundetræ thinks a person who lacks the ability to read and comprehend texts that relate to their own health can run into some serious short-term and long-term problems.

“Previous research has shown that persons with poor reading skills easily misunderstand prescriptions and the supplemental pharmaceutical information included in the packaging of their medications. This can end up with mistakes being made by the users.”

On the long term, it is important for the public to understand the health information found in magazines, newspapers or on the internet to help bolster disease prevention.

Not just a matter of immigration

The researcher thinks physicians and health officials should be aware that many today do not understand Norwegian health information.

“We know that speakers of minority languages in Norway are over-represented among those with poor reading skills. The ability to read Norwegian is important for orienting oneself in the health system and getting knowledge about ailments and treatment of chronic diseases.”

Only part of the association between reading skills and health can be explained by immigration, according to Lundetræ. The researchers’ results show the same pattern among all the Nordic countries. Yet we know that the share of immigrants in Finland is much smaller than in Sweden.

Elderly lag in reading skills

Another part of the study looks at data from both the PIAAC and PISA tests in the Nordic countries. It shows that the older the reader, the poorer are his or her reading skills. The quality of education a person gets in his or her first 25 years is decisive.

In the same Nordic project the Swedish researcher Jan-Eric Gustafsson of the University of Gothenburg has followed up 15-year-olds who were given PISA tests and subsequently seen how they have fared as adults.

He finds a clear connection between literacy skills among these teenagers and their reading skills twelve years later.

A solid elementary and junior high school education is also essential for good reading skills as an adult. The researchers found that it is hard to compensate later in life for an inferior basic education. 

Lundetræ points out that in today’s job market, where many of us can anticipate a need to be re-educated or re-trained, solid reading skills are more important than ever.

“It is easier to get squeezed out of the labour market and end up relying on benefits if you lose your job and lack good literacy skills,” she says.


Read the Norwegian version of this article at

Translated by: Glenn Ostling

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