Do your words match your intent? How to avoid stigma in health messaging
“Good words are worth much, and cost little.” – George Herbert
As communications professionals, we all know how much words matter. Raise your hand if you have recently spent way too long noodling every word, every comma, and every sentence of something you wrote. We want to be accurate and understood. We want the tone and cadence to be just right. We hope our words might educate, motivate, and inspire.
But, we have an even greater responsibility as health communicators: ensure the people hearing our words feel respected, and free of judgment and blame.
At the American Public Health Association (APHA) meeting a few months ago, I attended a session about the stigma that comes with certain words and phrases in the context of health care delivery. It highlighted how use of specific words across a range of issues (e.g., age, gender, health, race/ethnicity, disability) can lead to people feeling blamed, shamed, and deterred from getting health care or other services. This topic came to life among health care providers and patient advocates shortly thereafter on Twitter when the American Society of Clinical Oncology released guidance for its next Annual Meeting on The Language of Respect for patients, families, advocates, and colleagues. From the debate about the ‘war on cancer’ metaphor, to the recent Miriam Webster change for ‘they’ as an individual pronoun, we see how word choices make a real difference in how people feel, and that nomenclature evolves over time. It is our responsibility to stay current.
To ensure that our language matches our intention to be respectful and inclusive, here are five tips gleaned from the experts that are particularly relevant when communicating about health:
- Use person-first language. People are not defined by their diseases or circumstances. Language about health conditions or identity should be used as an adjective instead of a noun. For example, a person with diabetes should not be referred to as a diabetic or diabetes patient; there is more to that person than their diagnosis. (The one caveat here is that in the context of the provider-patient relationship, the word patient might still be appropriate.) Another example: instead of referring to someone as mentally ill, refer to them as a person with a mental health condition. The person—and our shared humanity—is at the center.
- Avoid victimizing people. It is disempowering to say that someone is a “victim” of their disease or “afflicted” by their disease. For example, rather than referring to someone as an AIDS victim or person suffering from AIDS, they should be referred to as a person living with AIDS.
- Look out for “health concerned trolling,” which has commonly been found in interactions between providers and people who are obese. It is considered a microaggression and refers to someone who (knowingly or not) makes undermining criticisms under the guise of concern. It is questioning someone’s choices and ending the sentence with, I’m just concerned about your health. In the clinical setting, it looks like a provider saying, ‘your acute condition would be better if you lost weight’, or ‘we can’t treat your acute condition until you lose weight’. This type of exchange can be stigmatizing and lead people to be less willing to seek out health care.
- Don’t be afraid to ask if you aren’t sure how people identify themselves. Language should reflect people’s choice and style in how they talk about themselves. And because language is constantly changing, the most respectful route is to check. Most people are appreciative when asked their preferences, and simply asking can build bridges.
- Be open to being corrected. It is becoming more common to hear about the act of “calling in,” which is a term used in a social justice context to describe peers explaining a misstep with compassion and patience in order to change behavior. We don’t always get it right, even when we try hard. Accept the feedback graciously and learn from it.
To dive deeper into non-stigmatizing language in health and beyond—and to find specific examples of terms to use and terms to avoid—check out these helpful resources: Sum of Us Progressive Style Guide, Conscious Style Guide, and Social Justice Phrase Guide