Inclusive language in health and care: why the words we use matter

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As the forthcoming Health and Care Bill ushers in new measures to promote and enable collaboration in health and care, it brings with it a slew of new terminology and acronyms. While we integrate this new language into daily usage, we must think critically about how and why we choose specific terms over others. The words we use (or don’t use) carry more power than we realise, and if used carelessly, terminology can silence, exclude, and dismiss certain people and their experiences. But applied carefully, certain terminology has the power to bring underrepresented voices to the forefront while making people feel included and valued. In this blog I share some examples I’ve come across that made me contemplate the impact language can have, and some reflections on how I personally think about the words I’m using.

What does inclusive language look like in practice? 

Although initially seen as a helpful way to refer to many different people at once, the term Black, Asian and minority ethnic (BAME) has since come under fire, with some calling it reductive. By attempting to represent many groups at one time, it simultaneously lacks specificity and ultimately groups a diverse range of people and experiences under one murky label. For example, while some experiences are shared across groups, health inequalities will inevitably show up differently in a Pakistani community in northern England compared to a Chinese community in central London as a result of differing determinants of health. The conundrum of using or not using BAME highlights the need to clarify who we are specifically addressing and in what context, how we refer to people and why we’ve elected to use those words over others.  

Ableist language– language that discriminates against those with disabilities – marginalises by reducing people to a label and stigmatising disability. For example, ableist microaggressions and a lack of understanding can prevent people with a learning disability from accessing essential services and support. This barrier contributes to the wider issue of people with a learning disability experiencing poorer physical and mental health compared to those without a learning disability. In the 1980s, the concept of ‘person-first language’ shifted the focus to identify the person first then acknowledge disability (‘a person with autism’, for example). More recently, some disability advocates are pushing for ‘identity-first language’, which flips the narrative of the former by more explicitly identifying the person by their disability (‘an autistic person’). Not only does this example highlight the evolving nature of language but also the reality that different people will prefer different terms. 

The way we speak about sexuality, gender and gender identity is another example of how language can include or marginalise people. For example, using a person’s correct pronouns (consistent with how they identify) and chosen names (rather given names or dead names) demonstrates respect and validation. Making assumptions about how a person identifies or conflating gender identity and sexual orientation can form additional barriers between non-binary people and necessary services. Assumptions about sexual orientation can also deter people who identify as lesbian, gay, bisexual, transgender, queer/questioning and other gender identities and sexual orientations (LGBTQ+) from reaching out for help. This is especially concerning, because people who identify as LGBTQ+ experience disproportionately worse health outcomes and have poorer experiences when accessing health services. (Our newest podcast episode on LGBTQ+ health inequalities touches on language)

How can we reflect on our language?

While the above examples demonstrate angles from which we can reflect on language, they are just that – examples. It’s essential to keep in mind that language, much like identity and culture, is constantly evolving. Not to mention that intersectionality reminds us how these shifting elements can overlap and interact with one another. So, rather than simply memorising ‘correct’ terms, we should make time to reflect on the language we use. When thinking about language, I ask myself some key questions.  

  • Where does this term come from and why am I choosing to use it? 
  • Does this terminology or phrasing capture the specific group or experience that I am referring to? 
  • Does this description share only the characteristics pertinent to this discussion? 
  • Is this terminology or phrasing used by the people concerned? If I’m not sure, have I verified it? 
  • Who is my audience? Is this language welcoming and accessible to that audience? 
  • Is this term or acronym widely understood, or would readers benefit from clarification? 
  • What are the implications of this language beyond this immediate piece of work? 

As researchers, policymakers, journalists, and health and social care professionals, the language we use matters. Whether we are interacting directly with people from underrepresented groups or communicating with colleagues or the wider public, we all have a role to play in normalising specific and intentional language. This could be as simple as including our own pronouns in our email signatures or more involved like challenging colleagues on terms used in our outputs. It’s inevitable that we will get some things wrong but that just means we have an opportunity to ask questions, learn more, and do better in the future. 

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