Words Matter: Tips to Use Inclusive Language in Healthcare

“Diversity and inclusion” are buzzwords we often hear at work, school and medical settings.

Diversity takes into consideration the varied traits and characteristics that make people unique. That includes age, ethnicity, socio-economic status, education level, sexuality, gender identity, disability, mental health, religion and spirituality.

Because our world is so diverse, organizations also must focus on ways to make people feel more included. One way to do this is through using inclusive language.

What is inclusive language? 

Inclusive language uses words to include everyone. According to the Linguistic Society of America, inclusive language “acknowledges diversity, conveys respect to all people, is sensitive to differences and promotes equal opportunities.”

By using inclusive language, we avoid pitfalls or habits that may unintentionally lead to marginalization, offensive words, misrepresentations or the perpetuation of stereotypes, the linguistic society says.

Why is it needed? Picture yourself at a party where no one greets you or engages you in a conversation. You feel left out, lonely and frustrated that you came in the first place.

A patient may feel the same way, especially if they have a language barrier. We achieve better care and outcomes by working with our patients, being sympathetic to their circumstances, getting to know their home and work life, and understanding how they respond best to suggestions and treatments.

Statistics show that marginalized groups experience poorer physical and mental health outcomes.

As clinicians, being mindful of using inclusive language reminds us that each patient has unique needs and circumstances, and those perspectives affect and contribute to their physical and mental health.

How to use inclusive language

Inclusive language may not come naturally to us because of the pace of cultural changes and sensitivities. One guiding principle is to recognize the patient is a person first, not just a condition. For example, your patient is a “person with diabetes,” not a “diabetic.” Someone who uses narcotics excessively is a “person with a substance use disorder,” not an “addict.”

Here are some more examples of patient-first:

• Say “wheelchair user” instead of “wheelchair bound” or “confined to a wheelchair.”
• Substitute “person with a disability” for “disabled person.”
• Use “living with (chronic disease)” or “being treated for (a chronic disease)” rather than “suffering from” a chronic disease.
• Choose words such as “needs,” “differences” or “challenges” instead of “deficit,” “defect” or “abnormality.”
• When discussing someone with autism, don’t use “high-functioning” or “low-functioning.” Instead, describe the person’s needs specifically: high-support needs, person with intellectual disabilities, person with language disabilities.
• Apply “patients,” “participants” or “individuals” instead of “subjects” when referring to clinical trials. 
• Describe a “person with obesity,” “person affected by obesity” or “person who has obesity” instead of using “obese person.”
• Use “older adults” or “people over age X” instead of “the aged,” “elders,” “the elderly” or “senior citizens.”

Of note, “deaf” and “hard of hearing” became the official terms recommended by the World Federation of the Deaf in 1991. Also, many people in the Deaf community prefer using the lowercase ‘d’ to refer to audiological status and the capital ‘D’ when referring to the culture and their community, according to the National Institutes of Health.

Communicating effectively

Besides substituting language, here are some suggestions for directing the conversation to include everyone effectively.

To better understand the patient’s home and personal life, consider starting the conversation like this: “I need to ask you several personal questions as a routine part of the process for all patients.”

Let your patient know that the answers will help you understand their background to provide the best care.

When making recommendations to patients, instead of rattling off what they should or should not do to make improvements, try a more friendly approach as described by Consultations 4 Health, a UK-based health consultant:

• Have you tried…?
• What about…?
• Would you like to consider…?
• What has worked for other people is….

Ask your patients how they would like to communicate in the future. Whether email, text or a call is the best way to reach them, for example.

Ultimately, taking the time to acknowledge the diversity of your patients and their situations and using inclusive language will contribute to even more effective patient care.