Person-first and Destigmatizing Language

Person-first language is a way to emphasize the person and view the disorder, disease, condition, or disability as only one part of the whole person. Describe what the person “has” rather than what the person “is.” Person-first language avoids using labels or adjectives to define someone, e.g., a person with diabetes not a diabetic; or person with cancer not cancer patient; or a person with bipolar disorder not a person who is bipolar.

Some communities, however, prefer identity-first language because they consider some characteristics as inseparable parts of their identity. Those who prefer identity-first language consider it a way to show pride in who they are and their membership in a community of similar people. The deaf and autistic communities, for example, often show a strong preference for identity-first language. When possible, ask if a person or group uses identity-first language (deaf students) or person-first language (students who are deaf). If the preference is not known, err on the side of person-first language. For example, always use person-first language for children; identity-first language is chosen.

See the CDC’s Health Equity Guiding Principles for Inclusive Communication and the NIH article Writing Respectfully: Person-First and Identity-First Language for more on person-first language and other inclusive principles.

Brain injury vs. brain-damaged

AP Stylebook: Brain injury
A traumatic brain injury (TBI) can be caused by a forceful bump, blow, or jolt to the head or body, or from an object that pierces the skull and enters the brain.

A traumatic brain injury should not be referred to as a head injury, which should be reserved for cases where the head is injured without damaging the brain.

Blind

AP Stylebook: Blind
The National Center on Disability and Journalism (NCDJ) says to use the term blind to describe someone with complete loss of sight. Use legally blind to describe someone with “almost complete loss of sight.” Another option is low vision. NCDJ recommends against using the term visually impaired. Ask your source what they prefer and if they prefer identity-first (blind students) or person-first (students who are blind) language.

Caesarean delivery vs. c-section

Use caesarean delivery, caesarean birth, or abdominal delivery instead of caesarean section or c-section.

Caregiver, care partner vs. caretaker

Use caregiver, rather than caretaker, to describe people providing care. The term caretaker generally refers to a person who takes care of something, such as a house, when the owner isn’t present.

Both caregiver and care partner are acceptable but consider the situation and individual’s preference before choosing a term. A caregiver provides care for someone who cannot care for themselves. A care partner is a partner in care, and this term is sometimes preferred to show that the person with the disease is able to care for themselves with some assistance.

Deaf

AP Stylebook: Deaf
According to NCDJ: “Deaf and hard of hearing became the official terms recommended by the World Federation of the Deaf in 1991. Many people in the Deaf community prefer the use of the lowercase ‘d’ to refer to audiological status and the use of the capital ‘D’ when referring to the culture and community of Deaf people.” Always ask your source what they prefer; some deaf people do not consider themselves to be a part of the Deaf community.

Avoid the term hearing impaired.

NCDJ says: “When quoting or paraphrasing a person who has signed their responses, it’s appropriate on first reference to indicate that the responses were signed. It’s acceptable to use the word ‘said’ in subsequent references.”

Developing nations vs. third-world countries

AP Stylebook: Third World
Use developing nations or developing country instead of third-world countries. The term third-world country is dehumanizing and offensive. The World Health Organization uses the following data-based terms instead (abbreviations included because they are commonly used). Whenever possible, specify the exact country or countries to avoid labeling altogether.

• low- and middle-income country (LMIC) and low- and middle-income countries (LMICs)
• upper-middle-income country (UMIC) and upper-middle-income countries (UMICs)
• high-income country (HIC) and high-income countries (HICs)

Disproportionately affected vs. vulnerable groups

Avoid use of terms such as vulnerable, marginalized, and high-risk as adjectives. These terms are stigmatizing and vague. They also imply that the condition is inherent to the group rather than the actual causal factors.  

The preferred terms are disproportionately affected, groups that have been [economically/socially] marginalized, groups at higher risk of [outcome], groups experiencing disadvantage, groups experiencing disproportionate impact, population of focus, or under-resourced communities.

Engage, prioritize vs. target, tackle

Use engage, prioritize, or consider the needs of instead of tackle, target, combat, or other terms with violent connotation when referring to people, groups, or communities.

These terms are okay to use when referring to disease, e.g., “NIH works to combat Alzheimer’s disease and related dementias...”

Failed treatment

Do not use the patient failed treatment, which inappropriately blames the patient. Use the treatment was not effective in the patient or the patient did not respond to treatment, instead.

Food insecurity

Food insecurity, when households lack access to adequate food because of limited money or other resources, is a leading health and nutrition issue in the United States. Reference the USDA’s Definitions of Food Security for ranges of food security and use recommendations. These terms may require brief explanations if the meanings aren't clear from the context.

Food insecurity is related to suboptimal and/or poor diet quality, which increases chronic disease risk among the socioeconomically disadvantaged.

HIV vs. HIV/AIDS

Use HIV instead of HIV/AIDS. AIDS evokes suffering and death and should be used only when describing AIDS specifically. HIV is inclusive of both HIV and AIDS when the reference is not specific, as in “the HIV epidemic.” HIV and AIDS do not need to be spelled out on first reference.

For additional guidance, please reference the National Institute of Allergy and Infectious Diseases’ HIV Language Guide.

Immigrant, refugee vs. illegal aliens, foreigners

AP Stylebook: Immigration
Use people with undocumented status, mixed-status households, immigrant, migrant, asylum seeker, refugee, or non-U.S.-born people (as appropriate and contextually) instead of stigmatizing terms such as illegals, illegal immigrants, illegal aliens, illegal migrants, foreigners, or the foreign-born.

Intimate partner violence vs. domestic violence

Use intimate partner violence or gender-based violence instead of domestic violence. The preferred terms are more specific and include relevant violence outside of a shared home.

Patients vs. subjects

Use patients, participants, or individuals instead of subjects when referring to clinical trial participants, unless research subjects is specific to a policy or regulation.

People experiencing homelessness vs. the homeless

AP Stylebook: Homeless
Use people experiencing homelessness, people without housing, or people without homes instead of the dehumanizing collective noun the homeless.

People living with HIV

Use people living with HIV instead of HIV-infected people or people infected with HIV. Infection carries the stigma of being contagious, a threat, or unclean. HIV advocates frequently highlight the damaging consequences of this word choice. Living with is an affirmation of life many advocates prefer. People with HIV is also acceptable.

People with lower incomes vs. poverty-stricken, the poor

Use people with lower incomes, people/households with incomes below the federal poverty level, people experiencing poverty, instead of poverty-stricken, the poor, or poor people. Do not use underserved when meaning low socioeconomic status. The term people with lower socioeconomic status (SES) should only be used when SES is defined (e.g., when income, education, parental education, and occupation are used as measures).

Stakeholder vs. collaborator

Avoid the term stakeholder when referring to working partners and community collaborators, especially when working with Tribes. Instead, use terms that describe the nature of their influence or involvement.

Stakeholder can be used to reflect a power differential between groups and has a violent connotation for some Tribes and Tribal members. It also groups all parties into one term, despite potential differences in the way they are engaged or interact with a project or activity.

Some alternative terms are community members, persons affected by [policy/program/practice] or partners, collaborators, allies, community engagement, or Tribal engagement.

Suffering from

Do not use general phrases like suffering from (condition/disorder). The word suffering has social and emotional implications that are unhelpful. Use specific medical language instead.

Suicide

AP Stylebook: Suicide
Use died by suicide or attempted suicide instead of committed suicide. Commit connotes criminality or sin.

Suicide attempts should not be described as successful, unsuccessful, or failed. Instead, use survived a suicide attempt, just as one might describe an individual who has survived cancer or a heart attack.