Now more so with changing times and labels, we need to be aware of our language especially as global leaders. We need to show that words matter because they change the way stakeholders engage with the most pressing issues in our fields. For instance, say we have a project that is offering services to a target population. What words would you use to describe that population, ‘recipients’ or ‘participants’?

“We should promote the use of non-stigmatizing, people-first language. The potential benefits of promoting people-first language are evidenced in discussions regarding social services such as Medicaid and SNAP. Identifying individuals as ‘participants’ in these social services creates a discussion about people taking action and participating in society. In contrast, describing them as ‘recipients’ creates a passive mental image of ‘takers,’ and serves to reinforce inaccurate, negative imagery about assisting people with low incomes or who may be experiencing poverty. This change echoes another linguistic shift we have already made within the public health community. Recognizing the rights to ethical treatment, beneficence, and justice, we no longer refer to individuals that engage in our research as ‘subjects.’ Instead, we respect the contribution that these research participants have made to our work.” (Crable, Ettinger de Cuba and Wirtz, 2017).

There is also the issue of micro-aggressions. These are defined as “brief and commonplace daily verbal, behavioral, or environmental indignities, whether intentional or unintentional, that communicate hostile, derogatory, or negative racial slights and insults.” Maggie Thomas of the Boston School of Public health says,

Microaggressions are specific actions not general attitudes and can have identifiable physical and mental health impacts. For example, using a derogatory term like “illegal aliens” precisely targets the legally risky and culturally ostracized position undocumented immigrants occupy. The stress of experiencing such microaggressions routinely can cause physical symptoms like disrupted sleep and heightened blood pressure and emotional symptoms like anxiety and depression.

Language sensitivity can be challenging to agree on, but countering microaggressions isn’t about political correctness, it’s about recognizing the specific harm and indignity of some language. Often debates about political correctness can be resolved if labels like “microaggression” are defined with precision, applied to specific actions, and not over-used to describe general patterns.

 People with mental illness also experience microaggressions, and recent research has demonstrated the similarity of those experiences to other marginalized identity groups’ experience of microaggressions. Among other consequences, experiencing microaggressions is associated with increased levels of stress and lower rates of engagement in therapeutic treatment, both of which could be particularly harmful for those experiencing mental illness.

It’s easy to use offensive words without knowing. Realizing that we could just as easily be on the receiving end should make us more conscious. These are some words we may need to find substitutions for in our vocabulary (gotten from University of Maryland’s Inclusive Language Campaign).


Words/Phrases Substitutes May offend people who…
‘That’s so ghetto” Tasteless, Wack, Grimey, Awkward, Broken, Messed Up grew up in urban areas or are from a lower socio-economic status.
“No homo, that’s so gay” Inappropriate, Weird, Strange, Out of Place/Order/Line, Wrong identify as lesbian, gay, bisexual, or transgender.
“Those illegal aliens” Immigrants, undocumented immigrants, undocumented citizens are undocumented and/or trying to achieve citizenship in the context of a complex family immigration status
“That exam just raped me” Hard, Impossible, Tough, Difficult, Brutal are survivors of sexual assault.
“That’s so retarded” Ridiculous, Off-base, Wack, Improper, Wrong have a disability.



Crable E., Ettinger de Cuba S. and Wirtz V. (2017). Words Matter: Where Public Health Professionals Can Do Better. Public Health Post, November 27, 2017.

Thomas M. (2017). Dignity in Language for Population Health. Public Health Post, March 16, 2017.