Inclusive Language in Medical Writing

Publication Manual of the American Psychological Association – 7th Edition – 9781433832178

Page 351 Review

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The Importance of Language in Medical Literature: Addressing Bias and Promoting Respect

Medical literature plays a crucial role in shaping healthcare practices, influencing policy, and ultimately impacting patient outcomes. Therefore, the language used in these publications must be carefully considered to avoid perpetuating biases and ensure respectful and accurate representation of all individuals. This commentary will delve into the significance of employing person-first language, acknowledging the historical context of socioeconomic status (SES) terms, avoiding deficit-based language, and adopting a strengths-based perspective in medical writing.

Person-First Language: Emphasizing Humanity

One of the most critical aspects of respectful language is the use of person-first language. This approach prioritizes the individual over their condition or circumstance, reminding readers that people are not defined by their challenges. As the text emphasizes, instead of using labels that can dehumanize individuals, it is essential to use phrases that acknowledge their personhood: “That is, use language like ‘people experiencing homelessness,’ ‘people who are homeless,’ ‘people in emergency shelter,’ or ‘people in transitional housing,’ rather than calling people ‘the homeless.’”

This seemingly subtle shift in wording can have a profound impact. By saying “people experiencing homelessness,” we recognize that homelessness is a temporary state, not an inherent characteristic. It acknowledges the individual’s identity beyond their current situation and avoids reducing them to a single, defining label. This principle applies to various conditions and circumstances. For example, instead of “the disabled,” we should say “people with disabilities.” This language reinforces the idea that these individuals are people first, and their disability is just one aspect of their lives.

Acknowledging the Historical Context of Socioeconomic Status Terms

The language we use to describe socioeconomic status (SES) can also carry implicit biases. Terms like “low income” and “poor” often have historical connotations that are linked to racial and ethnic minorities. Therefore, it is crucial to provide specific context when discussing SES: “It is important to note that SES terms such as ‘low income’ and ‘poor’ have historically served as implicit descriptors for racial and/or ethnic minority people. Thus, it is critical that authors include racial and/or ethnic descriptors within SES categories—for example, ‘This sample includes low-income and middle-income Puerto Rican fathers.’”

Failing to acknowledge this historical context can perpetuate stereotypes and reinforce existing inequalities. By explicitly stating the racial and ethnic composition of the group being studied, researchers can avoid generalizations and provide a more nuanced understanding of the factors influencing health outcomes. This level of specificity is essential for addressing systemic disparities and developing targeted interventions.

Avoiding Deficit-Based Language: Recognizing Systemic Influences

Deficit-based language focuses on what people lack, rather than what they possess. This type of language often blames individuals for their circumstances, ignoring the broader societal context that contributes to their challenges. The text cautions against using language that implies individual failings: “Implicit biases around economic and occupational status can result in deficit-based language that blames individuals for their occupational, educational, or economic situation (e.g., ‘attendant economic deficits’) rather than recognizing a broader societal context that influences individual circumstances. Deficit-based language also focuses on what people lack rather than on what they possess.”

Instead of focusing on “attendant economic deficits,” researchers should explore the systemic factors that contribute to economic inequality, such as unequal access to education, discriminatory hiring practices, and lack of affordable housing. By shifting the focus from individual failings to systemic issues, we can develop more effective and equitable solutions.

Adopting a Strengths-Based Perspective: Highlighting Capabilities and Resilience

In contrast to deficit-based language, a strengths-based perspective emphasizes the capabilities, resilience, and assets of individuals and communities. This approach recognizes that everyone has strengths, even in the face of adversity, and that these strengths can be leveraged to promote positive change. The text illustrates this point with examples related to education: “Instead of labeling people as ‘high school dropouts,’ ‘being poorly educated,’ or ‘having little education,’ provide more sensitive and specific descriptors such as ‘people who do not have a high school diploma or equivalent.’ Alternatively, by adopting a strengths-based perspective, authors can write about ‘people who have a grade school education.’”

Instead of focusing on what people *haven’t* achieved, this approach highlights what they *have* achieved. For example, “people who have a grade school education” acknowledges their commitment to learning and their existing knowledge base. Similarly, instead of writing about an “achievement gap,” the text suggests focusing on the “opportunity gap”: “Likewise, instead of writing about an ‘achievement gap,’ write about an ‘opportunity gap’ to emphasize how the context in which people live affects their.”

This subtle shift in language frames the issue as a lack of equitable opportunities, rather than a lack of individual ability. It acknowledges the systemic barriers that prevent some individuals from reaching their full potential and calls for efforts to create a more level playing field.

By consciously choosing language that is respectful, accurate, and strengths-based, medical professionals can contribute to a more equitable and just healthcare system.
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