In public health we’re faced with a dilemma. We want to help people – that’s our goal, that’s why we do what we do. But at the same time, we also need to be careful how we approach public health concerns – the last thing we want to do is further stigmatize the very people we’re trying to help. One of the most subtle, but most powerful ways we can either empower or belittle others is in the language we use.
One area at the forefront of this is the field of mental health research. The “traditional” language would be a “X person,” where X refers to any mental health issue. But this isn’t the best language to use. For one, it defines the person by their illness – not by who they are. They have X, first and foremost. Not their interests, their personalities, their hobbies. They’re labelled and defined.
However, there’s been a shift in the language used to be respectful and inclusive. Perhaps the most notable change is that appropriate language now is “person with X.” So for example, you would refer to someone as a person with autism, or a person who is hard of hearing. That shift, while subtle, has huge ramifications. They are no longer defined by one aspect of their personality – that is simply another facet of them, rather than a defining feature. I should point out here though that appropriate language does vary between countries, within countries, and even between individuals. I used the term “hard of hearing” above, but some people may prefer deaf. Some people may be okay with certain language while others are not – person-centric language has not been universally adopted.
The shift in language has also been accompanied with the retiring of archaic and stigmatizing language in favour of more inclusive and respectful language (a comparison of terms available here). Those who work with people with disabilities have been quite proactive about engaging stakeholders along with the individuals they serve, going as far as to set up guidelines and offering information pamphlets (see here, here and here) to help train others, as often people don’t know what the appropriate term is. Other fields are learning, and many are now using a similar approach in their research/public health area.
However, while we’re actively trying to tackle stigma as public health professionals, we’ve also got to consider the effect of the media and how the media reports the same issues that we’re concerned about. Fabiana Kubke over at Mind the Brain had a great post about this following the tragic events of Newtown, CT, highlighting how by adding the word “mental” implies that this is something different to “regular” health. It’s a subtle difference, but once you see it, you can’t unsee it. Why is mental health somehow viewed differently to physical health? Why can’t we refer to it as health? Again, we see how adding a label to something changes how we perceive it.
My research interest is in obesity, which has had a rocky relationship with the media. It’s something Travis Saunders at Obesity Panacea has discussed with respect to Georgia’s Strong 4 Life campaign, and we discussed the relationship between obesity and the media on a podcast together. The obesity research community is now making an effort, and work spearheaded by Dr Rebecca Puhl at the Rudd Center for Food Policy and Obesity has been at the forefront of bringing awareness to “casual” discriminatory language that is in use. Organizations are slowly providing tools to prevent this; for example the Canadian Obesity Network has a photo album freely available as part of their Perfect At Every Size image bank.
The flip side to the above is when people, with perfectly good intentions, make the situation worse. Perhaps the most powerful article I read around language was “We are not here for your inspiration.” It was posted in response to a picture of a little girl with prosthetic legs running next to Oscar Pistorius with the caption “The only disability in life is a bad attitude.” I highly recommend reading it, and to quote from the article:
… these modified images exceptionalise and objectify those of us they claim to represent. It’s no coincidence that these genuinely adorable disabled kids in these images are never named: it doesn’t matter what their names are, they’re just there as objects of inspiration.
But using these images as feel-good tools, as “inspiration”, is based on an assumption that the people in them have terrible lives, and that it takes some extra kind of pluck or courage to live them.
For many of us, that is just not true.
It’s a brilliant piece, and it highlights how we can (unintentionally) make things worse.
Because really, it all starts with us. If we make a conscious effort to change our language and encourage our colleagues to do the same, we can start the cycle of change. Simple things, like making sure ramps are clear, can make buildings more accessible. Encouraging colleagues and others to use appropriate language, and setting an example by using that language ourselves is the first step to making sure that we don’t hurt anyone by our words.
Special thanks to Shira T, Ally M, Kim F and Hilary B for feedback on this post.