Susan Awad

As children, many of us learned the nursery rhyme, “Sticks and stones may break my bones, but words will never harm me.” Unfortunately, most of us also learned the painful lesson that this convenient playground comeback isn’t really true. As communicators, we know especially well how powerful words can be. An inspiring speech can spark a great movement for positive change, while misplaced words and miscommunications can have tragic consequences.

When it comes to health, communication about a patient’s diagnosis, prognosis and treatment plan is a crucial element of their care. Outside of clinical settings, the words we use when we talk about sickness and health more broadly also matter, especially when the condition we are discussing is stigmatized.

Our culture stigmatizes many health conditions, leading patients to feel judgement or shame. Stigma arises when patients are perceived to be somehow responsible for their disease – as is the case with obesity and smoking-related lung disease. Stigma also surrounds conditions that negatively impact social interactions and patients’ ability to function in society, like substance use disorder and mental illness.

It’s no surprise that recent research shows patients with highly-stigmatized “invisible” health challenges, like migraine disease or other chronic pain conditions, often hide their disease at work.  Outside the workplace, conditions affecting the most intimate and private parts of our lives—like sexual health disorders—are also highly stigmatized. Stigma is painful on a personal level, but it also affects how we seek care. Research consistently shows that stigma can deter treatment-seeking behavior and even adversely affect the quality of care a patient receives

The language we use to describe these conditions can perpetuate or dispel stigma. Thoughtful, compassionate speech can change attitudes and set the stage for evidence-informed policy changes that benefit people living with stigmatized conditions. To help reduce stigma, consider these tips when writing or speaking about health conditions:

Always use person-centered language.

Labeling patients with their disease, like calling someone an “addict” or a “diabetic,” gives the impression that they are no more than their disease. It’s also out of style. The Associated Press Stylebook, known to many journalists as the “bible” for precise writing, made an interesting update in 2017 to recommend writers “avoid words like alcoholicaddictuser and abuser unless they are in quotations or names of organizations.” In the case of drug addiction, this change in language shifts the “blame” from the person to the condition. Using person-centered or person-first language (“a person living with lung cancer”) affirms their personhood and builds compassion.  Using personal narratives has also been shown to increase support for policies that benefit patients with stigmatized conditions. People are more than the disease they are battling, and it’s important that our language reflect that distinction.

Stick to the science.

Using scientific language rather than colloquialisms can help avoid value judgements and stay objective. For example, it is common slang to refer to drug tests as “clean” or “dirty” rather than “positive” or “negative,” as we do for other medical tests. The slang descriptors can perpetuate negative beliefs about drug use and the people affected by disease.

Focus on the positive.

Emphasizing the availability and effectiveness of treatment options for stigmatized conditions can change perceptions about them, reinforcing that they are medical conditions and not personal flaws. Greater awareness of treatment options can also encourage people to seek appropriate care for their conditions.

At Reservoir, we know the power of communication to change attitudes, impact policy, and ultimately improve public health. We know that words matter, especially when you are working to empower better clinical outcomes. Language can be used to reinforce the negative biases that perpetuate stigma and create barriers to treatment, or it can be used to promote wellness and the dignity of every person. We are proud to work with clients every day to shape the public dialogue around health, mobilizing words to heal rather than hurt.