What to know
- The list below is a collection of terms and phrases that, depending on the context and situation, should be carefully considered before use. These terms can be used in global public health communication activities like scientific literature, web content, social media, interviews, reports, presentations, discussion with communities and colleagues, etc.
Overview
The terms below can be used to advance global health equity. Visit our index page to find a full list of terms. These terms can be used in global public health communication activities like scientific literature, web content, social media, interviews, reports, presentations, discussion with communities and colleagues, etc.
Questions or feedback?
Beneficiary and donor country
The terms below can influence a power dynamic where 'beneficiaries' are passive recipients and 'donors' are benevolent entities. As much as possible, try to balance the power dynamic by emphasizing people's humanity, partnership, and specific descriptors.
Instead of...
Try this...
Specify exactly who you are talking about, as appropriate. For example:
- People with HIV or people diagnosed with HIV in [country].
- People using [health services/resources].
- People who will use [health services/resources].
Otherwise, use:
- People.
- [X] communities.
- [X] populations.
- Countries.
- Partners.
- Partner countries.
- Clients or patients.
Specify the countries involved and emphasize partnership and collaboration. When speaking generally, try:
- Partner countries.
Capacity building
Capacity building" is vague and implies that there was no existing capacity until an outside actor arrived to "save the day." As much as possible, expand and clarify what 'capacity building' means and emphasize partnership and collaboration.
Contextualize...
- Capacity building.C
Try this...
As much as possible, provide specific examples of what activities are ‘building capacity’. For example:
- [Agency] helps strengthen [partners'] capacities or capabilities to [conduct x activities].
- [Agency] partners with Ministries of Health to increase the countries' capacities or capabilities to [conduct x activities].
- [Agency] strengthens surveillance systems.
- [Agency] helps develop laboratory skills.
- [Agency] leads workshops for how to collect and analyze survey data.
- [Agency] trains community health workers in how to talk to community members about [public health issue].
Emphasize partnership and multi-directional exchange of information, ideas, and resources. When a succinct and broad term is necessary, try the alternatives below:
- Capacity strengthening.
- Enhancement of existing capacity.
- Capacity sharing.
- Mutual capacity strengthening.
Empower and empowerment
Underlying intentions may be good, but 'empowerment' terms are overused and can have condescending and paternalistic connotations.D On the other hand, these terms may still be appropriate when describing grassroots efforts to claim or exercise inherent power.E
Be cautious with...
Try this...
- Help equip with additional [knowledge, technical skills, etc.].
- Engage.
- Support.
- Share knowledge or expertise.
Field
Field-related terms and phrases are vague. When taken literally, the place of work can be misinterpreted as a dirt road or in a crop field, not in classrooms, offices, cities, rural towns, laboratories, etc.
Contextualize...
Try this...
Expand on what 'field' means and who/what is involved 'in the field' or in 'field work'.
Alternatives to consider for 'field':
- Office or classroom.
- Laboratory or clinic.
- Households or community (e.g., rural community).
- In [x country/location that is separate from headquarters].
- [X animal reservoir] habitat.
- Areas where we see many cases of [x].
- Where people from [x focus population] live.
Alternatives to 'field staff':
- Local project staff.
- Staff from [community].
- [X staff] who are currently working in [place].
- Colleagues who [conduct x activity].
Alternatives to 'field experience':
- Experience or career.
- Experience working in [x regions/countries].
- Working/project experience in global public health.
- Internship, fellowship, or mentorship.
- Training in [x,y,z].
- Applied experience in [public health activity].
- Collaboration with [x partners] in [conducting y activity].
Giving voice to the voiceless
These phrases tend to be used in reference to people living in low- and middle-income countries (LMICs) and people who are most affected by health inequities. Although there may be a noble notion similar to 'empower,' these phrases play into supremacy, saviorism, and dependency by implying that someone does not have a voice until someone else gives it to them.K
Instead of...
- Giving voice to the voiceless.
- Being a voice for the voiceless.
Try this...
- Listening to the voices of [community or population].
- Amplifying the voices of [community].
- Prioritizing the voices of [community].
Hotspots
'Hotspots' has potentially negative connotations and can influence stigma for people and places within the 'hotspot.'
Instead of...
Avoid referring to places with high transmission of disease as 'hotspots'.
Try this...
Localize the subject by being as specific as possible. For example:
- Local epidemic in [country/region].
- [Town] in [province] of [country], where case numbers and transmission rates are the highest.
- [Location] where the [disease] outbreak was first identified.
- In [location], where [disease] is spreading rapidly.
- In [location], where the [natural disaster] is causing the most damage and loss of life.
When speaking about specific areas where particular groups congregate, consider using:
- Concentration of [population or group].
- Area where [group congregates].
When speaking generally about specific areas that experience high incidence/prevalence of a public health issue, consider using:
- Location.
- Area.
- Region.
- Areas with high/increased transmission of [x disease].
Intervention
Not every public health action is an 'intervention' in the strictest sense. Many public health activities are educational workshops, trainings, and programs. Others are partnership building, collaboration, and information sharing. Try to be more specific.
Contextualize...
- Intervention.L
Try this...
Continue to use ‘intervention’ but be mindful of the context. Consider whether it is more appropriate to label a public health activity as an ‘intervention’ or one of the following:
- Program.
- Activity.
- Program activity.
- Program evaluation.
- Initiative.
- Clinical trial.
- Research project or study (randomized control trial, cohort study, etc.).
- Workshop or training.
- Outreach.
Name specific examples of "interventions", such as:
- Wearing a mask and getting a vaccine.
- Burying a person who died of Ebola in a safe and dignified way.
- Participating in contact tracing interviews.
- Following quarantine protocols.
- Receiving health care at an Ebola or HIV or other treatment center.
- Using condoms during sex.
- Getting tested and treated regularly for sexually transmitted infections.
Names of emerging diseases, new variants, or outbreaks
The names of emerging infectious diseases and new variants or outbreaks can have negative, stigmatizing effects on nations, economies, and people.M
Exercise caution with...
Be cautious when naming emerging infectious diseases or new variants and outbreaks.
Try this...
Follow WHO's best practices for naming new infections, syndromes, diseases, variants, and outbreaks lacking common names or prior recognition.
- Use generic descriptive terms, based on the symptoms that the disease causes. E.g.,respiratory disease, neurologic syndrome, fever.
- Use more specific descriptive terms when robust information is available on how the disease manifests, who is impacted, and the severity or seasonality.
- If the pathogen that causes the disease is known, include it in the disease name. e.g., influenza virus, salmonella.
- If appropriate, include the year of first detection or reporting. E.g., 2019 as part of 'COVID-19'.
- Arbitrary identifiers may be helpful for variants. E.g., Alpha, beta, gamma, a, b, I, II, III, 1, 2, 3.
A disease may have several nicknames/alternate names aside from the official name. Avoid use of names that have potentially stigmatizing effects on people, cultures, and countries. Instead, promote use of the name that best abides by WHO's best practices.
When communicating about new variants or outbreaks of known diseases:
Emphasize that the places experiencing the first known cases/highest prevalence may not be where the new variants or outbreak emerged. For example; rather than "the India variant of SARS-CoV-2"; try "the delta variant of SARS-CoV-2, which was first documented in India."
Overseas or abroad
'Overseas' and 'abroad' tend to be U.S.- or Europe-centric and are disproportionately used in reference to non-U.S. or non-European nations and people. Some usages can reinforce the 'us vs. them' mentality. The status of health anywhere can impact the status of health everywhere. Thus, global public health encompasses the health of populations in each nation across the globe.
Consider limiting the use of...
- Overseas.
- Abroad.
Try this...
Name the specific location(s) or region(s) you are talking about. For example:
- In [x countries].
- In [x region(s)].
When broad terms are necessary, consider using:
- Around the world/globe.
- Across the world/globe.
- Globally.
- Worldwide.
Resilient and resilience
When used inappropriately, these terms can perpetuate inequalities while telling people how strong they are, which is unhelpful. Also be cautious when using these terms to inspire or encourage staff/teams to "be resilient". This can give the perception that the staff are at fault for burnout and low morale, while exempting leadership from the responsibility to create a healthier working environment.
Exercise caution with...
- Resilient.
- Resilience.
Try this...
Use sparingly and consider current and local contexts when determining whether it is appropriate to use these terms. For example, perhaps it is appropriate to describe a community as resilient as they recover from an earthquake. However, it is less appropriate to describe a community as resilient while they continue to experience the effects of racism, imperialism, and colonialism.
Consider emphasizing the need for and celebration of sustainability in public health initiatives and working environments, rather than simply praising resilience.
Savior language
Savior language can indicate an attitude and/or practice of swooping/parachuting in because "they need our help." Savior language can also imply that a group, community, or population is incapable of solving major problems without help from external experts or institutions.N
Instead of...
- Saving.
- Rescuing.
- Protecting.
Try this...
Emphasize partnership and collaboration when referring to core tenets of public health (save lives, prevent deaths, and protect health). For example:
- We work with global partners to save livesO and prevent death from [x diseases].
- We collaborate with partners to [public health activity], which saves lives and promotes health.
Consider alternate framing such as:
- [Agency] and our partners work together to promote population health and decrease deaths due to [disease or issue].
- We seek to improve health outcomes among [population] by increasing access to [resource].
- We work towards a safer, healthier world by [strengthening public health systems, building global capacity for disease surveillance, increasing access to x resources].
Stakeholder
Globally, 'stakeholder' might not carry the same historical weight as it does in the United States.P Nonetheless, it is helpful to expand and specifically name the groups and/or individuals with interest in the activity you are communicating about.
Consider alternatives to...
- Stakeholder.
"Collaborators" is sometimes used as an alternative. While collaborate means to "work jointly on an activity", it can also mean to "cooperate or assist an enemy". Depending on the broader geopolitical/diplomatic reality, exercise caution with "collaborators".
Try this...
Instead of "stakeholder", if key groups are directly involved in the project/activity, use terms that describe the nature of their influence/involvement.
For general alternatives, consider using:
- Partners.
- Contributors.
- Community, community members.
- Community impacted/affected.
- Colleagues.
- Advocacy groups.
- Interested parties/groups.
If the key groups are people to whom you are accountable directly or indirectly, specify the relationship:
- Funders, funding agencies, donors.
- Policy makers.
- Broader public health community.
- Government officials.
- Elected officials.
- General public taxpayers.
Technical assistance
Subject matter expertise is among global public health agencies' greatest exportable assets. But the term 'assistance' is vague and can cause confusion between subject-matter assistance vs. foreign assistance vs. development assistance. 'Assistance' can also imply an inaccurate imbalance of knowledge, skills, and power.Q
Contextualize...
- Technical assistance.
Try this...
Expand on what is involved in technical assistance. For example, specify whether the technical assistance in question involves:
- Epidemiologic investigations/studies/analysis.
- Laboratory functions.
- Program evaluation.
- Emergency response.
- Public health law and policy.
When referring to an overall focus on providing subject-matter expertise in support and collaboration with global partners, consider using:
- Technical collaboration.
- Engage in technical collaboration with [partners].
- Beneficiary: Can invoke a loss of personal agency and lacks context as to why the inequity or disparity in question exists in the first place. Also, this term implies that the recipient is a passive recipient whom organizations have decided deserves some ‘benefit’.
- Donor country: In the international setting, labeling one agency or country as the ‘donor’ can reinforce power imbalances and sound demeaning toward the ‘receiving country’. In most cases is best to emphasize a horizontal partnership.
- Capacity building: This term can be helpful for capturing a broad range of activities with two words. However, this term is vague jargon when used by itself and implies a one-way teacher-to-learner dynamic. ‘Building capacity’ can also give the impression that there were no prior, locally driven initiatives, infrastructure, or capacities present before the ‘capacity building’ agency arrived. Contextualize what 'capacity building' truly means.
- Empower/Empowerment: The underlying intentions may be good, but ‘empowerment’ terms are overused, have condescending and paternalistic connotations. They also play into saviorism and supremacy. Dependency is implied when people are assumed to be helpless, devoid of power, and thus dependent on external actors to ‘swoop in’ to give them power.
- When "Empower/Empowerment" works: These terms may still be appropriate when describing grassroots efforts to claim/exercise inherent power, such as: 1) People who empower themselves through gaining knowledge, seeking information, speaking up, and engaging in advocacy; 2) Community members striving for community-defined goals and objectives; 3) Community members organizing in their own communities and gaining direct representation within local government.
- ‘Empower’ is defined as “to give someone the authority or power to do something.” The philosophy of ‘giving power’ masks the existing potential, leadership, and solutions within a community/person. Non-participatory solutions from external actors, even if well-intentioned, do not respect or draw from sustainable/relevant local experience and wisdom.
- ‘Community empowerment’ is sometimes defined as “the process of enabling communities to increase control over their lives”. But if empowerment is understood as being ‘enabled’ or ‘given’ to a community by external actors, it must also be claimed and exercised by the people themselves.
- ‘The field’ may denote people, patients, communities, healthcare workers, etc. However, this term can limit people ‘in the field’ as research objects to be studied, as requiring assistance, or as passive beneficiaries of services and policies. In the extreme, references to ‘the field’ can distance and exoticize the people and issues that should be at the center of focus, discussion, and action.
- ‘In the field’ most commonly refers to low- and middle-income countries as the setting or subject for external actors to conduct public health programs and research.
- ‘Learning from the field’ or ‘field experience’ can imply that learning/knowledge and consequential action/change is only in the hands of ‘external’ or ‘superior’ actors (e.g., health authority, service provider, agency, research institution, policymaker).
- ’Giving voice to the voiceless’ often signifies that people who have historically been underrepresented and excluded have gained opportunities to organize, increase visibility, and express themselves by leveraging the strengths of information, media, and communication technologies. However, although it is a noble notion similar to ‘empower’, this phrase plays into supremacy, saviorism, and dependency by implying that someone does not have a voice until ‘we give it to them’. The ‘voiceless’ is a socially constructed concept that oversimplifies the complex systemic factors that leave some people considered or feeling ‘voiceless.' Everyone has a voice. The issue is that many voices are not sought out, included, listened to, supported, or prioritized. The priority should be less ‘being the voice’ or ‘giving the voice’ and more ‘amplifying the voice’ of the ‘voiceless.'
- ‘Intervention’ means different things in different contexts. When describing programs at the community level, ‘intervention’ can imply ‘doing something to’ the people group. This implication undermines the concept of participatory practice. Not every public health action is an ‘intervention’ in the strictest sense. Many public health activities are educational workshops, trainings, and programs. Others are partnership building, collaboration, and information sharing.
- Names of diseases, variants, or outbreaks: The names of emerging infectious diseases and new variants or outbreaks can have negative, stigmatizing effects on nations, economies, and people. Historically, some disease names have provoked backlash against certain communities; created unjustified barriers to travel, commerce, and trade; and triggered needless slaughtering of food animals. See WHO guidance for examples of what to avoid when naming new diseases, variants, or outbreaks. Per WHO: 1) Avoid geographic locations such as: Middle East Respiratory Syndrome, Spanish Flue, Rift Valley fever; 2) Avoid using people’s names such as: Creutzfeldt-Jakob disease, Chagas disease; 3) Avoid species or classes of animals and food, such as: swine flu, bird flu, paralytic shellfish poisoning; 4) Avoid cultural, population, industry, or occupational references, such as: occupational, legionnaires, miners; 5) Avoid terms that incite undue fear, such as: unknown, fatal.
- Savior language: The framing of ‘saving lives’ is important to many public health agencies, initiatives, and demonstration of impact. However, be mindful that this language is disproportionately used by high-income nations in North America and Europe. Savior language can indicate an attitude and/or practice of swooping/parachuting in because ‘they need our help’. Savior language can also imply that a group, community, or population is incapable of solving major problems without help from external experts or institutions.
- Save lives: Despite good intentions, the framing of “We are here in [x country] to save lives” may not be well-received by partner communities, professionals, or countries. This type of framing and attitude can significantly damage partnerships. However, there is nuance between “We saves lives” vs. “We collaborate with partners to implement public health initiatives (e.g., childhood vaccination, cancer screening, disease surveillance, etc.) that save lives.” The second option (i.e., “We collaborate…”) begins to balance the power dynamic felt between experts/agencies from HICs and partners/experts/agencies from LMICs.
- Stakeholder: This term is used across many disciplines to reflect different levels of input or investment in projects or activities. This term can be used to reflect a power differential between groups and has a violent connotation for some tribes and tribal members in the U.S. ‘Stakeholder’ also groups all parties into one term, despite potential differences in the way they are engaged or interact with a project or activity.
- Technical assistance: Subject matter expertise is among global public health agencies’ greatest exportable assets. But the term ‘assistance’ is vague and can cause confusion between subject-matter assistance vs. foreign assistance vs. development assistance. Assistance includes technical capacities (e.g., knowledge, skills, and expertise), but often takes the form of tangible resources that have been delivered (e.g., funding, equipment, reagents, etc.). Additionally, ‘assistance’ can sometimes imply that the technical capacity of [x team/country] is limited, which can imply imbalance of knowledge, skills, and power.