Preferred Terms for Select Population Groups & Communities

Overview

Language in communication products should reflect and speak to the needs of people in the audience of focus. The following provides some preferred terms for select population groups; these terms attempt to represent an ongoing shift toward non-stigmatizing language. We recommend using this section as a guide and inspiration to reflect upon word choice and choose words carefully, inclusively, and appropriately for a specific use and audience. Best practices include engaging people from the population or community of focus to find out what they prefer.

Corrections & detentions

Instead of this:

• Inmate
• Prisoner
• Convict/ex-convict
• Offender
• Criminal
• Parolee
• Detainee

Try this:

• People/persons who are incarcerated or detained (often used for shorter jail stays, for youth in detention facilities or for other persons awaiting immigration proceedings in detention facilities)
• Partner/child of an incarcerated person
• Persons in pre-trial or with charge
• People who were formerly incarcerated
• Persons on parole or probation
• Persons detained by or under the custody of (specify agency) (for example, U.S. Immigration and Customs Enforcement [ICE] or other agencies)

Disability

Instead of this:

• Disabled
• Differently abled
• Afflicted
• Handicapped
• Hearing impaired
• Confined to a wheelchair or wheelchair-bound

Try this:

• People with disabilities/a disability
• People who are deaf or hard of hearing or who are blind or have low vision
• People with an intellectual or developmental disability
• People who use a wheelchair or mobility device

Notes:

• Avoid using vulnerable when describing people with disabilities.
• CDC is aware that some individuals with disabilities prefer to use identity-first terminology, which means a disability or disability status is referred to first. For the purposes of these guidelines, CDC promotes person-first language, but also promotes an awareness that language changes with time and individuals within groups sometimes disagree about the preferred language used to describe themselves.

Drug/Substance use

Instead of this:

• Drug-users/addicts/drug abusers
• Alcoholics/abusers
• Persons taking/prescribed medication assisted treatment (MAT)
• Persons who relapsed
• Smokers

Try this:

• Persons who use drugs/people who inject drugs
• Persons with substance use disorder
• Persons with alcohol use disorder
• Persons in recovery from substance use/alcohol disorder
• Persons taking/prescribed medications for opioid use disorder (MOUD)
• Persons who returned to use
• People who smoke

Healthcare access & access to services and resources

Instead of this:

• Underserved people/communities/the underserved
• Hard-to-reach populations
• The uninsured

Try this:

• People who are underserved by [specific service/resource]
• People who are underserved by mental health/behavioral health resources
• People who are medically underserved
• People who are uninsured/people who are underinsured/people who do not have health insurance

Note: Underserved relates to limited access to services that are accessible, acceptable, and affordable, including healthcare. Do not use underserved when you really mean disproportionately affected.

Homelessness

Instead of this:

• Homeless people/the homeless
• Transient populations

Try this:

• People experiencing homelessness
• Persons experiencing unstable housing/housing insecurity/persons who are not securely housed
• People experiencing unsheltered homelessness
• Clients/guests who are accessing homeless services

Lower socioeconomic status (SES)

Instead of this:

• Poverty-stricken
• The poor/poor people

Try this:

• People with lower incomes
• People/households with incomes below the federal poverty level
• People with self-reported income in the lowest income bracket (if income brackets are defined)
• People experiencing poverty (do not use "underserved" when meaning low SES)

Note:

• "People with lower socioeconomic status" should only be used when SES is defined (for example, when income, education, parental education, and occupation are used as a measure of SES).

Mental health and behavioral health

Instead of this:

• Mentally ill
• Crazy
• Insane
• Mental defect
• Suffers from or is afflicted with [condition]
• Asylum

Try this:

• People with a mental or behavioral health condition
• People with a pre-existing mental health or behavioral health condition
• People with a diagnosed mental health or behavioral health condition
• Psychiatric hospital/facility

Notes:

• Organizations may use the terms "mental health condition," "mental illness," and "mental health disorder" interchangeably. The term "mental health condition" is preferred by CDC when communicating with the public. "Mental health disorder" may be used by researchers or for clinical use.
• "Behavioral health" is an umbrella term that encompasses a number of distinct but related subtopics. These include psychological distress, mental health conditions, suicidal ideation or suicide attempts, and substance use or substance use disorders.
• Specific mental health conditions can be named whenever possible (for example, when not referring to people with different mental health conditions collectively). Researchers and healthcare professionals use guidelines in the Diagnostic and Statistical Manual of Mental Disorders to diagnose mental health conditions. For example, consider:
  • Person with depression
  • People with obsessive-compulsive disorder
• When referring to people who are experiencing symptoms (for example, depression, anxiety) or other forms of mental distress but a mental health condition has not been diagnosed or the symptoms may not reach a clinical threshold, consider:
  • People experiencing mental distress
  • Persons experiencing crisis or trauma
  • Persons experiencing persistent high stress or anxiety

Non-U.S.-born persons/ Immigration status

Instead of this:

• Illegals
• Illegal immigrants
• Illegal aliens
• Illegal migrants
• Foreigners
• The foreign-born

Try this:

• People with undocumented status
• Mixed-status households
• Immigrant, migrant
• Asylum seeker; people who are seeking asylum
• Refugee or refugee populations
• Non-U.S.-born persons/foreign-born persons

Notes:

• Use accurate and clearly defined terms when referring to foreign-born persons. For example, do not use "refugee" if you mean "immigrant."
• The term "alien" (person who is not a citizen of the United States) may be stigmatizing in some contexts and should only be used in technical documents and when referring to or using immigration law terminology. "Refugee" and "migrant" are often used interchangeably. Confusion in the use and understanding of these terms can impact the lives and safety of refugees and asylum-seekers. Refugees who leave their homes may be entitled to a range of legal protections and aid to which migrants are not entitled.
• Non-U.S.-born or foreign-born persons may also be used to refer to individuals born in a country other than the U.S., similar to the international migrant concept.
• The term "migrant farmworker" or "migrant agricultural worker" is often used to refer to persons who travel from their home base to another location within the same country, or from one country to another, to perform agricultural work.
• If combining subpopulations in writing, ensure American Indians and Alaska Natives from tribes located in what is now called the United States are not included in the "immigrant" category.

Older adults

Instead of this:

• Elderly
• Senior
• Frail
• Fragile

Try this:

• Older adults
• Persons aged [numeric age group] (for example, persons aged 55-64 years)
• Elders when referring to older adults in a cultural context
• Elderly or frail elderly when referring to older adults in a specific clinical context

Note: Tribes, American Indian and Alaska Native urban communities, and federal agencies define AI/AN Elders aged ≥ 55 years.

People who are at increased/higher risk

Instead of this:

• High-risk people
• High-risk population
• Vulnerable population
• Priority populations

Try this:

• People who are at increased/higher risk for [condition]
• People who live/work in settings that put them at increased/higher risk of becoming infected or exposed to hazards

Race & ethnicity

Instead of this:

• Referring to people as their race/ethnicity (for example, Blacks, Hispanics, Latinos, Whites, American Indians, etc.)
• Referring to people as colored people, colored Indian (to refer to American Indian)
• Native American (for federal publications)
• Eskimo
• Oriental
• Afro-American
• Negro
• Caucasian
• The [racial/ethnic] community (for example, "the Black community")
• Non-White (used with or without specifying non-Hispanic or Latino)

Try this:

Racial groups:

• American Indian or Alaska Native persons/communities/populations
• Asian persons
• Black or African American persons; Black persons
• Native Hawaiian persons
• Pacific Islander persons
• White persons
• People who identify with more than one race; people of more than one race; persons of multiple races

Ethnic groups:

• Hispanic or Latino persons

When describing a combination of racial/ethnic groups (for example, 3 or more sub-groups) use "people from some racial and ethnic groups" or "people from racial and ethnic minority groups".

Notes:

• The racial and ethnic group terms provided in CDC's Health Equity Guiding Principles align with those in the Office of Management and Budget (OMB) Race and Ethnic Standards for Federal Statistics and Administrative Reporting and the OMB Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity. It may help to know that the 1997 OMB standards are minimum standards required for federal data and are in the process of being updated. For inclusive communication, more detailed terms are encouraged as appropriate. Be as specific as possible about the group you are referring to (for example, Korean persons, Samoan persons).
• Consider racial/ethnic groups as proper nouns and capitalize (for example, Black, White).
• "People/communities of color" is a frequently used term, but should only be used if included groups are defined upon first use; be mindful to refer to a specific racial/ethnic group(s) instead of this collective term when the experience is different across groups. Some groups consider the term "people of color" as an unnecessary and binary option (people of color vs. White people), and some people do not identify with the term "people of color." If you describe one group, use the same type of description for all groups being compared. For example, a statement comparing parents with parents of color implies that White parents are the norm against which others (parents of color) are compared.
• American Indian and Alaska Natives are the only federally recognized political minority in the United States. Tribes hold a unique government to government relationship with the United States.
• "American Indian or Alaska Native" should only be used to describe persons with different tribal affiliations or when the tribal affiliations are not known or not known to be the same. Other terms, "tribal communities/populations" or "indigenous communities/populations," could also be used to refer to groups with multiple tribal affiliations. Otherwise, identify persons or groups by their specific tribal affiliation.
• The term "Indian Country" describes reservations, lands held within tribal jurisdictions, and areas with American Indian populations. "Indian Country" is generally used in context and is rarely used as a stand-alone – it typically is used in writing only after "American Indian or Alaska Native" (AI/AN) has already been used, and the writer wants to avoid continuing to repeat AI/AN or "tribes" and refer more broadly to the general wide community of AI/AN peoples and tribes. Within context, there shouldn't be any confusion about it referring to the Asian country, India.
• Latinx has been proposed as a gender-neutral English term, but there is debate around its usage. Its use may be considered on an audience-specific basis.
  • Latino (individual man, group of men, or group of people including men and women)
  • Latina (individual woman or group of women)

Rural

Instead of this:

• Rural people
• Frontier people

Try this:

• People who live in rural/sparsely populated areas
• Residents/populations of rural areas
• Rural communities

Sexual orientation & gender identity

Instead of this:

• Homosexual
• Using MSM (men who have sex with men) as shorthand for sexual orientation to describe men who self-identify as gay or bisexual, individually or collectively
• Transgenders/transgendered/transsexual
• Biologically male/female
• Genetically male/female
• Hermaphrodite
• Gendered pronouns:
  • Her or she
  • He/she
  • His or her
  • His/her
• Sexual preference, which is used to suggest someone's sexual identity is a choice and therefore could be changed by choice

Try this:

• LGBTQ (or LGBTQIA or LGBTQ+ or LGBTQIA2)
• Lesbian, gay, or bisexual (when referring to self-identified sexual orientation)
• MSM (men who have sex with men)
• Queer
• Pansexual
• Asexual
• Transgender
• Assigned male/female at birth
• Designated male/female at birth
• Gender non-conforming
• Two-spirit
• Non-binary
• Genderqueer
• Gender diverse
• People/person with intersex traits
• Pronouns:
  • Singular they or their
  • He/she/they

Notes:

• Use LGBTQ community (and not, for example, gay community) to reflect the diversity of the community unless a specific sub-group is meant to be referenced.
• Consider using the terms "sexual orientation," "gender identity", and "gender expression".
• Use gender-neutral language whenever possible (for example, avoid "actress" and consider "actor" instead for both male and female actors).
• Considering using terms that are inclusive of all gender identities (for example parents-to-be; expectant parents).
• Be aware that not every family is the same, and that some children are not being raised by their biological parents. Build flexibility into communications and surveys to allow full participation.

Working partners & community collaborators

Instead of this:

• Stakeholder

Try this:

• Consider the audience when determining the appropriate term(s) to use. Whenever possible, describe specific groups and/or individuals with interest in an activity using relevant names, categories, or descriptions of the nature of their influence or involvement (for example, advisors, consultants, co-owners).
• If your key groups are organizations or people directly involved in the project/activity, use terms that describe the nature of their influence or involvement.

Notes:

• Stakeholders are persons or groups who have an interest or concern in a project, activity, or course of action. The term "stakeholder" 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. It also groups all parties into one term, despite potential differences in the way they are engaged or interact with a project or activity.
• Consider using words other than "stakeholder" when appropriate for your audience and subject matter, recognizing it may not always be possible to do so.

Examples: contributors, community, community members, community impacted, community affected, community of solution, coalition members, allies, colleagues, clients, tribes, advocacy groups, interested parties/groups, interest holders, implementing partners, working partners, funders