Does Public Health Have a Language Problem?

Photo by Nick Fewings

In a recent interview with journalist Ben Meiselas, Kentucky Gov. Andy Beshear spoke at length on the failure of the progressive movement to appeal to voters in the most recent U.S. election. Although the focus of the interview was largely on political rhetoric, some of Beshear’s harshest critiques were leveled at the language of public health: 

“We’ve gotten to a point where we use language that doesn’t mean anything. We use the term substance use disorder instead of addiction. Well, the folks I know who have gone through addiction, they call it addiction. Or calling it food insecurity when people are going hungry. It makes us sound like professors as opposed to talking to people like they’re people. And when we fail to do that, our words lose their power and meaning.”

Beshear has a point. The language of public health can come across to outsiders as overly academic and full of jargon. This is not inherently a problem; after all, every knowledge domain has its lingo, and part of professionalization is learning to speak the language of your professional peers. And one of the terms Beshear singles out–substance use disorder–was adopted in order to avoid the social stigma associated with addiction. But when our language fails to connect on both an intellectual and emotional level with the public, that becomes a big problem for public health. 

Beshear’s critique stems from what he sees as a fundamental disconnect between public health officials and the public they serve. And while there are some star communicators in the field, public health has historically put remarkably little effort into exploring what makes a specific communication strategy effective or ineffective. As an effort to mitigate these shortfalls, in 2022 the NIH was poised to set aside funds for a program called “Advancing Health Communication Science and Research.” The funds would have been used for “the development, testing, and sharing of new approaches for effective and equitable health communication.” 

However, by the middle of 2024 and before any funds had been distributed, the program was abruptly canceled. Many experts decried this sudden reversal of course, citing a trend of increasing political pressure within the sciences. In an editorial published by JAMA, Dean Schillinger and Richard Baron claim that “NIH’s unfortunate decision to halt the program, which took place in the face of mounting political pressures related to the study of misinformation, represents a serious threat to the integrity of science and to its successful translation.” 

But unfortunately, the general lack of funding for research on health communications does not only impact efforts to combat mis/disinformation; it also leaves researchers and public health professionals who engage directly with the public without a body of research on which to rely when they design programs and communications campaigns. Recent reports on the state of American public health from the Trust for America’s Health and the John A. Hartford Foundation have also highlighted the need for additional funding for health communications. 

This chronic underfunding has left many public researchers and officials without a guidebook for how to effectively communicate to non-experts. But that doesn’t mean we are helpless. Beshear calls for language that acknowledges the lived experiences of those we serve. Terms like “food insecurity” and “substance use disorder” make abstract what is a lived experience for many. Words like “hunger” and “addiction” are more universal terms that speak to real human suffering. Language is especially important when politics enters the chat–in other words, when public health officials must make a case for how a given policy initiative, or lack thereof, will impact their communities. 

Health communications experts have been signaling the alarm for decades now. "This is certainly not a new problem. It's something we in the health communications field have been talking about for years -- using language that everyone can understand is key to ensuring that all people have the information they need to make informed decisions about their health," says Nora E. Lindner, MPH, a health comms consultant and plain language expert. "But the COVID-19 pandemic, and the recent federal funding cuts to our public health infrastructure, have helped to magnify the issue and given us an opportunity to really reevaluate not only how we talk about health topics but how we talk about public health work itself in ways that everyday people can understand.”

So next time you craft a social media post or engage in a conversation with a friend or neighbor, consider whether your language is appropriate for the context. Whenever possible, swap out jargon for relatable, easy to understand language. After all, approximately 54% of adult Americans read at a level below the sixth grade. The simpler and more direct your language, the more effective you will be at getting your message across. And all of us could use a reminder from time to time that at the end of the day, public health is about meeting people where they are, not where we wish they would be.