The Knowledge, Intelligence & Evidence Team in Public Health and Communities Suffolk want to make sure we are using appropriate language in our work. This guide gives preferred words and phrases so we can be consistent and clear in our language. Where we can, we explain why the term was picked.
This list is to support report writing when we refer to groups of people. We recognise that different people will prefer different ways to describe themselves, and wherever possible we will respect and use individual’s preferred terms. Everyone in Public Health and Communities was able to contribute to this guide, however we acknowledge this list will not cover everything. It will grow and change (last reviewed Summer 2023).
We would like your feedback and suggestions. Please email knowledgeandintelligence@suffolk.gov.uk
Before we publish content, we will ask:
- Have we used full words before we use abbreviations or acronyms, and have we explained all acronyms?
- Do we need to use the acronym?
- Can we simplify the language?
- If we were reading this for the first time, would it make sense?
- Have we followed Suffolk County Council's guide to writing and publishing for the web?
If we are quoting or using other organisations’ work, we will use their terms for accuracy. This may mean we can’t use our preferred terms.
Examples of the words and phrases we use and why
The preferred word or phrase is the heading. The list is in alphabetical order.
A person with addiction or substance use disorder
We will use this instead of: drug abuser, alcoholic, addict.
Substance use disorders are heavily stigmatised. Read more on the ‘Addictionary’ website.
Autistic people or people on the autism spectrum
We recognise that there is no single way to describe autism and autistic people that is universally accepted. We have used work from the All age autism strategy (coproduced in 2023) to create this section.
Many terms are based on medical, rather than social models, including Autistic Spectrum Disorder (ASD), Autistic Spectrum Conditions (ASC), Kanner’s Autism, Asperger syndrome, High or Low-Functioning etc. We will use autism and autistic; autistic person and people; and autistic children, young people and adults. (Which terms should be used to describe autism? Perspectives from the UK autism community)
We will not use a capital “A” as autism is not a proper noun, and using a capital letter may make the word look intimidating or too negative. This may change on the advice of our coproduction group. More information can be found on the NHS website.
More information can be found on the NHS website.
Behaviour that communicates distress or behaviour that challenges services
Use instead of "challenging behaviour", when someone acts in a way that could hurt themselves or someone else. More information can be found on the NHS website.
Carers, Parent Carers and Young Carers
"A carer is anyone, including children and adults who looks after a family member, partner or friend who needs help because of their illness, frailty, disability, a mental health problem or an addiction and cannot cope without their support. The care they give is unpaid. When we refer to carers... this is inclusive of both adult and young carers." (NHS England – Who is Considered a Carer?)
Co-existing mental ill health and substance use
We will use this instead of dual diagnosis which is used widely but inconsistently. Find out more about this terminology. The term dual diagnosis can also refer to an individual experiencing co-existing mental ill health and learning disabilities so definitions and explanations need to be clear.
Death by suicide
Use instead of "committed suicide" to remove the inference that suicide is a criminal act. The Samaritans website contains more information. We will avoid describing methods (or details) unless this is absolutely necessary – for example for preventative work.
Ethnic minorities
This is a changing area. See this 2022 Race Disparity Unit blog. For example, the Civil Service write about ethnicity using different guidelines to the Office for National Statistics (ONS). We will follow the ONS guidance.
Wherever possible we will use the specific ethnic classifications used in the Census.
We will use "ethnic minorities" only if it is necessary and appropriate to group people from all ethnic backgrounds (including White minorities) except White British.
We will not use BAME, BME people, ‘Non-White’, ‘Non-Black’. We will refer to individual ethnic groups, as combining several groups into a larger group such as “BAME” can mask differences between ethnic groups. The Commission on Race and Ethnic Disparities has recommended that the government stop using the term BAME.
We will write about the person first and then the group – for example:
- People in the “Asian or Asian British: Pakistani” ethnic group
- Babies in the “White: British” ethnic group
- Adults in the “Mixed or Multiple” ethnic groups
We will continue to use capital letters for ethnic groups, (such as ‘Black’ or ‘White’), following the ONS guidance:
- To show they are technical categories
- To be consistent
- To make content easier to read (to distinguish between “the Other ethnic group” and “other ethnic groups”) as well as national identities such as “Chinese”
Ethnicity
We will use this for race. This is the government's preferred term, and research by the ONS found that race was considered a less acceptable term by respondents.
Gender
See also the section on Sex. We will use gender rather than sex when talking about people’s personal gender identity, and when referring to:
- data sources that specifically ask about gender or gender identity
- commonly used and recognised terms, such as “the gender pay gap”
For example: “The gender identity statistics include categories such as trans female, trans male, and non-binary.”
This follows ONS guidance.
Gender identity equality (PDF), a guide published by the University and College Union in 2022 gives a picture of this developing area and the language used at that time. A Government standard on gender identity data is under development (2023).
Health behaviours
We will use this for lifestyle. The term "lifestyle" frames public health at an individual level. View more information on the Association for the Directors of Public Health website.
Inclusive language: words to use and avoid when writing about disability
Not everyone will agree on everything but there is general agreement on some basic guidelines. The word ‘disabled’ is a description not a group of people. Use ‘disabled people’ not ‘the disabled’ as the collective term.
Avoid medical labels. They say little about people as individuals and tend to reinforce stereotypes of disabled people as ‘patients’ or unwell.
Don’t automatically refer to ‘disabled people’ in all communications – many people who need disability benefits and services don’t identify with this term. Consider using ‘people with health conditions or impairments’ if it seems more appropriate.
Read the full government guide.
Indices of Deprivation (IoD)
We will use this for Indices of Multiple Deprivation (IMD) where appropriate. This is in line with Government terminology for the 2019 of the Indices of Deprivation. Continue to use IMD if you are referring specifically to the IMD dataset within the IoD release.
Learning disability
We will use “people with a learning disability” not “people with learning disabilities”. More information can be found on the NHS website.
Local authorities (or councils)
In Suffolk these are the councils that administer services, and are led by elected councillors. There are three tiers:
- town and parish councils
- lower tier (district or borough) councils, also known as lower tier local authorities (LTLAs) - sometimes abbreviated to the individual council’s initials but we'll name the council in full first: Ipswich Borough Council (IBC)
- Suffolk County Council (SCC)
Mental ill health, (People experiencing) mental illness, or Mental health condition
We will use this for mental health problem/s, mental health issue/s. We should acknowledge the person first, and that mental illness is a condition that may need medical intervention. We will only use mental health when we are referring to mental health in general (not just mental illness).
Note that sometimes we need to use the terms used by other organisations for accuracy. For example, NICE refer to Common Mental Health Problem (CMHP) where we would refer to mental health condition.
More language is on the mental health foundation website and Mind mental health language guidance.
Neurodiversity
The term neurodivergent was reputedly coined by Kassiane Asasumasu, a neurodivergent, Neurodiversity activist in 2000.
Neurodiversity refers to all human minds not just autistic or otherwise neurodivergent people. We will use neurodivergent only if we need to talk about people who have a mind that functions in a way that diverges from what society calls typical, in contrast to neurotypical people.
Neurodivergence includes autism, Attention deficit hyperactivity disorder (ADHD), Dyspraxia, Dyslexia, Dyscalculia. Some people also include Post-traumatic stress disorder (PTSD), stammering, or Tourette’s syndrome.
"People aged..."
We will use this for "the over 64s", "over 18s", "65+". People are more than their age.
We need to be clear about the group we refer to: "People aged 65 and over" is clear, "the over 64s" is not – it could mean everyone 65 and over, or everyone over 64 years and 1 day!
People facing multiple disadvantages
We will use this for "people with complex needs".
People with obesity
We will use this for "obese people" to reduce stigma and the idea that obesity is a choice - for example, some medications cause weight gain. Read more on the BBC website.
Polydrug use
We will use this for "using two or more types of substances or drugs". Polydrug use is the use of more than one drug, often to enhance or counter the effects of another drug, this should be recognised when writing about substance use. The DrugWise website provides useful information.
Recurrence
We will use this for relapse. Disorders involving substance use are heavily stigmatised. Read more on the ‘Addictionary’ website.
Sex
Sex is often used to refer to biological characteristics, while gender is often seen to reflect social and cultural constructs.
In line with ONS guidance on gender and sex, we will use sex rather than gender – except in certain circumstances – see Gender (above).
We will refer to people wherever possible. Where relevant, we will refer to:
- “women” instead of “adult females”
- “men” instead of “adult males”
- “children” or “girls” or “boys” as appropriate
- “females” or “males” if a group includes children and adults
Sexual orientation
We will use this for “sexual identity” or “sexuality”.
Wherever possible we will use the sexual orientation classifications listed below (as used in the Census).
We will use LGBT+ or LGBTQ+ if it is necessary and appropriate. We will use lowercase: lesbian, gay, bisexual in text, like ONS, Stonewall and the guidance on sexuality from the NHS.
The sexual orientation data standard is currently (2023) under development. It set out the following categories:
- Heterosexual / Straight
- Gay / Lesbian
- Bisexual
- Other
This area is continually developing area, with many terms used to describe sexual orientation. Look at the latest information on sites such as Stonewall, and the LGBT language guide from the University and College Union (2022) for glossaries of terms relating to sexual orientation.
Substance use
We will use this for substance misuse. Substance misuse disorders are heavily stigmatised. Read more on the ‘Addictionary’ website.
Suffolk
Where we use “Suffolk” we are referring to the whole county – be aware that Suffolk and North East Essex Integrated Care System (ICS) does not include the Waveney area (part of Norfolk and Waveney ICS).
Underrepresented
We will use this for "hard to reach", “seldom heard”, and “underserved” groups.
It moves the burden from the individual or population to the service to engage rather than blaming the population or individual. Read more in the NHS Increasing diversity in research participation guide.
Wellbeing
We will use this for well-being. To be consistent, and to simplify and remove the hyphen.