Position statement: People with Disabilities Person-Centered Language

Position

The Sudbury & District Board of Health values diversity and effective communication.[i] We understand that bias, stigma, and discrimination towards people with disabilities can be reduced through the use of respectful language and we are committed to the following:

  1. Inquiring with individuals with disabilities and representative groups how they wish to identify; and
  2. Using person-first language, which puts the person before the disability, when it is not possible to inquire or when the response is mixed; and
  3. Remaining up to date with the evolution of language about disabilities.

Background

Many people consider disabilities to be a weakness, but people are increasingly defining disabilities in positive and affirming ways. Disabilities can also be seen as natural variations in human abilities – a type of diversity that we can take pride in.[ii]

The SDHU is committed to improving the health of our populations using a health equity lens by acting on socially produced determinants of health. People living with disabilities and/or mental illness are examples of priority populations that may be at increased risk for health inequities.[iii]

Healthy equity

The Human Rights Commission estimates that one in seven Ontarians lives with one or more disabilities.[iv] People with disabilities are a priority population that is less likely to engage in health promoting behaviors such as physical activity and smoking abstinence, and to participate in screening for cancer, oral health, cholesterol, blood pressure, and vision and hearing than people without disabilities.[v] People with disabilities also experience poorer health outcomes such as hypertension, diabetes, chronic pain, obesity, heart disease, falls-related injuries, depression, and suicide compared with other adults.[vi]

Historically, people with disabilities have experienced abuse, neglect, exclusion, marginalization and discrimination.[vii] The employment rate of Canadians living with a disability is significantly lower than that of Canadians without disability.[viii] Of those that were employed, 27% reported that their employer was unaware of their limitations. More than half (54%) of Ontarians with mental health and addiction disabilities are not in the labour force, compared to 43% of those with other disabilities and 21% of those with no disability.[ix]

People with disabilities experience unjust, avoidable, and socially constructed exclusion resulting in health inequities.

Language

The language that we use everyday shapes our understanding of the world around us. It influences how people feel about themselves as well as how they are perceived by others.[x] Using certain words, even in ways that are well-intentioned, can lead to stigma and further health disparities. Changing our language can lead to more autonomy, respect, understanding, and empathy.

Since the civil rights movements of the 1970s, we have made changes in the way we talk about gender (fireman vs firefighter), age (elderly vs older adult) race and ethnicity, social class (poor people vs people who live in poverty), and many other social groups. The new language is developed by people who identify as part of the group and by experts in the field. Similarly, the way we talk about people with disabilities is shifting in important ways.

Person-first or identity-first language

In Canada, organizations have used person-first language to discuss disabilities since the 1980s.[xi] This practice was used on the premise that language used to refer to people with disabilities should be objective and respectful. Recently, there has been some debate within the disability community about whether it is most appropriate to use person-first or identity-first language. Person-first language puts the person before the disability; for instance, instead of saying disabled, one would say people with disabilities. Identity-first language puts the identity first, using terms like “disabled” without negative connotations. Critics of person-first language believe that it does not align with the concept of disability as socially produced, and implies that disability is an individual medical characteristic as opposed to a public issue.[xii]

Person-first language

Person-first language considers the disability to be a label, not a defining characteristic of the person.[xiii] People with disabilities are, first and foremost, people. The person is not a disability, they have a disability. This language was designed to emphasize the value of the individual by seeing them as a person, not a condition and to promote respect and autonomy.

Identity-first language

Advocates of identity-first language argue that putting the person first is only necessary if disabilities are seen as inherently negative.[xiv] Person-first language doesn’t remove the stigma from the disability, but removes the disability from the person. It is also not the language we use to talk about other identities. For instance, we say a person is male or Caucasian, not a person with maleness or person with Caucasian ancestry. Some people with disabilities see their disability as an essential part of their identity and culture, particularly people in the Deaf community and autistic people. According to this position, person-first language can come across as saying that the person matters despite the presence of disability. Identity-first language is a disability affirming statement. Disabilities become neutral or positive identities as opposed to limitations, constraints, or diagnostic conditions.

Appropriate use of language

Person-first language is generally the accepted way for professionals and organizations to speak and write to and about people with disabilities.[xv] When possible, ask the individual or the group representative how they would like to refer to themselves and use the language they request. If that is not possible, use person-first language.

Table 1: Guidelines for speaking and writing about disabilities

GuidelineRationaleSay this (example)Not this (example)
Use person-first language if you cannot ask how the person/group wishes to identifyTo emphasize the person, not the disabilityPeople with Disabilities
Person with paraplegia
Person who is blind, person with low vision
The Disabled
Paraplegic
Blind, visually impaired, without sight
Use active languageEmphasize autonomy and ability, not dependence and disabilityWheelchair userWheelchair-bound or confined to a wheelchair
Avoid everyday phrases that may stigmatize people with disabilitiesSome common sayings are based in ableist language and can unintentionally marginalize people with disabilitiesThat’s outrageous, ridiculous,unfair
Accessible parking, bathrooms
That’s crazy, insane, lame
Handicapped parking, bathrooms
Do not conflate lack of disability with normalcyCalling one group of being ‘normal” sets everyone who is not part of that group as “abnormal”People without disabilitiesNormal, healthy, able-bodied
Avoid patronizing remarksPeople with disabilities are just like anyone else; only complement in ways appropriate for adults without disabilitiesCongratulations, Good job on [achievement]You’re so inspirational, brave
Use balanced languageLanguage with negative connotations emphasizes passivity and stigmatizes people with disabilitiesDiagnosed with [condition]
Person living with AIDS
Suffers from, victim of [condition]
AIDS victim
If you make a mistake, apologize and move onWe all make mistakes. It is part of learning. If you do make a mistake and a person with disability corrects the language that you use (even if it is different from what is written here), apologize briefly but sincerely, and try to switch to their preferred language. Do not dwell on it, as that can be uncomfortable.

Images

It is important to include images of people with visible disabilities in order to normalize their presence in everyday situations, even when the topics do not involve disability. These images should portray people with disabilities as actively engaged with the world around them. Individuals with disabilities should be portrayed in a variety of activities, careers, and behaviors without emphasis on the disability.

For instance, the following images are symbols for accessible accommodations in the built environment, such as accessible washrooms, seating, or ramps.[xvi] In the image on the left, which is commonly used, the person is sitting in a chair as though waiting to be pushed. In the other, it is clear that the person is actively moving through the world. These small changes can have a lasting impact on attitudes, values, and beliefs about disability.

(left) 1968: The International Symbol of Access; (right) 2013: The Accessible Icon Project

Conclusion

The language that we use to talk about people with disabilities has shifted over the past few decades and will likely continue to change. People with disabilities are not a homogeneous group and the language they use may shift for some and not others. For instance, people with autism and the Deaf community are much more likely to use identity-first language than other people with cognitive disabilities (although service providers and parents of children with autism tend to use person-first language).

The Sudbury & District Health Unit recognizes the importance of using sensitive and respectful communication practices. Ongoing engagement with local dis/ability groups and associations will ensure that programs and services are fully accessible and inclusive to all.

[i] Sudbury & District Health Unit. (nd). Strategic Plan 2013-2017. Sudbury & District Health Unit.

[ii] Dunn DS & Hammer ED. (2014). On teaching multicultural psychology. APA Handbook of multicultural psychology, Theory and Research, (p.43-58). Washington DC: APA.

[iii] Sudbury & District Health Unit. 2009. Priority Populations Primer: A few things you should know about social inequities in health in SDHU communities.

[iv] Ontario Human Rights Commission. (2016). By the Numbers: A statistical profile of people with mental health and addiction disabilities in Ontario

[v] AUCD. (2016). Including People with Disabilities: Public Health Workforce Competencies. Association of University Centers on Disabilities (AUCD), National Center for Birth Defects and Developmental Disabilities (NCBDDD), Office of the Director, Centers for Disease Control and Prevention (ODCDC), and the Office for State, Tribal, Local, and Territorial Support (OT); Havercamp SM. & Scott, HM. (2015). National health surveillance of adults with disabilities, adults with intellectual and developmental disabilities, and adults with no disabilities. Disability and Health Journal, 8(1), 165-172.

[vi]AUCD, 2016; Lunksy Y, Klein-Geltink JE & Yates, EA. (2013). Atlas on the Primary Care of Adults with Developmental Disabilities in Ontario. Institute for Clinical Evaluative Sciences and Centre for Addiction and Mental Health. Toronto, ON.

[vii] Ontario Human Rights Commission, 2016.

[viii] Arim, R (2015). Statistics Canada’s Canadian Survey on Disability, 2012. Retrieved March 15 2017 from: http://www.statcan.gc.ca/pub/89-654-x/89-654-x2015001-eng.pdf

[ix] Ontario Human Rights Commission, 2016.

[x] Titchkosky T (2001). Disability: A Rose by Any Other Name? “People-First” Language in Canadian Society, CRSA/RCSA, 38(2): pp 125-140

[xi] Titchkosky, 2001

[xii] ibid

[xiii] Dunn, DS & Andrews EE. (2015). Person-First and Identity-First Language: Developing psychologists’ cultural competence using disability language. American Psychologist, 70(3): pp. 255-264.

[xiv] ibid

[xv] See American Psychological Association (http://www.apa.org/pi/disability/resources/choosing-words.aspx), The Americans with Disabilities Act National Network (https://adata.org/factsheet/ADANN-writing), The Canadian Journalism Project (http://www.j-source.ca/article/five-things-journalists-should-keep-mind-when-writing-about-autism).

[xvi] The Accessible Icon Project. 2017. Redesigned Accessibility Symbol Coming to New York, Image from HandiLift. http://www.handi-lift.com/articles/redesigned-accessibility-symbol-coming-to-new-York/


This item was last modified on June 19, 2017