Hastings Center News

Hastings Center Scholar Addresses Implications of CDC Avoiding Seven Words

Vulnerable. Entitlement. Diversity. Transgender. Fetus. Evidence-based. Science-based. Last week, news outlets reported that the Centers for Disease Control and Prevention had been advised to avoid using these seven words in budget documents. In an interview with Medscape Hastings Center research scholar Nancy Berlinger discussed potentially dangerous policy and health consequences.

She said that she was particularly concerned that the federal government’s recommendation against using these words would create a “chilling effect” at CDC. “When public health experts are discouraged from using normal useful public health language out of fear that public health programs will not be funded, that’s the definition of a chilling effect,” she said.

“It’s been said that a budget is a moral document,” she continued. “It shows what society is willing or unwilling to commit resources to. If the word ‘transgender’ is avoided in a budget document, how will the health concerns of transgender people be reflected in that document?”

The Medscape article continued:

“Berlinger likewise noted that diversity is an important concept in public health because America is such a diverse society. What is different about different groups within our country, whether that be income, language, or geographical location, ‘must be studied and responded to,’ she said.

The word ‘vulnerable,’ Berlinger noted, is commonly used as a modifier for ‘population’ in public health research and clinical trials. Not using that word could be problematic, for instance, in discussing the potential harm that certain people could suffer in clinical trials because of their specific characteristics.

And the word ‘entitlement,’ she said, can be part of describing certain aspects of a program’s budget that apply to particular groups of people, such as those on Medicare or Medicaid. ‘It’s a strange word to take off the table if you want to talk about our health system accurately.’

Based on her conversations with physicians and nurses, as well as recent Facebook posts, she said, ‘People are really concerned about this. They see a connection between the chilling effect on language translating into a reduction in funding or obscuring of important issues. And how does that translate into patient care, how public resources are being made available to different patient populations?’

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