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Language matters: “naming” and “framing” the moral foundation for health equity

November 10, 2015

Language is a tricky thing … it is both biological and a learned system rooted in cultural norms and beliefs.  It makes it possible for us to think and act conceptually within a moral or values-based frame. Language is both rational and emotional.  It simultaneously makes us think and makes us feel.  Like I said, it’s tricky!

Let me give you a personal example …

I very much see myself as a second-wave feminist, but I would much rather be one of the “girls” than one of the “ladies” or “women”.  There is nothing rational about it … I just like the playfulness of being with a group of women who are clearly no longer girls but having fun and being a bit crazy like we did when we were girls.  However, if you include me with the ladies, all I can think about is the rules for ladylike behaviour and everything I am not supposed to do … and women just sounds, well, serious.  The rules change again if you are a man, in which case you are not allowed to call me a girl or a lady.  Like I said, language is both rational and emotional.

Power, privilege, culture … welcome to the world of communicating about the social determinants of health and health equity, of which gender is just one dimension.

When our public health colleagues said they wanted help using clear and effective language that resulted in action, we got a bit nervous.  Finding the appropriate language to help name the core social justice values of public health is important, but the dilemma is that framing the idea we want to communicate needs to come first.  As the cognitive linguist George Lakoff points out,

[n]aming and framing are different. Framing is conceptual, it is about ideas that allow you to understand what you are experiencing. Naming is giving language to those ideas – often ideas you already have, possibly as part of your unconscious brain mechanisms. Naming can make the unconscious conscious.” 

At the risk of putting the cart before the horse, we decided to create English and French glossaries of essential health equity terms.  Our hope is that by helping to provide language related to health status, intervention strategies, populations, and root causes of health inequities we would be supporting public health advocates to make their case for the change they want and provide a key mechanism to communicate their values.  However, public health actors still need to first frame the issue:

Once the steps to a solution for a given public health problem have been identified and the mechanisms for instituting them have been determined, then language should be developed to communicate the solution and why it matters. That language, the specifics of the message, will then emerge from how the issue is being framed.” – Berkeley Media Studies Group

This is the first of a series of blogs about the glossaries, in which we plan to explore the power of language and what we have been learning about how health equity language is used in Canada in English and French.  In future blogs we will discuss how one language might borrow from the other in order to communicate more powerfully.

The glossaries are intended to be living collections that capture how our understanding of equity shifts and changes as our language changes.  I would encourage everyone to visit the Glossary web-page and add comments about how you use the terms and what terms you think we should be adding. 

And no, you won’t find “girls” or “ladies” defined there … but you will find “gender/gender identity” named as a social determinant of health, helping us make the unconscious conscious. 

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