Language Matters: Exploring Preferred Terms for Diverse Populations

Abstract

This article explores the significance of employing preferred terms and inclusive language in research practices concerning diverse populations. It highlights how inappropriate terminology can lead to labeling, stereotyping, and stigma, particularly for equity-denied groups. The study aimed to identify and analyze terminology preferences for diverse communities by major international organizations. Through a systematic environmental scan methodology, data were collected from 12 prominent organizations. The results indicate a concerted effort toward adopting inclusive language, with organizations favoring respectful and accurate terminology. For instance, terms like “people made vulnerable by systemic inequities” and “migrant workers” were preferred over outdated or stigmatizing alternatives. The discussion emphasizes the importance of identifying conflicting terms and trends in terminology preferences over time. We recommend prioritizing the use of preferred terms to promote respectful and accurate discourse, with a focus on person-centered language. Ultimately, the findings underscore the critical role of language in shaping perceptions and attitudes toward diverse communities, and advocate for continued efforts to promote inclusivity and equity in research, policy, and practice.

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https://doi.org/10.1177/23333936241275266
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Social Justice and Health Equity for Diverse Population Groups—Ethics, Theoretical
Development, or Methodological Development Article
Introduction
Language and terms used for describing some populations
can contribute to problematic outcomes from research prac-
tices and knowledge dissemination and negatively impact
equity-denied groups, which include populations who face
barriers to accessing resources and opportunities that are
available to other members of the society because of sys-
temic discrimination and disadvantage (Government of
Canada, 2024). Past research involving various popula-
tions, particularly equity-denied members of society from
different contexts, showed how inappropriate use of terms
to describe research participants contributes to labeling,
ordering, stereotyping, and stigma (Di Pietro & Illes, 2016;
Grover et al., 2020; Linda et al., 2009; Yang et al., 2015).
There is much awareness of smothered constructs for
diverse social identities and locations and the surrounding
sensitivities and controversies about the use of those terms
in the scientific literature, education, and practices Flanagin,
Frey, and Christiansen (2021), given that most social iden-
tities, including race and ethnicity are socially-constructed
and may be context-specific rooted in the socio-historical
and political environments (Crenshaw, 2018). For instance,
Almaguer (1998) work highlighted how the sexual behavior
and sexual identity of Chicano gay men are shaped by distinct
American-European and Latin American sexual systems
and how one embraces being “a gay.” Thus, researchers
tend to inaccurately describe participants or fail to catego-
rize some populations who may not fit into groups assigned
by researchers based on dominant-Eurocentric Anglo-
Saxon definitions and labels. This problem is more pro-
found in ethnocultural contexts like Australia, Brazil,
Canada, France, New Zealand, the United Kingdom, and
1275266GQNXXX10.1177/23333936241275266Global Qualitative Nursing ResearchFernandez-Sanchez et al.
research-article2024
1The University of Texas Health Science Center at Houston, USA
2University of Alberta, Edmonton, Canada
3The University of Alabama, Tuscaloosa, USA
Corresponding Author:
Higinio Fernandez-Sanchez, The University of Texas Health Science
Center at Houston, 6901 Bertner Avenue, SON-592, Houston, TX
77030, USA.
Email: Higinio.fernandezsanchez@uth.tmc.edu
Language Matters: Exploring Preferred
Terms for Diverse Populations
Higinio Fernandez-Sanchez1, Emmanuel Akwasi Marfo2,
Diane Santa Maria1, and Mercy Mumba3
Abstract
This article explores the significance of employing preferred terms and inclusive language in research practices concerning
diverse populations. It highlights how inappropriate terminology can lead to labeling, stereotyping, and stigma, particularly
for equity-denied groups. The study aimed to identify and analyze terminology preferences for diverse communities by
major international organizations. Through a systematic environmental scan methodology, data were collected from 12
prominent organizations. The results indicate a concerted effort toward adopting inclusive language, with organizations
favoring respectful and accurate terminology. For instance, terms like “people made vulnerable by systemic inequities” and
“migrant workers” were preferred over outdated or stigmatizing alternatives. The discussion emphasizes the importance
of identifying conflicting terms and trends in terminology preferences over time. We recommend prioritizing the use of
preferred terms to promote respectful and accurate discourse, with a focus on person-centered language. Ultimately, the
findings underscore the critical role of language in shaping perceptions and attitudes toward diverse communities, and
advocate for continued efforts to promote inclusivity and equity in research, policy, and practice.
Keywords
diversity, equity, inclusion, language, social justice, social marginalization
Received May 2, 2024; revised July 29, 2024; accepted July 30, 2024

2 Global Qualitative Nursing Research
the United States, where discussions about using preferred
and inclusive language to describe populations are ongoing
(Flanagin, Frey, & Christiansen, 2021; The New York Times,
2021) and recommendations to support equity and inclu-
sion have been developed by many organizations (Canadian
Institute for Health Information, 2022).
The use of preferred terms and inclusive language for
describing populations in research demonstrates attentive-
ness to the potential positive and negative impact of research
on a particular population or group (CDC, 2022a). Those
preferred terms display respect for communities involved in
the research (Flanagin, Frey, & Christiansen, 2021), elimi-
nate biases and stigma, and can easily reach and be used by
intended audiences (CDC, 2022a). Owing to this essence of
preferred languages, many journals and organizations
Flanagin, Frey, and Christiansen (2021), including American
Psychological Association (APA, 2023a), American Cancer
Society (2023), American Medical Association (AMA,
2021a), and the Canadian Institute for Health Information
(2022) have progressively developed policy statements,
frameworks, and guidelines for reporting identities (e.g.,
gender, race, ethnicity, disease conditions, disabilities, incar-
ceration, and sexual orientation) among diverse communities
in research planning and dissemination that is continuously
updated. Likewise, many publishers, including SAGE
(2024), Elsevier (2024), Taylor & Francis (2024), and Wiley
(n.d.) support Equity, Diversity, and Inclusivity commit-
ments by encouraging diverse and equitable language and
referencing. Additionally, international organizations,
including the World Health Organization (WHO) have
implemented a strategic communications framework for an
inclusive and respectful messaging and communication with
and about diverse populations that is periodically updated
(WHO, 2017). Yet, there remain knowledge gaps in how
major international organizations use or apply preferred ter-
minologies for diverse populations and communities in their
activities, including research, policy, and knowledge dis-
semination, justifying a need for more research on this topic.
Obtaining a global picture of the preferred terminologies
used by major international organizations will generate
insights into gaps and inconsistencies in terminology use and
offer opportunities to suggest recommendations for consis-
tent, respectful, and culturally appropriate terminologies for
these organizations. Therefore, the purpose of this study was
to identify and analyze the terminology preferences for
diverse communities and populations applied by major inter-
national organizations.
Methods
Design. We employed a systematic environmental scan
(e-scan) methodology to identify non-harming, preferred
terms for population groups and communities (Fernández-
Sánchez, 2024; Shahid & Turin, 2018). Our approach fol-
lowed these six steps:
Step I: Research Question. We formulated our research
question using the Population, Concept, and Context
framework (Parker et al., 2021): “What are the preferred
terms (Concept) for population groups and communities
(Population) as identified by international organizations
(Context)?”
Step II: Selection Criteria. We included all available English-
language information on preferred terms for population
groups and communities from the official web pages of inter-
national organizations.
Step III: Search Strategy and Data Sources. A trained research
assistant conducted a systematic search of the webpages of
12 prominent international organizations Such as the United
Nations (UN, 2023), International Labor Organization
(ILO, 2020), UN Women (n.d.), International Organization
for Migration (IOM, 2024), United Nations Development
Program (UNDP, 2014), Centers for Disease Control and
Prevention (CDC, 2022a), APA (2023b), Joint United
Nations Program on HIV/AIDS (UNAIDS, 2015), AMA
(2021b), United Nations High Commissioner for Refugees
(UNHCR, 2021), United Nations Educational, Scientific
and Cultural Organization (UNESCO, 1999), and the WHO
(2023). The 12 international organizations selected for
review were chosen based on their influential roles in shap-
ing global standards and policies related to our research
focus on preferred terms for population groups and com-
munities. Each organization contributes expertise in areas
crucial to defining terminology, including migration,
health, gender equality, and labor standards. Their inclu-
sion ensured a comprehensive examination of preferred
terms across diverse sectors, enriching the breadth, and rel-
evance of our study findings.
Step IV: Screen and Selection. Our search strategy used terms
from the National Library of Medicine’s Medical Subject
Headings (MeSH) database, such as “vulnerable populations”
and “minority groups.” Additional search terms included
“population demographics,” “ethnic groups,” “gender iden-
tity,” “sexual orientation,” “socioeconomic status,” “cultural
communities,” “LGBTQ+ communities,” “immigrant popu-
lations,” “indigenous communities,” “disabled or differently-
abled individuals,” “religious groups,” “urban communities,”
“rural populations,” and “refugee communities.” We also
included terms related to preferred language and terminology,
such as “inclusive language” and “culturally sensitive
terminology.”
Step V: Data Extraction. All relevant information was tran-
scribed into a structured Excel spreadsheet by a trained research
assistant. Data captured included: (a) terminology variations for
different population groups, (b) contextual information accom-
panying preferred terms, (c) citations and source details, and (d)
any nuances in the usage of specific terms.

Fernandez-Sanchez et al. 3
Step VI: Analysis and Synthesis. It involved conducting content
analysis (Krippendorff, 2019) on the collected data to dis-
cern recurring themes and patterns in the preferred terms
adopted by the selected international organizations. The
research team meticulously grouped and categorized the
identified terms into clusters representing diverse population
groups and communities. To ensure comprehensive evalua-
tion, an expert panel comprising specialists in HIV, migra-
tion, homelessness, substance use, LGBTQ+ issues, and
older adult populations was convened. Each panelist brought
unique expertise to review the findings critically. Their
invaluable feedback was thoughtfully integrated to enrich
the depth and relevance of this project.
Results
Our study involved examining the web pages of 12 interna-
tional organizations. We could not locate the preferred terms
page for two organizations; however, they did have a
Glossary of Terms (UNESCO, 2023; WHO, 2021). Among
the population groups identified, we found terminology
guidance for 10 groups: migrants, persons with disabilities,
persons living with HIV, people experiencing homelessness,
persons in custody, persons who use drugs, people with men-
tal health disorders, older adults, persons of various racial
identities, and persons with an LGBTQ+ identity.
Additionally, one organization provided guidance for people
made vulnerable in general, and another organization that
focused on gender-inclusive language (see Table 1).
Inclusive language guides used by organizations typically
feature a structured format designed to promote respectful and
accurate communication across diverse contexts. They begin
with an introduction emphasizing the importance of inclusiv-
ity in language use, followed by definitions of key terms such
as “inclusive language” and “preferred terms.” These guides
provide specific guidelines for language use, advocating for
person-centered and non-stigmatizing language choices.
Practical examples and scenarios illustrate these principles,
helping users apply them effectively. For instance, the CDC
(2022b) uses “Instead of this (lists the terms we should avoid)
and Try this (lists the terms we should use).” Additional
resources and acknowledgments of contributors may be
included to support ongoing learning and guide updates.
Overall, these guides serve as comprehensive tools to foster
environments that respect and reflect the diversity of individu-
als and communities.
The preferred terms for population groups, as outlined in
Table 2, reveal nuanced approaches aimed at promoting dig-
nity, respect, and inclusivity while addressing the diverse
needs and identities within various communities. For
instance, when referring to migrants, preferred terms such as
“Migrant worker” and “Undocumented migrant” highlight
the importance of recognizing the different circumstances
and statuses among migrant populations (AMA, n.d.; APA,
2023b; ILO, 2020; IOM, 2019). Similarly, descriptors for
persons with disabilities emphasize person-first language
and specific descriptors based on the type of disability or
impairment, reflecting a respectful and inclusive approach
(AMA Manual of Style Committee, 2020; APA, 2023b;
CDC, 2022b; UN, 2023; UNAIDS, 2015). In the context of
persons living with HIV, preferred terms focus on person-
first language while also addressing treatment and advocacy
aspects, showcasing a supportive and empowering stance
(APA, 2023b; UNAIDS, 2015; UNDP, 2014).
The preferred terms for people experiencing homeless-
ness encompass a range of descriptors that highlight housing
insecurity and the diverse situations faced by individuals
without stable housing (AMA, n.d.; CDC, 2022b; UNDP,
2014). Similarly, descriptors for persons in custody empha-
size respectful language and avoidance of stigmatizing ter-
minology, recognizing the dignity of individuals within the
criminal justice system(CDC, 2022b). The preferred terms
for persons who use drugs prioritize person-first language
and emphasize recovery and support, steering away from
stigmatizing language associated with substance use disorder
(APA, 2023b; CDC, 2022b; UNAIDS, 2015).
Our findings highlight preferred terms for populations
made vulnerable, underscoring the importance of address-
ing disparities in access to resources and services based on
socioeconomic status, race, ethnicity, and other factors
(AMA, n.d.; APA, 2023b; CDC, 2022b; UNAIDS, 2015;
UNDP, 2014). Furthermore, preferred terms for persons of
different racial identities and persons with an LGBTQ+
identity prioritize inclusivity, specificity, and respect for
diverse identities, fostering an environment of acceptance
and understanding (APA, 2023b; CDC, 2022a; UNHCR,
2021).
Discussion
The findings from the environmental scan provide valu-
able insights into the evolving landscape of terminology
preferences for diverse communities and populations as
identified by major international organizations. The dis-
cussion of these findings highlights several important
Table 1. Organizations and Populations Addressed.
Organizations Populations addressed
UN People with disability
ILO Migrant populations
UN Women Gender-inclusive language
IOM Migrant populations
UNDP Multiple populations
CDC Multiple populations
APA Multiple populations
UNAIDS Multiple populations, primarily people with HIV
AMA Multiple populations
UNHCR People with an LGBTQ+ identity

4 Global Qualitative Nursing Research
Table 2. Preferred Terms for Population Groups.
Population groups Organizations Preferred terms
Migrants AMA (2021b); APA (2023b);
ILO (2020); ILO (2022); ILO
(n.d.); IOM, (2019)
Migrant worker
Undocumented migrant
Migrant with irregular status
Labor migration
Mobility
Movement
Domestic worker
Sex work/sex worker
Forced labor
Labor exploitation
Human trafficking
Forced marriage
People with undocumented status
Mixed-status households
Immigrant
Migrant
People who are seeking asylum
Refugee or refugee populations
Non-U.S.-born persons/foreign-born persons
Economic migrant (only in specific contexts)
Temporary Foreign worker (if legally employed)
International migration
Mobile populations
Survivors of human trafficking
Victims of forced marriage
People seeking refuge
Displaced persons
Persons with
disability
AMA (2021b); APA (2023b);
CDC (2022b); UN (2023);
UNAIDS (2015)
Person with disability
Person with [type of impairment]
Persons with disabilities
People with disabilities (only in Easy Read documents, informal text, and
oral speech)
Person without disability
Have [disability/impairment/condition]
Person with an intellectual disability
Person with a psychosocial disability
Deaf person
Person with hearing loss
Blind person
Person with a vision/visual disability
Person with low vision
Person with a physical disability
Person who uses a wheelchair
Person with a mobility disability
Person using a mobility device
Person with achondroplasia (only if the person has this condition)
Person with Down syndrome
Person with albinism
Person affected by leprosy
Person who uses a communication device
Person who uses an alternative method of communication
Parking reserved for persons with disabilities
Accessible bathroom
Child with a congenital disability
Child with a birth impairment
(continued)

Fernandez-Sanchez et al. 5
Population groups Organizations Preferred terms
Persons living with
HIV
APA (2023b); UNAIDS
(2015); UNDP (2014)
Individuals affected by HIV
People affected by AIDS
Person with HIV
HIV-positive individual
HIV and AIDS survivor
Person on HIV treatment
Person living with HIV-related conditions
Person living with HIV who is undetectable
Person living with HIV who is virally suppressed
HIV advocate
Person with an HIV diagnosis
HIV community member
People with HIV and their families
Person managing HIV/AIDS
Safer sex
Intimate partner transmission
People
experiencing
homelessness
AMA (n.d.); CDC (2022b);
UNDP (2014)
People experiencing homelessness
Persons experiencing unstable housing/housing insecurity/persons who
are not securely housed
People experiencing unsheltered homelessness
Clients/guests who are accessing homeless services
People without housing
People experiencing unsheltered
People experiencing homelessness
People experiencing housing or food insecurity
People experiencing housing insecurity or food insecurity
Individuals experiencing homelessness
People without stable housing
Individuals facing housing insecurity
People living on the streets
Those experiencing housing instability
People in transitional housing
Individuals experiencing housing crisis
Persons in custody CDC (2022b) People/persons who are incarcerated or detained (often used for shorter
jail stays, for youth in detention facilities, or for other persons awaiting
immigration proceedings in detention facilities)
Partner/child of an incarcerated person
Persons in pre-trial or with charge
People who were formerly incarcerated
Persons on parole or probation
Persons detained by or under the custody of (specify agency) (e.g., U.S.
Immigration and Customs Enforcement [ICE] or other agencies)
Individuals who are incarcerated
People in custody
Those in detention facilities
Persons under correctional supervision
Individuals in the justice system
People in confinement
Individuals in the prison system
(continued)
Table 2. (continued)

6 Global Qualitative Nursing Research
Population groups Organizations Preferred terms
Persons who use
drugs
APA (2023b);
CDC (2022b); UNAIDS
(2015)
Persons who use drugs/people who inject drugs
Persons with alcohol use disorder
Persons in recovery from substance use/alcohol disorder
Persons taking/prescribed medications for opioid use disorder (MOUD)
Persons who returned to use
Person who uses drugs
Person who injects drugs
Person with substance use disorder
Person in recovery from substance use/alcohol disorder
Person taking/prescribed medications for opioid use disorder (MOUD)
Person who returned to use
Person who smokes
Individuals who use substances
People with substance use disorder
Persons with substance dependence
Those struggling with substance abuse
Individuals with a history of substance use
People with substance misuse issues
Persons with substance dependency
Individuals with a history of drug use
Those experiencing drug addiction
People managing substance use challenges
Populations made
vulnerable
AMA (n.d.); APA (2023b);
CDC (2022b); UNAIDS
(2015); UNDP (2014)
People who are underserved by. . .
People who are medically underserved
People who are uninsured/people who are underinsured/people who do
not have health insurance
People with lower incomes
People/households with incomes below the federal poverty level
People with self-reported income in the lowest income bracket (if
income brackets are defined)
People experiencing poverty (do not use “underserved” when meaning
low SES)
People who live/work in settings that put them at increased/higher
susceptibility of becoming exposed to hazards
Communities of color
Populations that are minoritized
Individuals from underrepresented groups
Communities that have been historically marginalized
Individuals with marginalized identities
Developing countries
People who live in rural/sparsely populated areas
Residents/populations of rural areas
Residents of communities made vulnerable
Groups that have been economically/ socially marginalized
Groups that have been historically marginalized or made vulnerable
Groups that are struggling against economic marginalization
Communities that are underserved by/with limited access to (specific
service/resource)
Groups experiencing disadvantage because of (reason)
Groups experiencing disproportionate prevalence/rates of (condition)
(People from) racial and ethnic groups
(People from) racial and ethnic minority groups
(People from) sexual/gender/linguistic/religious groups
(People with/living with) mobility/cognitive/vision/hearing/independent
living/self-care disabilities
Table 2. (continued)
(continued)

Fernandez-Sanchez et al. 7
Population groups Organizations Preferred terms
Engage/prioritize/collaborate with/serve (population of focus)
Consider the needs of/Tailor to the needs of (population of focus)
Communities/populations of focus
Intended audience
Eliminate (issue/disease)
Key populations
Priority populations
Engage, involve, focus, designed for and by
People with mental
health disorders
APA (2023b);
CDC (2022b)
People with a pre-existing mental health disorder
People with a pre-existing behavioral health disorder
People with a diagnosis of a mental illness/mental health disorder/
behavioral health disorder Psychiatric hospital/facility
Person living with a mental illness
Person with a preexisting mental health disorder
Person with a preexisting behavioral health disorder
Person with a diagnosis of a mental illness/mental health disorder/
behavioral health disorder
Individuals living with mental illness
Those experiencing mental health challenges
Individuals managing mental health disorders
People facing mental health issues
Persons with psychiatric conditions
Those living with emotional difficulties
Individuals with psychological conditions
People coping with mental health concerns
Persons navigating mental health disorders
Older adults APA (2022b);
CDC (2023b)
Persons aged [numeric age group] (e.g., persons aged 55–64 years)
Elders when referring to older adults in a cultural context Elderly or frail
elderly when referring to older adults in a specific clinical context
Elderly individuals
Older persons
Aging adults
Retirees
Older population
Elderly community members
Aging population
Elderly residents
Persons of
different racial
identities
APA (2022); CDC (2023) American Indian or Alaska Native persons/communities/populations
Asian persons
Black or African American persons; Black persons
Native Hawaiian persons
Pacific Islander persons
White persons
People who identify with more than one race; people of more than one
race; persons of multiple races
Hispanic or Latino persons
African American/Black
Nigerian, Kenyan, Jamaican, Bahamian, Puerto Rican, or Panamanian; in
these cases, use “Black.”
Asian/Asian American Refer to the specific nation or region of origin,
when possible, for example, “Asian origin” may be divided regionally
into South Asian, East Asian, and Southeast Asian
BIPOC (Black, Indigenous, and people of color) use specific terms when
referring to different racial and ethnic groups. When such a level of
specificity is not possible, instead of “BIPOC” use alternative terms,
such as “people/ persons of color” and “communities of color.”
People from various ethnic groups
Table 2. (continued)
(continued)

8 Global Qualitative Nursing Research
Population groups Organizations Preferred terms
Persons of different racial identities
Individuals from diverse racial and ethnic backgrounds
People of color
Racially diverse individuals
Ethnic community members
Multicultural populations
Racially and ethnically diverse communities
Persons with
an LGBTQ+
identity
APA (2023b); CDC (2022b);
UNHCR (2021)
- LGBTQ (or LGBTQIA or LGBTQ+ or LGBTQIA2)
Lesbian, gay, or bisexual (when referring to self-identified sexual
orientation)
MSM (men who have sex with men)
Queer
Pansexual
Asexual
Transgender
Assigned male/female at birth
Designated male/female at birth
Gender non-conforming
Two-spirit
Non-binary
Genderqueer
Gender diverse
People/person with intersex traits
Singular they or their
He/she/they
Transgender person
Transgender people
Trans and gender nonbinary folks or folx
Queer LGBTQ+
LGBTQ+, LGBTQIIA+, etc.
Queer community members
Individuals with diverse sexual orientations and gender identities
LGBTQ+ people
Members of the LGBTQ+ community
Gender and sexual minority individuals
Queer and transgender individuals
LGBTQ+ community members
People with diverse gender expressions and sexual orientations
Individuals with non-binary or fluid identities
Gender-inclusive UN Women (n.d.) People, humanity, human beings, humankind, women and men
Representatives, business community, business people
Chair, chairperson, head
Legislator, congressional representative, parliamentarian
All
Human induced disaster
Police officer
Flight attendant
First-year student
Owner
Layperson, average person
Partners, spouses
Cleaner
Nurse
Doctor
Politician
Table 2. (continued)

Fernandez-Sanchez et al. 9
considerations regarding terminology usage, including the
significance of adopting preferred terms for inclusive and
respectful discourse.
Our findings highlight conflicting or controversial terms
in understanding the potential impact of language on diverse
population groups. For instance, the use of terms like “minor-
ity groups” can perpetuate a sense of otherness or marginal-
ization, reinforcing stereotypes and inequalities (APA,
2023a). Additionally, terms defined solely based on numeri-
cal size, such as “minority,” may fail to capture the full extent
of power dynamics and systemic discrimination experienced
by these groups (Flanagin, Frey, & Christiansen, 2021).
Instead, we suggest that adopting terms like “communities
made vulnerable” or “populations marginalized by . . .” cen-
ters the experiences and identities of the people involved,
promoting a more respectful and accurate portrayal.
However, Andoh (2022) and Santiago et al. (2021) empha-
sized that inclusive language entails recognizing power
dynamics, embracing diversity, and creating environments
conducive to genuine self-expression. This process involves
listening to various groups’ self-identification, respecting
their language preferences (e.g., person-first, identity-first),
confronting biases, and remaining open to ongoing growth
and comprehension.
The consideration of sex and gender is paramount when
discussing inclusive language and preferred terms. Sex and
gender identity influence how individuals experience and
express themselves, and the terminology used can signifi-
cantly impact their well-being and recognition in society
(Borger, 2023). In our scan, we observed that terms such as
“gender diverse individuals” and “people of all genders” are
increasingly preferred over binary and potentially exclusion-
ary terms. These preferred terms acknowledge the spectrum
of gender identities beyond the binary categories of women
and men, and girls and boys, fostering inclusivity and respect
(Springer, 2022). It is crucial for researchers, policymakers,
and practitioners to employ gender-sensitive language that
respects individuals’ self-identification and promotes equity
(Rioux et al., 2022). Using inclusive language in relation to
sex and gender not only validates the identities of those often
marginalized but also challenges societal norms that perpetu-
ate gender biases and discrimination.
The scan also revealed notable trends or shifts in termi-
nology preferences over time, reflecting a growing recogni-
tion of the importance of inclusive language. Major
international organizations included in this work have dem-
onstrated a commitment to adopting respectful and accurate
terminology when referring to diverse populations. This shift
toward inclusive language aligns with broader efforts to pro-
mote diversity, equity, and inclusion in research, policy, and
practice. For instance, Flanagin, Frey, Christiansen, and
Bauchner (2021) emphasized the ongoing revisions to the
AMA Manual of Style’s section on inclusive language, spe-
cifically focusing on terms related to race and ethnicity. We
recommend that experts across various fields, including HIV,
migration, and LGBTQ+ issues, not only employ preferred
terms and phrases in their work but also promote efforts to
advocate for inclusive language that is less harmful to the
population groups they serve.
While our e-scan reveals that many guidelines have been
developed to promote the use of inclusive language, there is
a significant gap between these guidelines and their practical
application. For instance, the National Institutes of Health
(NIH, 2023a) advocates for inclusive terminology yet fre-
quently uses terms such as “vulnerable populations” and
“underserved populations” in their funding opportunity
announcements. We believe that this inconsistency often
arises from unconscious biases rather than intentional disre-
gard for inclusivity. It highlights a crucial need for organiza-
tions to not only establish but rigorously implement inclusive
language policies. We advocate for the consistent use of
terms like “populations made vulnerable” to accurately
reflect systemic inequities and avoid perpetuating stigma.
Adhering to inclusive language is essential in promoting
respect, equity, and a more accurate representation of diverse
communities. As authors, we are also constantly vigilant in
checking our own language use to ensure it aligns with these
principles. It is imperative that organizations bridge the gap
between policy and practice to foster truly inclusive and
respectful discourse.
Based on these findings, international organizations,
researchers, policymakers, community leaders, and the gen-
eral population should prioritize the use of preferred terms for
selecting population groups and communities in their dis-
course. We recommend a change in the way we employ the
terms “vulnerable,” “marginalized,” “oppressed,” “hard to
reach,” “underprivileged,” and “underserved.” Instead, we
advocate for being as specific as possible. For example, using
phrases like “communities marginalized by systemic inequal-
ities” or “populations made vulnerable by historic discrimina-
tion and colonization” offers clarity and acknowledges the
underlying factors contributing to their circumstances (Garrett
& Altman, 2024). We encourage individuals to regularly
check the websites of major organizations that focus on spe-
cific areas to stay updated on preferred terminology.
Additionally, we recommend that whenever in doubt, starting
with the word “person” can serve as a guiding principle,
emphasizing the importance of person-centered language and
respectful communication. For instance, phrases like “people
with disabilities” or “people with HIV” acknowledge the
individuality and dignity of each person while avoiding stig-
matizing or dehumanizing language (NIH, 2023b).
In discussing the importance of inclusive language, we
draw from Likis (2021) and Bares et al. (2023), who empha-
sized the significance of language choice in conveying respect
and promoting equity. Likis (2021) provided recommenda-
tions for inclusive language alternatives in various domains,
such as race and ethnicity, socioeconomic status, sex and gen-
der, sexual orientation, age, and ability and disability. Bares
et al. (2023) advocated for the use of person-first language in

10 Global Qualitative Nursing Research
scientific discourse as a means of respecting individuals and
avoiding stigmatization based on medical conditions. We rec-
ommend that organizations, journals, policymakers, research-
ers, and the broader community refrain from listing harmful
and offensive terms. Doing so is unnecessary, potentially trig-
gering, and could inadvertently reinforce their usage. Instead,
we strongly advise directing attention towards the appropriate
terms that should be used. Additionally, we suggest that when
listing the race or the ethnicity of individuals, this should be
done in alphabetical order. These recommendations align
with broader efforts to prioritize the use of preferred terms for
diverse population groups and communities in discourse, as
advocated by international organizations and scholars
(Ashwell et al., 2023; Garrett & Altman, 2024). See Appendix
A for more recommendations.
Future research should consider several avenues to advance
our understanding and application of preferred terms for popu-
lation groups and communities. Firstly, there is a need for lon-
gitudinal studies that track changes in terminology preferences
over time, reflecting evolving societal norms, and advance-
ments in inclusivity. Secondly, comparative analyses across
different regions and cultural contexts could provide valuable
insights into the universality versus context-specific nature of
preferred terms. Additionally, qualitative studies exploring
community perspectives on language use and its impact on
identity and well-being would deepen our understanding of
the practical implications of terminology choices. Lastly, col-
laborative efforts involving academia, policymaking, and
affected communities themselves could facilitate the develop-
ment of comprehensive guidelines for inclusive language that
resonate across diverse settings and disciplines.
Conclusion
This research contributes to a more profound understanding
of the complexities and considerations associated with the
use of preferred terms for population groups and communi-
ties, with implications for policy development, communica-
tion, and the fostering of inclusive environments. This
analysis sheds light on the evolving landscape of inclusive
language and terminology within international contexts. The
findings of this environmental scan underscore the critical
role of language in shaping perceptions and attitudes toward
diverse communities. By adopting inclusive terminology,
international organizations can contribute to creating more
equitable and inclusive societies, where all individuals are
respected and valued. Moving forward, continued efforts to
promote respectful and accurate language are essential for
fostering understanding, empathy, and solidarity across
diverse populations worldwide. Finally, guidelines and pol-
icy statements on appropriate and respectful use of inclusive
language and terminologies need to be continually updated.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect
to the research, authorship, and/or publication of this article.
Funding
The authors received no financial support for the research, author-
ship, and/or publication of this article.
ORCID iD
Higinio Fernandez-Sanchez https://orcid.org/0000-0003-4992-
7096
Appendix A
We encourage organizations, journals, policymakers, research-
ers, and the broader community to:
 Advocate for the use of inclusive language in scien-
tific discourse, promoting equity and respect across
various domains such as race, ethnicity, socioeco-
nomic status, sex, gender, sexual orientation, age, and
ability.
 Actively promote efforts to advocate for inclusive lan-
guage and discourage the use of harmful or offensive
terms.
 Provide education and training on inclusive language
usage to ensure that individuals are equipped with the
knowledge and skills to communicate respectfully
and effectively with diverse populations.
 Foster an environment of open dialogue and continu-
ous learning, where individuals are encouraged to lis-
ten to various groups’ self-identification, confront
biases, and remain open to ongoing growth and
comprehension.
 Collaborate with communities to co-create language
guidelines that reflect the preferences and needs of the
populations being addressed.
 Conduct regular reviews and updates of terminology
guidelines to reflect evolving language preferences
and best practices in promoting inclusivity and
respect.
 Encourage the adoption of preferred terms not only in
written communication but also in verbal and oral dis-
course to ensure consistency and alignment with
inclusive language principles.
 Prioritize the use of preferred terms for selecting pop-
ulation groups and communities in discourse, avoid-
ing terms that can be perceived as harmful.
 Whenever in doubt, start with the word “person” as a
guiding principle, emphasizing the importance of per-
son-centered language and respectful communication.
 Regularly check the websites of major organizations
that focus on specific areas to stay updated on pre-
ferred terminology.
 When listing the race or ethnicity of individuals, do
so in alphabetical order to promote fairness and
consistency.
 Engage in ongoing advocacy for inclusive language
practices, recognizing the significance of language
choice in conveying respect and promoting equity.

Fernandez-Sanchez et al. 11
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Author Biographies
Higinio Fernandez-Sanchez, PhD, MN, BSN, RN is an assistant
professor at The University of Texas Health Science Center
Houston, located in Houston, Texas, United States.
Emmanuel Akwasi Marfo, MN, RN is a doctoral candidate (PhD[c])
at the Faculty of Nursing, Edmonton Clinic Health Academy,
University of Alberta, situated in Edmonton, Alberta, Canada.
Diane Santa Maria, DrPH, RN, PHNA-BC, ACRN, FSAHM,
FAAN serves as the dean and professor, occupying the Jane and
Robert Cizik Distinguished Chair at The University of Texas Health
Science Center Houston, located in Houston, Texas, United States.
Mercy Mumba, PhD, RN, CMSRN, FAAN is an associate profes-
sor at Capstone College of Nursing, The University of Alabama,
where she also serves as the director of the Center for Substance
Use Research and Related Conditions and acts as the principal
investigator for Minds and Mentors Programs & RESTORE
Alabama.