Health Literacy Consulting How-To Tip
May 2015

Respecting Our Readers

Here’s my wish. As you choose words and graphics for health-related materials, please consider not only the learning and language needs of your intended audience but also their emotions and life experiences. Several years ago I was leading a plain language workshop for directors of programs for victims of domestic violence. One strategy I taught was about using bullet points. I was startled when a participant asked me to use less violent language to describe those marks indicating items in a list. 

I have since thought a lot about her request. To me, it seems right (not just politically correct) to respect the sensitivities of our readers. Here are my musings about how to do just that:

  • Instead of the term “bullet points,” come up with other words for this common convention. I recently spoke with a plain language colleague from Hong Kong who said he uses the term “dot points.” Sounds good to me.
  • When including illustrations of internal body parts, begin with a drawing of the intact body. A second illustration can then be a close-up of the specific organ, such as the spleen. Doing so not only shows the organ in proportion to the whole body but also avoids a lopped-off torso which may be upsetting to some. 
  • Think of those we write for as our "intended readers," not "stakeholders." A Native American colleague says she is uncomfortable with the term "stakeholders." To her and others, this term is an unpleasant reminder about an unfortunate time in our history when some people were tied to stakes. I have since changed my wording to "intended readers." Hoping you might do the same.
  • Consider not using warlike verbs and descriptors. I often read, and hear, about patients who “battle” a serious disease like cancer. Sometimes the patient is described as “heroic.” Well, I had cancer and don’t feel that showing up for treatment was equivalent to going to war. Maybe it feels that way for some, but not necessarily for all. What to say instead? How about simply stating the facts. An example is “She is being treated for cancer.” And then let those in that situation take the lead about words they choose to use.

Sometime people scoff and say that I am going too far when raising these concerns. After all, communicators have long talked about bullet points, illustrated only certain body parts, used the term stakeholders, and described patients as being in battle. But to me, just because we always have communicated this way does not mean it is right. What do you think?

For permission to include Health Literacy Consulting Tips in your organization's newsletter, please contact Helen Osborne by e-mail at:, or by phone at: 508-653-1199.