Dehumanizing Language in the Health Care System Harms Children With Incarcerated Family Members

Dehumanizing Language in the Health Care System Harms Children With Incarcerated Family Members 1024 683 Rosemary Martoma, MD and Kelly Kelleher, MD, MPH

Dehumanizing Language Causes Harm

Labels and language matter. Language has the power to condemn or redeem, and words reflect our values and beliefs as clinicians, scholars, and members of the community.” – Bedell et al., Humanity: Person-First Language in Correctional Health Epidemiology, American Journal of Epidemiology

Children with incarcerated family members frequently face stigma and systems mistrust as a result of their relationship with their imprisoned loved ones. Child health care providers may unintentionally perpetuate harm by using labels that are embedded in criminal justice language and are inherently stigmatizing. Examples of dehumanizing labels used to refer to people with justice involvement include inmate, prisoner, convict, felon, offender, ex-prisoner and ex-offender. These labels deprive individuals of their complex identities and define a child’s loved one by their relationship to the criminal justice system instead of by their relationship to the child.

People-First Language

The people-first language movement formed in the 1980s with the goal to eliminate dehumanizing labels ascribed to individuals with chronic illness or disability. Advocates called for a shift from identity-first language to people-first language – a linguistic style that emphasizes the person before the condition. People-first language can be applied to any situation in which a person can be defined by a condition: for example “person with a disability” rather than “disabled person” or “person with obesity” rather than “obese person.”

By 2007, person-first language trickled into the criminal justice realm when the late Eddie Ellis, a prominent criminal justice advocate penned an open letter:

We are asking everyone to stop using these negative terms and to simply refer to us as PEOPLE. People currently or formerly incarcerated, PEOPLE on parole, PEOPLE recently released from prison, PEOPLE in prison, PEOPLE with criminal convictions, but PEOPLE.” – Eddie Ellis, founder and director of the Center for NuLeadership on Urban Solutions, An Open Letter to Our Friends on the Question of Language

Ellis’ powerful prose and continued advocacy to reject the use of stigmatizing language led to widespread changes in the use of dehumanizing labels in the criminal justice system and beyond. By 2016, The Justice Department’s Office of Justice Programs, announced that it would begin to use person-first language, such as “person who committed a crime” or “individual who was incarcerated” in place of “felon” or “convict.”

While not everyone agrees on the best linguistic style to use when addressing individuals with justice system involvement, recent scholarly articles in the American Journal of Epidemiology and the Journal of the American Medical Association have advocated for person-first language in the health care setting.

Child-Friendly Language

In pediatric practices, clinicians should avoid dehumanizing labels and instead focus on relationships to describe family members with criminal justice involvement: father, mother, brother, sister, aunt, uncle, grandparent, etc.,

Criminal justice reform organization, the Osborne Association was an early proponent for using humanizing language. They believe that systems that separate families – criminal justice, child welfare, immigration – use the term “visitation” and suggest replacing it with “visit” or “visiting” when speaking about seeing an incarcerated loved one at a correctional facility.

Allison Hollihan, of the New York Initiative for Children of Incarcerated Parents at the Osborne Association explains, “Using ‘visitation’ signals to children that their visit is different, an experience that is observed, restricted, and should not be talked about. This institutional language can negatively influence a child’s view of her parent and herself and conveys to parents that they are inadequate and different from other parents.”



  1. Bedell, Precious S., et al. “Corrections for Academic Medicine.” Academic Medicine, no. 2, Ovid Technologies (Wolters Kluwer Health), Feb. 2019, pp. 172–75.
  2. Bedell, Precious S, et al. “The Names Have Been Changed to Protect the . . . Humanity: Person-First Language in Correctional Health Epidemiology.” American Journal of Epidemiology, no. 6, Oxford University Press (OUP), Apr. 2018, pp. 1140–42.
  3. Ellis, Eddie. “An Open Letter to Our Friends on the Question of Language.” CMJ Center, Accessed 13 June 2021.
  4. “The Language Project | The Marshall Project.” The Marshall Project, The Marshall Project, 12 Apr. 2021, Accessed 13 June 2021.
  5. “We Are People: Resources for Humanizing Language – OsborneNY.” Home – OsborneNY, Accessed 13 June 2021.

Image credit: Adobe Stock

About the author

Rosemary Martoma, MD, MBChB, is a board-certified pediatrician trained in trauma-informed care and practicing at Nationwide Children’s Hospital, Assistant Professor at The Ohio State University College of Medicine, and president of KidsMates Inc., a national nonprofit focused on advancing childhood equity. Dr. Martoma completed medical school at Auckland University in New Zealand and residency at Tufts Children’s Hospital in Boston. Dr. Martoma is a nationally recognized expert, peer-reviewed author, and pioneer of health equity advocacy for children of incarcerated parents. Dr. Martoma’s research interests include a wide range of health equity issues. Dr. Martoma is the recipient of an American Academy of Pediatrics (AAP) Community Access to Child Health (CATCH) grant to assess childhood adversity screening, a member of the AAP’s Child Welfare Learning Collaborative, and a contributor to the AAP’s official parenting website.

Dr. Kelleher is a pediatrician whose research interests focus on accessibility, effectiveness and quality of health care services for children and their families, especially those affected by mental disorders, substance abuse or violence. He has a longstanding interest in formal outcomes research for mental health and substance abuse services. Dr. Kelleher is director of the Center for Innovation in Pediatric Practice and vice president of Health Services Research at The Research Institute at Nationwide Children’s Hospital. Dr. Kelleher is also professor in the Department of Pediatrics of The Ohio State University College of Medicine.