When it Comes to Promoting Health Equity: Language Matters!
Original article published on policiesforaction.org/blog.
The recent Executive Orders EO 14151 and 14173, which aim to reverse the nation’s efforts toward racial diversity, equity, and inclusion (DEI), have created tremendous confusion and fear within organizations whose missions involve delivering health, housing, and social services to vulnerable populations.
Almost all federally supported efforts to understand and resolve demographic discrepancies in health, environmental, or economic outcomes have ceased, creating ripple effects across networks of researchers, service providers, and advocacy groups. Funding cuts and censorship have severely affected the capacity of organizations to provide sufficient health care and social services to citizens who need them. The uncertainty has forced some organizations to reconsider their personnel decisions, budgets, and programs to align with these new federal dictates.
Terminological Confusion
Among many other constraints, leaders and frontline workers at nonprofits and other organizations funded, or partly funded, by the federal government must now carefully consider the language they use to describe their work. A list of 163 words has reportedly been banned from use in all federal government communications (NY Times, 2025) and in the operations and communications of organizations receiving federal funding.
Some now face outright prohibitions, threats of termination, or suspension of funding, leaving them with stark choices. Others may choose to exercise their rights to free speech in defense of programs designed to remove the structural and societal barriers to health and well-being. Others, still, are choosing to shift their language while preserving the integrity of their work and practices. All are left with a Faustian bargain, forced to consider the trade-offs between shutting down, modifying language, altering services, or continuing to champion the needs of societies’ most vulnerable through the words they use. The potential consequence of each choice has risked chilling even the most effective equity work. EOs 14151 and 14173 are essentially amounting to federal preemption over local service delivery.
Examining the Fallout from Language Censorship
A team of researchers from the University of Kansas (KU), University of Wyoming (UW), and the National Academy of Public Administration (NAPA) undertook a project in 2024 titled “The Role of State Preemption on the Health Equity & Economic Security of Communities of Color in the Kansas City Metro Area.” The ongoing study, which focuses on policy narratives that may drive state preemption of local policymaking, is funded by Policies for Action, a signature research program of the Robert Wood Johnson Foundation.
In recent months, the team has expanded its research and outreach focus to examine the fallout from these recent Executive Orders, funding cuts, and freezes. On September 30, 2025, they partnered with consulting firm Sophic Solutions to convene a group of health equity leaders in Kansas City for the first of two Language Matters workshops. Approximately 50 participants representing 30 different organizations attended, including county and city public health departments, trauma hotlines, food shelves, health care providers, healthcare data services, housing services, and poverty support providers.
The afternoon was divided into three sections. Participants addressed the first topic, perceived risk, in small-group discussions organized according to each organization’s self-defined risk profile: high, medium, or low. The second topic focused on examining the meanings of censored words and exploring what is lost when such words are altered or avoided. The third section of the workshop provided practical guidance on external communication strategies.
Varied Risk Levels
The following themes emerged from the risk conversation.
All organizations expressed an increased sense of risk as a result of recent federal actions. These perceived risks include potential loss of funding, increased public exposure to trolling and incivility, and political pressure to alter service delivery methods or abandon the use of specific words.
By grouping participants according to their self-assessed levels of risk, organizations facing similar challenges were able to share experiences, exchange strategies, and articulate key messages for those in other risk categories.
Participants from lower-risk organizations encouraged higher-risk groups to rely on them to speak out or act in ways that, for them, might be too risky. For example, advocating for continued services for pregnant women of color to reduce infant mortality, or communicating to policymakers about the real-world consequences of federal actions and censorship.
Higher-risk organizations emphasized the challenges they face, including program cuts that result in service closures for vulnerable populations, resource reallocations between programs, declining staff morale, and the burden of having to justify their existence simply because they serve protected groups.
Despite these challenges, some participants identified promising strategies such as engaging in comprehensive strategic planning processes and exploring potential silver linings, including opportunities to develop new models of health service delivery.
Linguistic Tension
The second section of the workshop focused explicitly on language itself. A pre-workshop survey had revealed that more than half of the organizations in attendance had already stopped using words associated with DEI. Part two of the workshop explored potential working definitions of selected terms such as equality, equity, health equity, discrimination, universalism, inclusion, belonging, bias, prejudice, racism, anti-racism, class, gender, and LGTBQ.
The discussion lead to difficult conversations about how to best serve vulnerable communities without referencing demographic distinctions or risk levels.
A central theme that emerged was that language truly matters. Participants said that terms like equity, equality, and inclusion remain essential and meaningful, regardless of how the federal government currently interprets them.
Participants also discussed the legality of Executive Orders 14151 and 14173, which are being challenged in court as unconstitutionally vague and a violation of free speech and civil rights protections.
Strategy and Preparedness: Communications Planning
The workshop concluded with a brief presentation on the importance of developing a communications plan that includes strategies for framing messages for different audiences. Participants discussed ways to advance narratives about their work and the impacts of federal preemption on their constituencies, as well as plans for a follow-up workshop.
The Language Matters workshops are part of a larger project examining how policy narratives are used to describe and justify state preemption of public policies and practices related to the social determinants of health, particularly those affecting economic and housing security. The team is currently analyzing public hearing testimonies from ordinary citizens, floor speeches by state legislators, news articles pertaining to state preemption policies and legislation, and interviews with key stakeholders to understand the rationale and consequences of state preemption. The team has several academic papers and policy briefs in various stages of development, including a peer-reviewed article focused on the Language Matters workshops and supporting materials.
For copies of the protocols and exercises used in the Language Matters exercises, please contact project PI, Chris Koliba; ckoliba@ku.edu.