Identifying Patterns of Stigmatizing Language Use in the Safety Net
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By
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Kriti Gogia
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Zeyu Li
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Kara Simpson
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Nichola J. Davis
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Remle Newton-Dame
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June 24, 2026
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Clinical Scorecard: Recognizing Trends in the Use of Stigmatizing Language within Safety Net Systems
At a Glance
| Category | Detail |
|---|
| Condition | Stigmatizing Language Use |
| Key Mechanisms | Bias transmission between providers, negative impact on clinical care and patient trust. |
| Target Population | Low income and historically minoritized communities. |
| Care Setting | Safety net health systems. |
Key Highlights
- Stigmatizing terms were found in 0.6% of medical notes, affecting 3.1% of unique patients.
- Highest prevalence of stigmatizing language was among Social Workers, Counselors, and Psychologists (1.7%).
- Prevalence was notably high in inpatient (1.0%) and emergency department (0.9%) notes.
- Significant racial variation in stigmatizing language prevalence was observed.
- Key patient-level factors included homelessness, SUD/AUD, and multiple chronic conditions.
Guideline-Based Recommendations
Diagnosis
- Identify and mitigate stigmatizing language in clinical notes.
Management
- Implement training and culture change initiatives to reduce stigmatizing language.
Monitoring & Follow-up
- Use rapid lexicon search strategies to monitor stigmatizing term prevalence.
Risks
- Negative language can enhance disparities and worsen treatment outcomes.
Patient & Prescribing Data
Patients seen in NYC Health + Hospitals, particularly those with behavioral health needs.
Focus on replacing stigmatizing language with neutral terms in EHR templates.
Clinical Best Practices
- Tailor interventions to address hotspots of stigmatizing language.
- Emphasize respect and dignity in communication with patients.
Related Resources & Content
