How Language Shapes Health Equity
A Q&A With Samantha Wang, MD
March 6, 2026
In today’s polarized climate, even the words we use to talk about health can shape whether people lean in, or tune out. A new national study led by Samantha X. Y. Wang, MD, set out to understand exactly how language influences public attitudes toward health equity, a concept that centers on making sure everyone has a fair chance to be healthy by removing barriers like limited access to care and resources.
The team surveyed 1,000 U.S. adults across the political spectrum, testing reactions to terminology such as “health equity” versus “health equality”, other commonly used equity-related terms, and different public health message framings. Participants rated how well each aligned with their personal values and perceived American values.
To learn more about the findings, and what they mean for clinicians, researchers, and public health leaders, we connected with Wang for a quick Q&A.
What we found was very similar to what we see in clinical care: language can build bridges or it can build walls. - Samanatha Wang, MD
What first prompted you to study language and framing around health equity? Was there a specific moment or experience that sparked this work?
The project started after an emotional moment for me. Shortly after the first executive orders targeting DEI language, some of my research was suddenly interrupted. It felt soul crushing. I remember mentioning it offhand to one of my division chiefs, Kevin Schulman, MD, who is the senior author on the paper, but I really was just venting in a moment of frustration. He commiserated but also asked me, “Is the backlash really about the work or is it about the words?” That was the spark. At the time, it felt like language had become the battleground. This led us to wonder: what if we could really find a way to talk about the goals of health equity in a way that people could actually hear across political differences? That’s what led to this study.
As a clinician, how have you personally seen language affect trust or engagement with patients or communities?
Language shapes trust and it shapes whether my patients feel respected, judged, understood, heard, and seen. If I use language that is too technical or stigma-laden, my patients may misunderstand, become guarded, or shut down. Words that feel routine to us as clinicians can feel judgmental or dehumanizing to a patient. It can land as if I’m talking “about” them instead of “with them”. Also, so much of what we write – especially medical instructions - is more complicated than it needs to be. When our patients don’t understand, that’s not a failure on their part. It’s a communication failure of ours because we haven’t made information accessible.
What our study did was take the same idea: that words shape trust and engagement – and zoom out. Instead of looking at language we use at the bedside, we looked at language at the societal level: how we talk about health equity in the public sphere.
"If we want to improve the health of all communities, we need to share the same understanding of the goal and what we are aiming for." - Samantha Wang, MD
One of the striking results is that people across ideologies felt more aligned with the term “health equity” rather than “health equality.” Why do you think that distinction matters in practice?
“Equity” and “equality” sound almost identical but are two very different concepts. Equity is real fairness, and the CDC defines health equity as “attaining the highest level of health for all people.” Equality is about giving everyone the same thing, so it’s “sameness”. On the surface level, it sounds fair, but the reality is that we don’t all start from the same place. Some of us face challenges in accessing transportation, stable housing, health insurance, language, discrimination, and more. Giving everybody the same input won’t create the same outcomes in health.
On a practical level, this distinction matters because if we treat the two terms as interchangeable, we’ll end up creating solutions that sound good on paper but don't change health outcomes. If we want to improve the health of all communities, we need to share the same understanding of the goal and what we are aiming for, and equity makes that goal explicit.
Your team found that terms like “accessible health care,” “health care investment,” “population health,” and “community health” were broadly well received. What do these terms have in common that might explain their resonance?
If you think about these terms, they’re very plainspoken. Language that is clear and easy to picture feels more trustworthy. People can imagine more easily what action would look like.
For example, “accessible health care” immediately makes me think of concrete interventions like: improving affordability or transportation or expanding clinic access. These terms also feel universal and solutions-oriented or practical. The benefits can be shared across neighborhoods, communities, and populations, and they sound like something that helps all of us and strengthens the system overall.
Some phrases — like "marginalized communities" or "inclusive health care" — elicited more divided reactions. What should we take away from that?
One key takeaway is that not all equity language is received the same way, even when it’s meant to express the same values. In this study, those two phrases led to more negative reactions, especially depending on political views. That’s because they point to specific groups and, in today’s climate, can feel politically charged — even when you’re simply describing real situations.
They’re also abstract. When language is vague, people fill in the meaning themselves, based on their own beliefs. As a result, these terms can feel less about health care and more about ideology. For example, “inclusive” can sound moral or accusatory, as if someone did something wrong. That can make some people defensive.
By contrast, a word like “accessible” feels more concrete and practical — it sounds like a problem you can solve.
The lesson isn’t to stop talking about equity. Instead, in diverse audiences, it helps to start with shared goals, use clear and simple language, and give enough context so people don’t have to guess what you mean.
If you were advising a hospital, public health department, or research team tomorrow, what are three practical language changes you’d recommend based on this study?
First, I want to be very clear that the goal of the study wasn’t to “police” anybody’s language or tell people we can’t use certain words. It’s about being aware and intentional that language can shape whether people lean in or tune out.
Your paper notes that communication alone can’t solve deeper disagreements about equity. Where do you see the limits of language, and where does it still have real power?
It would be short sighted to say we can “fix” disagreement about health equity by swapping out words. That’s the opposite of what we want people to take away from the study.
Communication is not a substitute for policy or real engagement with communities who have different lived experiences and priorities. But language still has power because words communicate intent, and can build bridges or shut people down.
One interesting finding in our study was that many respondents aligned with the concept of health equity as a personal value. However, there was a gap between what people believed personally and what they thought reflected “American values”, which suggests we may be living with a lot of misperception about where others stand.
Acknowledgments:
This study reflects the combined efforts of a cross-disciplinary team to make the study as rigorous and real-world relevant as possible, including: Kevin Schulman, MD, who contributed a strategic communication lens as senior author; Bob Kaplan, PhD, an expert in research design and survey methods; Zak Tormala, PhD, a leading scholar in persuasion and message framing; Meg Nikolov, PhD, who led biostatistical analysis; and Sujin Song, MS, our research analyst who helped structure and present the results.
Wang concludes, “Research like this truly takes a village, and I’m deeply grateful to this team.”