Researched and written by Natabhona Mabachi, PhD, MPH and Maria Alonso Luaces, PhD, Office of Diversityand Inclusion, University of Kansas, and by Lauren J. Germain, PhD, MEd and Amy Caruso Brown, MD, MSc, MSCS, SUNY Upstate Medical University.

  1. Ableism: “Discrimination and social prejudice against people with disabilities and/or people who are perceived to be disabled; ableism characterizes people who are defined by their disabilities as inferior to the non-disabled [and] assign[s] or denie[s them] certain perceived abilities, skills, or character orientations” (Wikipedia)
  2. Access to care: “The timely use of personal health services to achieve the best health outcomes” (IOM, 1993); includes the 4 components of insurance “coverage (facilitates entry into the healthcare system; uninsured people are less likely to receive medical care and more likely to have poor health status), services (having a usual source of care is associated with adults receiving recommended screening and prevention services), timeliness (ability to provide health care when the need is recognized), and workforce (capable, qualified, culturally responsive providers)” (Healthy People, 2020)
  3. Allostatic load: “Wear and tear on the body” that accumulates as an individual is exposed to repeated or chronic stress (McEwan, 1998), including the stress of racism, resulting in cumulative negative mental and physical health effects
  4. Bias: Preconceived opinion or inclination that is not rigorously based on reason, experience or evidence (though it may have roots in these things); can be positive, negative or both; occurs on a spectrum from implicit (or unconscious) to explicit (or consciously endorsed)
  5. Binary (gender): The idea that human gender is divided into two distinct sexes, female and male, typically associated with distinct gender roles
  6. Cisgender: Describes a person whose gender identity aligns with those typically associated with the sex assigned to them at birth (Human Rights Campaign)
  7. Cognitive disabilities: Limitations in mental functioning affecting skills such as communication, self-help, or social interaction and cause greater difficulty with such tasks than experienced by people defined by society as “average” or “typical”
  8. Cultural humility: “Ability to maintain an interpersonal stance that is other-oriented (or open to the other) in relation to aspects of cultural identity that are most important to the [other person]”; focuses on self-humility rather than achieving a state of knowledge or awareness regarding culture (Tervalon and Murray-Garcia, 1998)
  9. Culture: Values, beliefs, systems of language, communication, and practices that people share in common and that can be used to define them as a collective; also includes the material objects that are common to that group or society (
  10. Disability: Impairments, activity limitations, and participation restrictions. An impairment is a problem in body function or structure; an activity limitation is a difficulty encountered by an individual in executing a task or action; while a participation restriction is a problem experienced by an individual in involvement in life situations; complex phenomenon, reflecting an interaction between features of a person’s body and features of the society in which he or she lives (WHO)
  11. Discrimination: Unfair or prejudicial treatment of people and groups based on characteristics such as race, gender, age or sexual orientation (APA)
  12. Diversity: Representing or acknowledging all aspects of human differences including but not limited to socioeconomic status, race, ethnicity, language, nationality, sex, gender identity, sexual orientation, religion, geography (including rural and highly rural areas), disability, and age (AAMC)
  13. Equity: Absence of avoidable or remediable differences among groups of people, whether those groups are defined socially, economically, demographically, or geographically (WHO)
  14. Health equity: Achieved when every person has the opportunity to “attain his or her full health potential” and no one is “disadvantaged from achieving this potential because of social position or other socially determined circumstances”
  15. Ethnicity: Groups (e.g., Fijian, or Sioux, etc.) that share a common identity-based ancestry, language, or culture; often based on religion, beliefs, and customs as well as memories of migration or colonization (Cornell & Hartmann)
  16. Explicit biological differences: Health differences among different racial and ethnic groups that are attributed to differences in the distribution of genes, often falsely; the vast majority of health differences are not genetic in origin but are due to social and structural inequity, although biology (through mechanisms such as toxic stress and epigenetic modification) may play a role
  17. Gender identity: A socially and personally constructed identity that can be associated with masculinity, femininity, androgyny, any combination of these, or altogether different conceptions of gender.
  18. Gender role: How a person is expected to act, speak, dress, groom, and conduct oneself based upon assigned sex or gender identity and within a particular culture, community and/or society
  19. Gender: Range of characteristics pertaining to, and differentiating between, femininity and masculinity; depending on the context, these characteristics may include biological sex, sex-based social structures (i.e., gender roles), or gender identity
  20. Health disparities: “Differences in the incidence, prevalence, mortality and burden of diseases and other adverse health conditions that exist among specific population groups, compared with the general population susceptible to those conditions” (NIH, 1999)
  21. Health outcomes: Health outcomes measure a change in the health status of an individual or a group which can be attributed to intervention.
  22. Immigration status: Refers to the way in which a person is present in a country; everyone has an immigration status; examples in the U.S. include citizens (by birth or naturalization), legal permanent or conditional residents, non-immigrants (present on temporary visas, such as student visas) and undocumented immigrants
  23. Implied biological differences: The suggestion or implication (not overtly stated) that disparities in the health status or health outcomes of different racial and ethnic groups is due to genetic differences rather than social and structural inequity
  24. Inclusion: The practice or policy of providing equal access to opportunities and resources for people who might otherwise be excluded or marginalized, such as those who have physical or mental disabilities and members of other minority groups.
  25. Inequity in healthcare: Systematic differences in the opportunities groups have to achieve optimal health, leading to unfair and avoidable differences in health outcomes (Braveman, 2006; WHO, 2011).
  26. Intersectionality: Interconnected nature of social categorizations such as race, class, and gender as they apply to a given individual or group, regarded as creating overlapping and interdependent systems of discrimination or disadvantage, as well as privilege and advantage (Williams Crenshaw, 1989)
  27. Intersex: Individuals born with physical sex markers (genitals, hormones, gonads, or chromosomes) that are neither clearly male nor female
  28. Judgment: An opinion; in this context, an opinion formed by a healthcare professional regarding the quality of a patient’s decisions, behaviors, lifestyle, etc., often based upon the professional’s own beliefs and values rather than the patient’s
  29. Marginalization: Process of making a group or class of people less important or relegated to a secondary position.
  30. Mass incarceration: Extremely high rate of incarceration in the United States for both adults and youth, especially Black adults and youth. 
  31. Mental health: Emotional, psychological, and social well-being; affect how we think, feel, and act; helps determine how we handle stress, relate to others, and make choices
  32. Migrants: Previously used to designate people who move by choice rather than to escape conflict or persecution, usually across an international border; increasingly used as an umbrella term to refer to any person who moves away from their usual place of residence, whether internally or across a border, and regardless of whether the movement is ‘forced’ or voluntary
  33. Misogyny: “Contempt for, or prejudice against women or girls; enforces sexism by punishing those who reject an inferior status for women and rewarding those who accept it” (Wikipedia/Kate Manne)
  34. Monolithic: Intractably indivisible and uniform; in this context, refers to the tendency to perceive all members of another cultural or religious group (especially an unfamiliar group) as sharing the same values, beliefs and practices, despite all such groups having significant intra-group variation
  35. Neurodiversity: Variation in the human brain regarding sociability, learning, attention, mood and other mental functions (Singer, 1998); often used by advocates to discuss the value in different ways of thinking, such as those experienced by autistic people
  36. Physical disabilities: Limitation(s) on a person’s physical functioning, mobility, dexterity or stamina; may include or be distinguished from impairments in vision or hearing; typically distinguished from intellectual or cognitive disabilities and psychiatric disabilities
  37. Poverty: State or condition in which a person or community lacks the resources to meet basic and essential needs for a minimum standard of living; below an income threshold set by the federal government in the U.S.
  38. Prisoners: People deprived of liberty and kept under involuntary restraint, confinement, or custody; especially those on trial or in prison; a vulnerable group accorded additional protections under federal research regulations (OHRP, 2021)
  39. Quality of life: Measure of health, comfort, and happiness experienced by an individual or group; highly individual and subjective with many studies showing that people routinely underestimate the quality of life reported by those they perceive as other (for example, disabled people self-report higher quality of life than able-bodied report when asked about what it would be like to have a disability)
  40. Race: Grouping of humans based on shared physical or social qualities into categories generally viewed as distinct by a society; importantly, race is a social, not a biological construction, and a person’s racial grouping will vary between countries and societies
  41. Racism: “Prejudice, discrimination, or antagonism directed against a person or people on the basis of their membership in a particular racial or ethnic group, typically one that is a minority or marginalized” (
  42. Refugee: “Person who has fled their own country because they are at risk of serious harm” (including human rights violations and persecution); the risks to their safety and life were so great that they felt they had no choice but to leave and seek safety outside their country because their own government cannot or will not protect them from those dangers; refugees have a right to international protection (Amnesty International, 2021)
  43. Sex: “The male, female, or intersex division of a species, especially as differentiated with reference to the reproductive functions”, including “the sum of the structural and functional differences by which male, female, and intersex organisms are distinguished, or the phenomena or behavior dependent on these differences” (
  44. Sexism: Prejudice, stereotyping, or discrimination, typically against women, on the basis of sex
  45. Sexual behavior: Manner in which humans experience and express their sexuality
  46. Sexual orientation: “An enduring pattern of romantic or sexual attraction (or a combination of these) to persons of the opposite sex or gender, the same sex or gender, or to both sexes or more than one gender; generally subsumed under heterosexuality, homosexuality, and bisexuality, while asexuality (the lack of sexual attraction to others) is sometimes identified as the fourth category” (Wikipedia)
  47. Sexuality: Capacity for sexual feelings
  48. Shame: In the healthcare context, more accurately termed “medical shaming”; process by which patients are judged by healthcare professionals to be more responsible for their own situation (including their health, social and economic status) and less deserving of health and healthcare than the “ideal” patient (Serani, 2019)
  49. Social determinants of health: “Conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks” (IOM, 1999)
  50. Social structures: “Policies, economic systems, and other institutions (judicial system, schools, etc.) that have produced and maintain modern social inequities as well as health disparities, often along the lines of social categories such as race, class, gender, sexuality, and ability” (Hansen & Metzl)    
  51. Socioeconomic status: “Social standing or class of an individual or group”; “often measured as a combination of education, income and occupation” (APA, 2021)
  52. Spectrum (gender): Continuum of identity and expression stretching from men to women and masculine to feminine; concept that better reflects most people’s lived experience, as no one has exclusively masculine or exclusive feminine traits, interests, etc. 
  53. Spectrum (sexual orientation): Model of sexual orientation “which places people whose sexual and/or romantic orientation is toward persons of the same gender and/or sex—gay, lesbian and same-gender-loving people—at one end and people whose sexual and/or romantic orientation is toward persons of the other binary gender or sex—straight people—at the other end”; in this model, people who are sexually and/or romantically attracted to both men and women and/or non-binary people are in the middle (University of South Dakota, 2021)
  54. Stereotype: Fixed, overgeneralized and oversimplified image or idea of a particular type of person or thing; often widely held and applied to whole groups of people
  55. Stigma: “Powerful social process characterized by labeling, stereotyping, and separation, leading to loss of social status and discrimination, all occurring in the context of power”; in the context of healthcare, stigma can be related to living with a specific disease or health condition and is often associated with judgment or blame regarding the condition; a barrier to healthcare (Nyblade, et al., 2019)
  56. Structural competency: “Trained ability to discern how a host of issues defined clinically as symptoms, attitudes, or diseases (e.g., depression, hypertension, obesity, smoking, medication “non-compliance,” trauma, psychosis) also represent the downstream implications of a number of upstream decisions about such matters as health care and food delivery systems, zoning laws, urban and rural infrastructures, medicalization, or even about the very definitions of illness and health” (Hansen and Metzl, 2017)
  57. Structural humility: Approach which “cautions providers against making assumptions about the role of structures in patients’ lives, instead encouraging collaboration with patients and communities in developing understanding of and responses to structural vulnerability” (Metzl and Hansen, 2014) 
  58. Structural violence: Form of violence wherein some social structure or social institution may harm people by preventing them from meeting their basic needs (Galtung, 1969)  
  59. Structural vulnerability: “Risk that an individual experiences as a result of structural violence, including their location in multiple socioeconomic hierarchies; not caused by, nor can it be repaired solely by, individual agency or behaviors” (Bourgois, Holmes, Sue, and Quesada, 2017)
  60. Systemic racism: Form of racism that is embedded through laws and regulations within society or an organization; also called institutional or structural racism (see Camara Jones’ essay “Levels of Racism”)
  61. Substance use: Use of drugs or alcohol, and includes substances such as cigarettes, illicit drugs, prescription drugs, inhalants and solvents; distinguished from a substance use disorder 
  62. Substance use disorder: Persistent use of substances despite substantial harm and adverse consequences
  63. Traditional gender role: Roles that support or promote the gender binary and align with older notions of what is acceptable for women or for men (for example, women as nurturers, stay-at-home wives and mothers, etc.; men as physically aggressive, protectors, financial breadwinners, etc.; in healthcare, may include assumptions that women are nurses and men are doctors, not vice versa)
  64. Transgender: Person whose gender identity and/or expression is different from the gender they were thought to be at birth; some transgender people may take steps to better align their sex with their gender using hormones and/or surgery, while others may choose not to do so
  65. Toxic stress: See “allostatic load”, above
  66. Undocumented immigrant: Anyone residing in any given country without legal documentation from that country; includes people who enter a country without inspection and permission from the government, and those who enter with a legal visa but that remain after the visa expires (Immigrants Rising, 2021)
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