Terms Used at All.Can Canada

Ableism:

Ableism is the discrimination or prejudice against those with physical, intellectual, or psychiatric disabilities, which is often grounded in the assumption that people with disabilities must be, or desire to be, ‘fixed’ or healed. According to Access Living, “the world wasn’t built with people with disabilities in mind, and because of that, the world we live in is inherently ‘ableist.’” Ableism can take both macro and micro forms, from questioning someone’s disability to using verbal expressions that paint disability in a negative light (Access Living, “Ableism 101”). 

 

Adverse Childhood Events (ACEs):

Adverse childhood events (ACEs) refer to those taking place within the first eighteen years of life, which are categorized into abuse, neglect, and household challenges. In the CDC-Kaiser ACE Study (1995-1997), the Center for Disease Control found that ACEs can have lasting effects into adulthood, including physical health factors (injuries, HIV and other STIs, unintended pregnancy, cancer, diabetes, addiction), mental wellness (depression, anxiety, suicidal ideation, PTSD), and socioeconomic factors (education, occupation, income). Challenges faced by structurally marginalized groups can increase the possibility of ACEs caused by systemic oppression, discrimination, parents with addiction, domestic violence, and lack of education.

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Allied Health Professional:

Regulated health professionals who are not nurses or physicians. The allied health workforce provides a range of preventative, diagnostic, technical and therapeutic health-care and clinical support services across the lifespan and care continuum (British Columbia Health Careers).

 

Caregiver:

“Caregivers provide support to people with physical, intellectual, or developmental disabilities, medical conditions, mental illness, or needs related to aging. Caregivers are family, friends and other natural supports (like neighbours or chosen family) who provide care because of a relationship, not as a job or career” (Canadian Centre for Caregiving Excellence). This is separate from a care provider, which “include paid support professionals such as direct support professionals, personal support workers and respite workers” (Canadian Centre for Caregiving Excellence).

 

Care Pathway:

A complex intervention for the mutual decision-making and organisation of care processes for a well-defined group of patients during a well-defined period. The aim of a care pathway is to enhance the quality of care across the continuum by improving risk-adjusted patient outcomes, promoting patient safety, increasing

patient satisfaction, and optimizing the use of resources (Guus Schrijvers et al., “The Care Pathway,” 2012).

 

Clinical Practice Guidelines:

“Clinical guidelines (or “clinical practice guidelines”) are statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options. They have the potential to reduce unwarranted practice variation, enhance translation of research into practice, and improve healthcare quality and safety, if developed and implemented according to international standards. They can be used to provide best practice recommendations for the treatment and care of people by health professionals, to develop standards to assess the clinical practice of individual health professionals and healthcare organizations, to help educate and train health professionals and to help patients make informed decisions” (D. Panteli et al., “Clinical Practice Guidelines as a quality strategy,” 2019).

 

Communitarianism/Communitarian Knowledge:

Communitarianism is the philosophical understanding that human identities are partially shaped through social relations, and belonging to various constitutive communities, which impact our social and moral worldviews and reflect individual obligations to the community (Stanford). A term introduced to the ACC Team by Dr Evan Taylor (Co-Founder, Queering Cancer), who discussed the role of communitarian knowledge in patient communities in their doctoral dissertation, communitarian knowledge refers to knowledge shared among a specific group (such as LGBTQIA+ or racialized individuals) about their experiences in local healthcare, including their experiences of feeling either safe and listened to, or being discriminated against and/or invalidated. This knowledge can determine which healthcare providers members are preferred in certain communities and even has the potential to reduce the likelihood of patients receiving certain care if the only options for that care are known to be unsafe (All.Can Canada).

 

Community Health Centres (CHCs):

From the Canadian Association of Community Health Centres: “In contrast to solo practitioner models, CHCs offer high-quality primary care through a collaborative team approach. Social workers, family physicians, nurse practitioners, nurses, dietitians, chiropodists, dental hygienists, therapists and other clinicians provide services in a team environment, based on patient needs.CHCs integrate team-based primary care with health promotion programs, illness prevention programs, community health initiatives and social services focused on housing food security and other inputs for health, [which are reflective of the regions they serve]. This reduces silos and makes services more accessible. [...] CHCs engage members of the community in helping to identify priorities and strategies for services. This includes community needs assessments; client surveys; community advisory groups; and in many instances, a volunteer Board of Directors comprised of community members” (Canadian Association of Community Health Centres, “About Community Health Centres”).
 

Cultural Competency:

In the context of healthcare, cultural competence refers to the ability of organizations and providers to deliver healthcare services that effectively meet patients’ cultural, social, and linguistic needs. Georgetown University’s Health Policy Institute states that “a culturally competent health care system can help improve health outcomes and quality of care and can contribute to the elimination of racial and ethnic health disparities.” Cultural competency is a process of ongoing learning that is never completed. Cultural competency is applicable when giving care to any group of individuals that might have different experiences with accessing care or perceptions of their healthcare system, though the practice has been most vocally advocated for by the Black community. The four components of cultural competency in patient care are awareness (of a patient's cultural norms), knowledge (of how a patient’s culture may impact their understanding of their illnesses or care), attitude (effective communication with patients based on their cultural attitudes), and skills (the continued development of cultural competency) (Trusted Health, Black History Month: Cultural Competency in Healthcare). 

 

Cultural Humility:

As per the First Nations Health Authority, cultural humility is “a process of self-reflectio​n to understand personal and systemic biases and to develop and maintain respectful processes and relationships based on mutual trust. Cultural humility involves humbly acknowledging oneself as a learner when it comes to understanding another’s experience.” (First Nations Health Authority, “Creating a Climate for Change”).

 

Cultural Safety:

The First Nations Health Authority defines cultural safety as “an outcome based on respectful engagement that recognizes and strives to address power imbalances inherent in the health care system. It results in an environment free of racism and discrimination, where people feel safe when receiving health care” (First Nations Health Authority, “Creating a Climate for Change”).

 

Data Disaggregation:

Disaggregated data has been extrapolated from aggregated data before being divided into smaller information units. Aggregated data is data from two or more sources that has been combined into one whole. Disaggregated data makes it possible to highlight issues that pertain to specific groups, identify vulnerable groups, or establish the scope of particular issues. Disaggregation can be performed through intersections such as gender, race, income, language, age, sexuality and gender orientation, and geographical location (National Collaborating Centre for Aboriginal Health).

 

Determinants of Health:

The broad range of personal, social, economic and environmental factors that determine individual and population health. The main determinants of health include: income and social status; employment and working conditions; education and literacy; childhood experiences; physical environments; social supports and coping skills; healthy behaviours; access to health services; biology and genetic endowment; gender; culture; race / racism (Government of Canada, “Social determinants of health and health inequalities,” 2024).

 

Diagnosis:

The time from when an individual first tries to contact or interacts with a healthcare provider over a suspicion of cancer to the time a confirmed diagnosis is made or cancer is ruled out (All.Can Canada, “Optimizing Diagnosis in Canadian Cancer Care”).

 

Digital Inequity: 

The increased use of telemedicine  across Canada, while largely improving the accessibility of care for those requiring it due to geography or other factors, has also resulted in disparities in access, knowledge, and ability to use digital tools and technology, including inequities in access to the infrastructure needed to use technology (e.g. electricity, connectivity).  These inequities primarily affect the elderly, minority communities, lower-income individuals, and people who are housing insecure (Digital Inclusion, “What is Digital Inequity?”).

 

Disabled/disability:

“‘Disability’ and ‘disabled’ generally describe functional limitations that affect one or more of the major life activities, including walking, lifting, learning and breathing” (National Center on Disability and Journalism, “Disabled/disability”). Keep in mind that people who have disabilities have differing experiences and relationships to disability. Accordingly, preference is mixed between person-first language (“person with a disability”) over identity-first language (“disabled person”). When unsure, it is generally more accepted to use person-first language.

 

Diversity:

“Diversity includes all the ways in which individuals and groups of individuals differ. The term simply describes the presence of individuals from various identities, backgrounds, perspectives, and values” (Whiteness at Work “Words Matter” Glossary).

 

Early Diagnosis:

“Early detection of cancer greatly increases the chances for successful treatment. The [two] components of early detection of cancer are early diagnosis (or downstaging) and screening. Early diagnosis focuses on detecting symptomatic patients as early as possible, while screening consists of testing healthy individuals to identify those having cancers before any symptoms appear” (World Health Organization, “Cancer- Screening and Early Detection,” 2010).

 

Environmental Determinants of Health:

The ways in which environmental factors impact the health of a population and the healthcare received by said population. Examples can include environmental pollutants being related to heart diseases, respiratory diseases, and some types of cancer (United States Office of Disease Prevention and Health Promotion, “Environmental Health”). The World Health Organization cites 24% of worldwide deaths in 2016 (13.7 million) as environment-related. These can include factors such as water and sanitation, air pollution, increasing heat, severe weather conditions, agricultural practices, radiation, and chemical exposure. (World Health Organization, “Estimating environmental health impacts”). 

 

Equity:

“Equity is the fair and just treatment of all people, demonstrated through the

acknowledgment that systemically, individuals have vastly different access to opportunity and thus need additional resources to be successful. It also includes the intentional design and execution of fair policies, processes, trainings, systems, and structures” (Whiteness at Work “Words Matter” Glossary).

 

Ethnicity:

“Ethnicity refers to groups that share a common identity-based ancestry, history, religion, traditions, language, or culture generally associated with a specific geographic region. Ethnicity is generally used in reference to a person’s cultural attributes, not their physical appearance. Two people can share the same race but have different ethnicities. For example, among two white individuals one might identify as South African and another as Italian-American or among two Black individuals one may identify as African-American and another Haitian” (Whiteness at Work “Race and Ethnicity Glossary”).

 

First Nations:

First Nations are “the Indigenous Peoples of Canada who live predominantly south of the Arctic;” the term can refer to both status and non-status Indigenous Peoples, and bands or nations (Indigenous Peoples Atlas of Canada). The term does not encompass Métis or Inuit Peoples. There are over 630 First Nations communities in Canada, which represent more than 50 Nations and 50 Indigenous languages (Government of Canada, “First Nations”).

 

Health Equity:

From the National Collaborating Centre for Determinants of Health (NCCDH): “Health equity means that all people (individuals, groups and communities) have fair access to, and can act on, opportunities to reach their full health potential and are not disadvantaged by social, economic and environmental conditions, including socially constructed factors such as race, gender, sexuality, religion and social status. Achieving health equity requires acknowledging  that some people have unequal starting places,  and different strategies and resources are needed to correct the imbalance and make health possible. Health equity is achieved when disparities in health status between groups due to social and structural factors are reduced or eliminated” (Whitehead, M., Dahlgren, G. and Southern Jamaica Plain Health Center, Racial Reconciliation & Healing Project quoted in National Collaborating Centre for Determinants of Health, “Let’s Talk Health Equity,” 2023 2).

 

Health Inequities:

“Health inequities are avoidable health inequalities, and they can also be referred to as socially constructed inequalities. All health inequities share core features: they are the result of societal choices that are systematic, avoidable, modifiable and unfair” (Kawachi et al., Marmot, and Agence de la santé et des services sociaux de Montréal; Whitehead quoted in National Collaborating Centre for Determinants of Health, “Let’s Talk Health Equity,” 2023 3). Health inequity is different than health inequality: while health inequality “refer[s] to measurable differences in health outcomes between groups, communities, and populations,” health inequity refers to the unfair distribution of the social and structural conditions underlying good health, such as imbalances of power and social, economic, and environmental factors (Kawachi et al. quoted in NCCDH 3).

Health Literacy: The World Health Organization (WHO) defines health literacy as “the ability of individuals to ‘gain access to, understand and use information in ways which promote and maintain good health,’ for themselves, their families, and their communities” (Nutbeam quoted in WHO, “The mandate for health literacy”). The WHO notes that increased health literacy in populations yields wider social benefits, such as the mobilization of communities to address social, economic, and environmental determinants of health. The understanding that these determinants of health need to be addressed have prompted growing calls for health systems and governments to present information that is clear, appropriate, accessible, and accurate for diverse audiences (WHO, “The mandate for health literacy”) 

 

Inclusion:

“Inclusion enables people with different social identities to lead and succeed in different, self-determined, and authentic ways. It involves creating environments where [people are]  welcomed, respected, and supported” (Whiteness at Work “Words Matter” Glossary).

 

Indigenous:

“Indigenous is an umbrella term for First Nations (status and non-status), Métis and Inuit. ‘Indigenous refers to all of these groups, either collectively or separately, and is the term used in international contexts” (Queen’s University Office of Indigenous Initiatives, “Terminology Guide”).

 

Inefficiency:

A common understanding of healthcare inefficiency refers to medical overuse, or ‘“care in the absence of a clear medical basis for use or when the benefit of therapy does not outweigh risks’” (Morgan et al. quoted in All.Can “Towards Sustainable Cancer Care” 2017 32). We can also consider healthcare inefficiency to be “the allocation of resources to anything that does not focus on what matters to patients” (All.Can Canada, “Consolidated Report on Waste and Inefficiency in Canadian Cancer Care” 2017 5).

 

Integrative Health:

“Integrative health brings conventional and complementary approaches together in a coordinated way. Integrative health also emphasizes multimodal interventions, which are two or more interventions such as conventional health care approaches (like medication, physical rehabilitation, psychotherapy), and complementary health approaches (like acupuncture, yoga, and probiotics) in various combinations, with an emphasis on treating the whole person rather than, for example, one organ system. Integrative health aims for well-coordinated care among different providers and institutions by bringing conventional and complementary approaches together to care for the whole person” (National Center for Complementary and Integrative Health).

 

Intergenerational Trauma:

Intergenerational trauma, also known as secondary traumatization, refers to trauma that is passed down through a family. This concept is most frequently associated with historical trauma, or trauma that “describes intergenerational trauma that stems from oppression related to culture, race, or ethnicity” (Healthline, “Understanding Intergenerational Trauma and Its Effects”). While this can be experienced by people with a variety of cultural, racial, and ethnic backgrounds, in Canada a primary source of intergenerational trauma is from the Residential School system, which performed cultural genocide by separating Indigenous children from their families and communities. Many left the Residential School system traumatised, and “returned to their home communities without the knowledge, skills or tools to cope in either world” (The Canadian Encyclopedia, “Intergenerational Trauma and Residential Schools”). This is an example of historical trauma, which has been passed down through the generations since Residential Schools were in operation.

 

Intersectionality:

“Intersectionality describes the interconnected and interdependent nature of social categorizations such as race, class, and gender. It acknowledges how a person’s social and political identities combine to create unique experiences of discrimination and oppression” (Work 180 “Diversity and Inclusion | Glossary of Key Terms and Acronyms”).

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Social Justice:

“Social justice is the belief that everyone deserves equal rights, opportunities, and treatment regardless of their race, economic status, sexuality, or gender identity. Social justice must be considered in the context of historical systemic inequities in [global] social, economic, and political systems, and the long-term generational consequences of systemic injustice” (National Association of Social Workers, “Social Justice”). 

 

Learned Helplessness:

Quoted in Aboriginal Healing Foundation’s “Historic Trauma and Aboriginal Healing”, Christopher Peterson and Martin Seligman define learned helplessness as behaviour that “occurs when an individual (or a group) perceives that his or her behaviour cannot control events and that no action on his or her part will control outcomes in the future,” resulting in situations wherein, “even is a person finds herself or himself in a situation where she or he could act and react to outside pressures, she or he fails to make any attempt to do so.” This phenomenon tends to imprint itself onto the psychology of those faced with inescapable situations, such as colonial subjugation and/or cultural genocide (Aboriginal Healing Foundation “Historic Trauma and Aboriginal Healing” 66). Real-world health implications include the forced learned helplessness of some Indigenous populations, who – due to institutionalisation in systems like residential schools and prisons - lose skills like growing, harvesting, cooking, and nutrition.

 

Learning Health Systems:

Learning health systems are those that continuously gather data on their practice, such as patient-reported outcome or experience measures (PROMs and PREMs, respectively) and implement the findings from this data back into their practice, creating layered loops of continuous improvement (Health Research BC).

 

Neurodiversity:

From the National Center on Disability and Journalism (NCDJ): “the range of differences in individual brain function and behavioral traits, regarded as part of the normal variation in the human population (used especially in the context of autism spectrum disorders)” (Oxford English Dictionary quoted in NCDJ “Neurodiversity”). Advocacy surrounding neurodiversity argues against the concept of there being one ‘healthy’ or ‘normal’ type of neurocognitive function. Neurotypical, according to NCDJ, “refers to a person who is considered part of the normal variation in the human population” (NCDJ, “Neurodiversity”). It is important to remember that not all autism advocates embrace the neurodiverse terminology. 

 

Patient Navigator:

A patient navigator, or a nurse navigator, “acts as a link between you and the healthcare system. They may coordinate services and address a variety of physical, social, emotional and practical needs” (Canadian Cancer Society, “Nurse Navigator”). The navigator is assigned to the patient and is available and accessible throughout the diagnosis process from beginning to end (or possibly as part of the broader care continuum). They are further responsible for effective patient-to-provider communication and information sharing; clinical patient navigation; connecting the patient with other needed supports, including psychosocial supports; and consistent, accurate, and timely provider-to-provider communication (All.Can Canada).

 

Patient-Reported Measures:

Patient-reported measures (PRMs) are an example of patient-centred care by offering a more holistic view of patient experience and incorporating these patient experiences, and patient perspectives, into healthcare decision-making. Patient-reported measures are “standardized quantitative data collection instruments used to obtain reports from patients about their health status or experiences receiving care services” (Miller et al., “Patient-Centered Care and Patient Reported Measures,” 2014). The broad categories of patient-reported measures are patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs). PROMs are oriented towards experiential domains of health, such as treatment side effects, illness symptoms, and quality of life. Depending on whether PROMs are generic or condition-specific, they can be used for cross-condition comparisons or to detect changes in health over time. PROMs are primarily used in research contexts, such as clinical trials, or as clinical management tools. PREMs, or patient-reported experience measures, evaluate the patients’ experience receiving care, such as provider communication, accessibility of care, humanity of care (respect, empathy), care coordination, and patient involvement in care decisions. These are primarily used in the context of service improvement (Miller et al.).

 

Patient Self-Advocacy:

The National Coalition for Cancer Survivorship (NCCS) defines patient self-advocacy as the process of “arm[ing oneself] with the tools and skills necessary to feel comfortable about asserting yourself and communicating clearly about your cancer care needs,” therefore “taking responsibility and assuming some control of your life circumstances with cancer” (NCCS, “Self-Advocacy: A Cancer Survivor’s Handbook”). Patient self-advocacy is an imperative in healthcare systems that are overburdened and inflexible. This is problematic given the high degree of agency required that not all patients possess at all times for a variety of reasons. 

 

People Experiencing Homelessness/Housing Insecurity:

The change from “homeless” to “people experiencing homelessness” or “people experiencing housing insecurity” foregrounds personhood, while indicating that being unhoused is a transient state and not a defining quality of a person. It is important to recognize that people in racialized groups, people experiencing addictions, refugees, asylum claimings and immigrants, as well as2SLGBTQI+ people, including youth from this community, experience homelessness at higher rates (Government of Canada: Homelessness Data Snapshot: Homelessness among racialized populations).

 

Psychosocial Support:

Psychosocial support “involves care related to a person’s state of mental, emotional, social, cultural, and spiritual well-being.” As psychosocial issues can manifest as physical symptoms, health care professionals should be aware of the physiological symptoms that may be an indication of depression, anxiety, or other holistic wellness needs (Health Quality Ontario, “Psychosocial Aspects of Care”).

 

Quintuple Aim:

The Quintuple Aim is an extension of the Triple Aim for Healthcare Improvement proposed by Don Berwick, John Whittington, and Tom Nolan in 2008, which consisted of the threefold goals of patient experience, population health, and cost reduction. In 2014, the Triple Aim was expanded to include care team wellbeing, thus becoming the Quadruple Aim. In 2022, arguments began to emerge for the addition of equity as a primary goal of healthcare, becoming the quintuple aim, or a five-pointed star to guide healthcare. In “On the Quintuple Aim,” Kedar Mate argues that the pursuit of health equity is fundamental to the other aims and that a lack of focus on equity is why the quadruple aim has not been achieved (Mate, “On the Quintuple Aim,” The Institute for Healthcare Improvement).

 

Race:

“Race is a human-invented concept used to describe and categorize people into various social groups based on physical characteristics like skin color and physical features. Although race has no genetic or scientific basis, the concept of race is important and consequential. This socially constructed idea has been used to give or deny power and divide people based on the social, economic and political needs of a society at a given period of time” (Whiteness at Work “Race and Ethnicity Glossary”).

 

Racism:

Racism is the relegation of people of color to inferior status and treatment based on unfounded beliefs about innate inferiority, as well as unjust treatment and oppression of people of color, whether intended or not. Racism is not always conscious, intentional, or explicit—often it is systemic and structural. Systemic and structural racism are forms of racism that are pervasively and deeply embedded in and throughout systems, laws, written or unwritten policies, entrenched practices, and established beliefs and attitudes that produce, condone, and perpetuate widespread unfair treatment of people of color. They reflect both ongoing and historical injustices (Braveman et al., “Systemic and Structural Racism,” Health Affairs, para. 2).

 

Self-Managed Care:

Self-managed care refers to patients taking an active role in their care, in terms of defining their needs and determining how these needs are met. Cancer Care Ontario defines cancer self-management as “what a person does, in collaboration with their healthcare team, to manage the symptoms, medical regimens, treatment side-effects, physical changes, psychosocial consequences, and lifestyle changes following a cancer diagnosis and/or treatment,” and self-management support as involving “a collaborative relationship between patients and healthcare providers to identify the need for education and supportive interventions […] the aim of self-management support is to enhance patient skills and confidence in managing their health and well-being” (“Self-Management in Cancer, Quality Standards,” Cancer Care Ontario 4).

 

Social Determinants of Health (SDH):

The World Health Organization (WHO) describes social determinants of health (SDH) as the “non-medical factors that influence health outcomes,” the social forces that shape our lives, such as political systems, social policies, and economic policies. SDHs can affect individuals in either positive or negative ways. SDH can include education, working conditions and job security, food insecurity, income, housing, social inclusion, and access to affordable health care. Analysis of SDH has demonstrated that lower socioeconomic positionality is correlated with poorer health outcomes, with social determinants accounting for 30-55% of health outcomes” (WHO, “Social Determinants of Health”).
 

Structural Determinants of Health:

The National Collaborating Centre for the Determinants of Health (NCCPH) identifies structural determinants of health as “processes that create inequities in wealth, power and resources,” including “political, cultural, economic and social structures; natural environment, land and climate change; and history and legacy, ongoing colonialism and systemic racism” (Commission of the Pan American Health Organization on the Equity and Health Inequalities in the Americas quoted in National Collaborating Centre for Determinants of Health, “Let’s Talk Health Equity,” 2023 4). The structural determinants of health stem from the same structures which dictate the conditions of daily life, or the social determinants of health (above).

 

Structurally Underserved Populations:

Health and social underservice refers to the “increased likelihood that individuals will, because of their membership in a certain population, experience difficulties in obtaining needed care; receive less, or a lower standard of care; experience difficulties in treatment by health personnel; receive treatment that does not adequately recognize their needs; or, be less satisfied with health care services” (Government of Canada, “Certain Circumstances Issues in Equity and Responsiveness in Access to Health Care in Canada”). Aside from underserved populations, there are also underserved areas; these are geographic regions that face inadequate distribution and supply of health services and personnel, or access to certain types of care that are only available in larger urban areas (Government of Canada, “Certain Circumstances Issues in Equity and Responsiveness in Access to Health Care in Canada”).

 

Team-Based Care:

Team-based care are models of healthcare delivery where many health professionals work together to support a patient’s needs. Types of team-based care include interprofessional teams, which the Toronto Western Family Health Team describes as “a team approach that brings together primary care providers (family doctors, nurse practitioners and medical residents) with other health care providers to give you the best possible care;” this can include a team of interprofessional healthcare providers, including pharmacists, occupational therapists, physiotherapists, registered dieticians, social workers, registered nurses, respiratory therapists (Toronto Western Family Health Team, “Interprofessional Healthcare Providers”). 

 

Transphobia/transmisia:

According to TransActual UK, “the core value underlying all transphobia is a rejection of trans identity and a refusal to acknowledge that it could possibly be real or valid,” with the ultimate outcome of “the erasure of trans people as a viable class of people.” Transphobia, or transmisia, can include many behaviours, including the misrepresentation/misgendering of trans people (see below for more information on misgendering), abuse and discrimination, advocating for the removal of trans rights, and excluding trans people from conversations about their health (from TransActual UK, “Transphobia”). Trans individuals are at high risk of their health concerns being invalidated, being denied or offered inappropriate gender-affirming care, and lack of insurance coverage for gender-affirming care. 

 

Trauma-Informed Care (TIC):

EQUIP Health Care writes that trauma-informed care “aims to create safety for people seeking care by understanding the effects of trauma, and its close links to health and behaviour. Unlike trauma-specific care, it is not about eliciting or treating people’s trauma histories but about creating safe spaces that limit the potential for further harm for all people” (EQUIP Health Care, “Trauma- and Violence-Informed Care,” 1).

 

Trauma- and Violence-Informed Care (TVIC):

Trauma- and Violence-Informed Care “expands the concept of TIC to account for the intersecting impacts of systemic and interpersonal violence and structural inequities on a person’s life. This shift is important as it emphasizes both historical and ongoing violence and their traumatic impacts and focuses on a person’s experiences of past and current violence so problems are seen as residing in both their psychological state, and social circumstances” (EQUIP Health Care, “Trauma- and Violence-Informed Care,” 1).

See also: adverse childhood experiences and intergenerational trauma (above). 

 

Two-Eyed Seeing:

A term created by the Mi’kmaq Elder Albert Marshall, which refers to “learning to see from one eye with the strengths of Indigenous ways of knowing and from the other eye with the strengths of Western ways of knowing and to using both of these eyes together” (Marshall M., Marshall A., Bartlett C., “Two-eyed seeing in medicine”).

 

Two-Spirit:

Two-Spirit is the term for members of Indigenous groups who are male, female, or intersex and combine traits from both genders and unique aspects of Two-Spiritedness (Indian Health Service, “Two-Spirit”).

 

Value-Based Healthcare:

According to the International Consortium for Health Outcomes Measurement (ICHOM), “value-based healthcare, or VBHC, is health care that delivers the best possible outcomes to patients for the lowest possible cost,” with value being defined as “the outcomes that patients experience relative to the cost of delivering those outcomes.” A value-based healthcare system would reduce inefficiency and improve quality, and also privilege healthcare providers that deliver superior patient outcomes; suppliers would market their products on value; and patients would be able to choose providers based on informed expectations of costs and outcomes (ICHOM, “What is Value-Based Healthcare?”).

 

Worldview:

“A collection of attitudes, values, stories and expectations about the world around us, which inform our every thought and action. Worldview is expressed in ethics, religion, philosophy, scientific beliefs and so on (Sire quoted in National Library of Medicine, “Worldviews”). 

 

2SLGBTQI+:

“The acronym used by the Government of Canada to refer to the Canadian community. 2S: at the front, recognizes Two-Spirit people as the first 2SLGBTQI+ communities; L: Lesbian; G: Gay; B: Bisexual; T: Transgender; Q: Queer; I: Intersex, considers sex characteristics beyond sexual orientation, gender identity and gender expression; +: is inclusive of people who identify as part of sexual and gender diverse communities, who use additional terminologies” (Government of Canada, “2SLGBTQI+ terminology).

 

Extended Glossary of Equity, Inclusion, and Social Justice Terms:

 

AAPI:

“This term stands for Asian American Pacific Islanders, which consists of over 50 ethnic groups that speak over 100 distinct languages, with ancestries connected to Japan, the Philippines, Vietnam, Korea, India, Sri Lanka, and Hawaii, among others. According to the 2020 census, 24 million people identified as Asian, and nearly 1.6 million individuals identified as Native Hawaiian and Pacific Islander” (Whiteness at Work “Race and Ethnicity Glossary”).

 

Addict/Addiction:

Addiction “is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences” (American Academy of Pain Medicine quoted in National Center on Disability and Journalism (NCDJ), “Addict/addiction”). Alcoholism is often conflated with alcohol addiction. The NCDJ notes that some prefer the term “substance abuse disorder” to “addiction” and that the term “recovery” should be used in reference to someone trying to overcome an addiction.

 

Antisemitism:

“Antisemitism involves negative beliefs, deliberate targeting, and discrimination of Jews and Jewish culture, religion, practices, values, beliefs, and systems. Antisemitism is a form of racialization that propagates financial, social, and political stereotypes about Jewish people. While antisemitism is a core tenet of white nationalism, it predates white nationalism and is also intertwined with the discrimination of non-Christians across the world” (Whiteness at Work “Race and Ethnicity Glossary”; from The Southern Poverty Law Center “Antisemitism”, Boston University “Antisemitism”).

 

Belonging:

“An individual’s sense of acceptance and comfort within a particular space as a valued member of that organization or community. Includes trust in others within the organization or community. It generates feelings of security and support when there is a sense of acceptance, inclusion, and identity for a member of a particular group or place” (Whiteness at Work “Words Matter” Glossary).

 

BIPOC:

“This term stands for Black, Indigenous, and People of Color. BIPOC centers and leads with Black and Indigenous identities to address anti-Black racism and the erasure of Indigenous communities. This term uplifts the collective power of all people of color, especially Black and Indigenous people, and is also committed to advancing racial justice and dismantling White Supremacy” (Whiteness at Work “Race and Ethnicity Glossary”).

 

Colonialism:

“Colonialism is a practice of political, economic, and social domination, which involves the subjugation of one people [by] another. The term colony comes from the Latin word colonus, meaning farmer. This root reminds us that the practice of colonialism usually involves the transfer of population to a new territory, where the arrivals lived as permanent settlers while maintaining political allegiance to their country of origin” (Whiteness at Work “Race and Ethnicity Glossary”).

 

Colonization:

“Colonization is the enactment or practice of colonialism. It is the process by which colonialism unfolds and is maintained. There are several key pillars through which colonization is enacted including land occupation, violence, ownership and extraction of natural resources, exploitation of people, and creation of hierarchies among people by weaponizing racial, linguistic, ethnic, religious, cultural, and caste-based differences” (Whiteness at Work “Race and Ethnicity Glossary”).

 

Diversity, equity, and inclusion acronym list:

• “DEI: Diversity, equity, and inclusion

• DEIB: Diversity, equity, inclusion, and belonging

• JEDI: Justice, equity, diversity, and inclusion

• DEIBJ: Diversity, equity, inclusion, belonging, and justice

• DIB: Diversity, inclusion, and belonging

• D&I: Diversity and inclusion” (Whiteness at Work “Words Matter” Glossary).

 

Gender Pronouns:

“Gender pronouns are the words an individual would like others to use when talking to or about them. These include common pronouns like ‘he, him, his’ and ‘she, her, hers’, while people who are transgender or gender nonconforming may choose to use ‘they, them, theirs’.

These declarations might not seem important to a person with a singular and visible gender identity, but not everybody has this privilege. It’s still your job to remember and respect someone’s gender pronouns. If you mistakenly use incorrect pronouns, of course apologize, but don’t dwell on the mistake. It’s unfair to make the person feel awkward and responsible for comforting you” (Work 180 “Diversity and Inclusion | Glossary of Key Terms and Acronyms”).

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Gender Spectrum:

“The gender spectrum understands that gender is not binary (female/male), but rather a spectrum of biological, mental, and emotional traits existing along a continuum. When using the terms sex and gender, it’s important to note:

• Sex (female/male/intersex) describes biological traits.

• Gender (woman, man, transgender, nonbinary) reflects how a person lives within society.

• Cisgender describes a person whose gender identity aligns with the sex they were assigned at birth.

• Transgender describes a person whose gender identity does not align with the sex they were assigned at birth.

• Non-binary is an umbrella for various gender nonconforming identities most often used by those who do not strictly identify as ‘male’ or ‘female’.

• Heterosexism or Heteronormativity describes biases in favor of heterosexuality. It includes the assumption cisgender and heterosexual relationships are the norm and therefore superior” (Work 180 “Diversity and Inclusion | Glossary of Key Terms and Acronyms”).

 

Imperialism:

“Imperialism is the process of extending and expanding power, control, domination, and influence through military force, colonization, and humanitarian aid. Through imperialism, few dominant countries exert social, economic, and political control over other countries. A necessary characteristic of imperialism is inequity” (Whiteness at Work “Race and Ethnicity Glossary”).

 

Islamophobia:

“Islamophobia is a form of religious bigotry and targeting of Muslims and people who are perceived to be Muslim on the basis of their religion, religious practices, beliefs, and ideologies. Islamophobia often plays out in tandem with xenophobia which contributes to an anti-immigrant sentiment. Jews for Racial and Economic Justice note that ‘antisemitism and Islamophobia are not only entangled, but deeply rooted in the same systems of white supremacy and Christian hegemony that have also driven ongoing genocide against indigenous people, and bigotry toward non-Christians from other parts of the world’” (Whiteness at Work “Race and Ethnicity Glossary”).

 

MENA:

This term refers to the geographical region of the Middle East and North Africa, which is composed of 22 nations— Algeria, Bahrain, Egypt, Iran, Iraq, Palestine, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Qatar, Saudi Arabia, Tunisia, United Arab Emirates, Yemen, Mauritania, and the Comoros Islands. (Whiteness at Work “Race and Ethnicity Glossary”).

 

Microaggression:

“Microaggressions are seemingly innocuous and well-intentioned comments that are indirect expressions of racism, sexism, ageism, or ableism. The recipient of these comments is often left feeling vaguely insulted, despite the words sounding complimentary or curious. Examples include:

• ‘Your name is so hard to pronounce, do you have a nickname?’

• ‘You have a mental illness? But you seem so normal’

• ‘You should smile more’”

(Work 180 “Diversity and Inclusion | Glossary of Key Terms and Acronyms”).

 

Mixed-Race:

“Describes the way people describe racial identity as ‘half-this’ or ‘quarter-that’ limiting identities to a total of one. This method of measuring ethnicity as fractions originated when the ‘interbreeding of different racial types’ was outlawed” (Work 180 “Diversity and Inclusion | Glossary of Key Terms and Acronyms”).

 

Multiracial:

“The term multiracial offers another way to describe those who identify two or more races for themselves. The term has a far less negative history behind it, however it’s impossible to create universal truths for everybody as each experience is unique. The best answer is always to first question whether a term is necessary at all to the context and if it is, simply ask someone what they prefer” (Work 180 “Diversity and Inclusion | Glossary of Key Terms and Acronyms”).

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Native American:

“This term came into use in the 1960s, referring to the over 2,000 tribal groups and their descendants native to the land of what became the United States and its territories through European colonization. Native American is not a monolithic term; there are numerous languages, cultures, and tribal membership systems within Native American communities” (Whiteness at Work “Race and Ethnicity Glossary”).

 

POC:

“This term stands for People of Color. This term became more frequently used in the late 1970s as a unifying and more inclusive framework to refer to all racial groups that are not White and to address the racial inequities they experienced. While POC can be a useful term, it often conflates and equates the experiences of many different racial and ethnic groups, each of which has distinct and specific experiences with race” (Whiteness at Work “Race and Ethnicity Glossary”).

 

Racial Equity:

“Racial equity is when race does not determine or predict the distribution of resources, opportunities, and burdens. Race equity must be addressed at the root causes and not just its manifestations. In an organization, it is the active process of identifying and eliminating racism and racial bias by changing systems, structures, policies, practices, and attitudes so that power and resources are redistributed and shared equitably” (Whiteness at Work “Words Matter” Glossary).

 

Terms to Avoid:

Work 180 keeps an updated list of terms that are considered outdated or offensive. 

 

Tokenism: “Tokenism describes the superficial or symbolic effort to recruit or include a small number of people from underrepresented groups to just appear diverse and inclusive. The intent is important in the definition of tokenism. The efforts could only be to prevent criticism and give the appearance of fair treatment (tokenism) or there could be a genuine intention to improve diversity, but they have only just begun (not tokenism)” (Work 180 “Diversity and Inclusion | Glossary of Key Terms and Acronyms”).

 

Unconscious Bias:

“Unconscious biases are underlying attitudes and stereotypes about various social and identity groups stemming from the tendency to organize social worlds by categorizing. These biases affect how people understand and engage with other people or groups. For example, affinity bias is the tendency of connecting better with others who share similar interests, experiences, and backgrounds. Confirmation bias is the partiality to interpret information and draw conclusions favoring our existing beliefs rather than on unbiased merit” (Work 180 “Diversity and Inclusion | Glossary of Key Terms and Acronyms”).

 

Underrepresented Groups:

“Shifting away from terms like ‘marginalized’ and ‘minority’, the term ‘underrepresented group’ better describes a subset of a population with a smaller percentage than the general population. For instance, whereas women make up roughly 50% of the global population, less than a third (29.3%) of those employed in STEM fields are women – making them an underrepresented group in this industry” (Work 180 “Diversity and Inclusion | Glossary of Key Terms and Acronyms”).

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White:

“The top classification of the socially constructed and structurally reinforced racial categories. Those both perceived and categorized as white are granted social, cultural, institutional, psychological and material resources. Most often white people are of European Descent” (Whiteness at Work “Race and Ethnicity Glossary”).

 

White Dominant Culture/Norms:

“The National Museum of African American History and Culture describes “how white people and their practices, beliefs, and culture have been normalized over time and are now considered standard in the United States. As a result, all Americans have all adopted various aspects of white culture, including People of Color.” This definition is predicated on an understanding of whiteness and white racial identity as the way white people, their customs, culture, and beliefs operate as the standard by which all other groups are compared. White dominant culture is broadly enacted across society and within the context of social entities such as organizations” (Whiteness at Work “Words Matter” Glossary).

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