Don't walk this talk: Public health discourse that disempowers

How many of us have “targeted low-income audiences,” “served at-risk populations,” or “empowered consumers?” Using critical discourse analysis, this paper examines how public health messages position the people and “communities” with whom we work. Using examples from the field, and from obesity prevention in particular, I demonstrate how some language used in public health discursively disengages communities from creating their own health and reinforces existing marginalizations, particularly by discounting citizen agency and expertise. This paper does not propose “politically correct” speaking, or a list of words to avoid; it surfaces the power relations and values that our language reflects and reinforces. The paper closes with alternative and additional frames for public health, both in use and proposed, that center the margins. For example, describing people as negotiators, actors, or citizens denotes much more power than reducing them to clients, customers, or subjects. Naming forces that marginalize and stigmatize helps denaturalize these states, even if as vague as “people our society marginalizes” instead of “marginalized people.” The talk we walk in public health should cast the public not as (for example) recipients of our services or targets of our interventions, but as powerful actors in individual and community health promotion.