health care providers, we’re always looking for ways to create a more inclusive environment for our patients, a place they know they are welcome. As part of that initiative, we need to look at the language we use to describe our patients.  

At Redwood Health Center, where we treat many patients who have immigrated to the United States, we are not only welcoming people to our center, but to our country. That’s why we are making a transition from using the word “refugee” to using the term “New Americans.” 

The term refugee didn’t feel appropriate when used in clinic to refer to a patient’s background, even if it was with the intent of providing them with culturally sensitive care. Once our patients had resettled in the United States, they were no longer a refugee. This was their new home, and that term only described their journey to get here. With feedback from patients, the community, and trends with nationwide programs, we decided to join the movement of using new inclusive language. We are encouraging other health care professionals to use the new language too as we recognize our newcomer patients.   

The importantance of using New American instead of refugee

Using this new language helps our patients feel welcome in our community and our country. We are recognizing that they are part of our society and that they belong with us.

We are honoring their journey and recognizing what they’ve overcome.  

Unfortunately, the term refugee has also become politically charged. No one chooses to be a refugee, but the term has developed a stigma around what it means. Some people assume that refugees are uneducated, poor or incapable of contributing to the community. These assumptions are so far from the truth but can affect how we see our patients and how we care for them. 

It can also make New Americans feel like they are separate, not part of our community. It can affect their sense of belonging, self-esteem, and potentially be retraumatizing. Using the new inclusive language can help them feel included and feel equal to other members of our community. It doesn’t come with stigma or pre-existing notions. When you use the term New American, you are helping newcomers know that you see them, accept them and know that they are here to be part of our community.  

But it’s also important to recognize how patients may want to be referred to in context of their background. We don’t want to make anyone feel uncomfortable. Some patients want to claim their history as a refugee, who are proud of what they have been through to get here. If a patient asks to be referred to as a refugee, it is always respectful to continue to use that language.  

You can also try using language like newcomer, patient with refugee background, and former refugee as appropriate. 

Response to the language change 

Many New Americans are supportive and becoming more vocal with requests for a change in language, many of whom are established in the community and supporting other newcomers. 

However, some people outside of the New American community have been hesitant to stop using the term refugee. It’s a big change, but words have big power. Language shapes our perception and using the right language is absolutely necessary for developing good relationships with our patients. Fortunately, once we or former refugees explain the reason behind the change, many people understand how important it is. 

The more we use inclusive language, the more we explain it, the more people will get used to hearing it and using it.

We highly encourage our health care providers to make the effort to use inclusive language as it can create a welcoming enviornment and it's a great start to the patient-provider relationship. 

Incorporating the language into your care

U Health has already made modifications throughout EPIC with the inclusive language. A major component of supporting newcomers is through collection of resettlement information, which upgraded on April 16th with its own folder in demographics. The upgrade also displays an identifier, New American, in the storyboard column so care teams are signaled to tap into trauma informed techniques immediately.  This process is created to assist any patient who resettled here under the refugee resettlement umbrella which can include humanitarian parolees, asylees, individuals with special immigrant visas, and survivors of trafficking.

An additional way to incorporate the new language into your practice is to update your dotphrases or smartsets in EPIC. You can also update marketing materials, language in presentations and language you use with trainees.  

The way forward

While many community-based organizations are making the change, government organizations may continue to use the term refugee as a legal description, one that helps guide visa and domestic health screening processes. It’s possible that the term will change in the future, especially as the U.S. continues to welcome newcomers with various backgrounds under the refugee resettlement umbrella.  

Dropping the term refugee is just one small part of the conversation on how to be more welcoming and inclusive of our immigrant communities. This is much larger than just updating historically stigmatizing language with new inclusive language.

There are so many opportunities to make our community, Utah and the U.S. more welcoming to people who create a new home here. But we can start with this change, right now, as a small step forward.