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Use of Stigmatizing Language in Pediatric Clinician Notes.

Rahul Dadwani1,2, Austin Wesevich3, Hui Zhang4

  • 1Department of Medicine, University of Chicago, Chicago, Illinois.

Hospital Pediatrics
|July 1, 2026
PubMed
Summary

Stigmatizing language appears in over 6% of pediatric medical notes, disproportionately affecting Black children. These disparities are more severe in children with chronic illnesses and increase with age.

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Area of Science:

  • Medical Informatics
  • Health Equity
  • Pediatric Healthcare

Background:

  • Stigmatizing language is present in 8% of medical notes.
  • It disproportionately affects Black patients, potentially impacting care.
  • Previous research has not specifically examined pediatric notes.

Purpose of the Study:

  • To quantify the prevalence of stigmatizing language in pediatric notes.
  • To evaluate racial differences in the use of such language.
  • To explore how race interacts with chronic illness and age.

Main Methods:

  • Cross-sectional analysis of 79,475 pediatric notes (April 2020-February 2022).
  • Identified 11 specific stigmatizing terms after validation.
  • Used mixed-effects logistic regression to assess race-based associations and interaction effects.

Main Results:

  • 6.2% of pediatric notes contained stigmatizing language.
  • Black patients' notes had higher odds of stigma (aOR, 1.35).
  • Disparities were amplified for Black children with chronic illness (aOR, 1.78) and increased with age.

Conclusions:

  • Over 6% of pediatric notes contained stigmatizing language, disproportionately affecting Black patients.
  • Racial disparities in stigmatizing language were most pronounced in those with chronic illness and increased with age.
  • Clinicians should adopt equitable language that addresses social barriers.