The Washington Post recently reported that the US Centers for Disease Control and Prevention (CDC) staff were advised to avoid using 7 “banned words” in official budget documents. Although the source of the ban is uncertain, such censorship would carry the risk of jeopardizing the work of US government-funded healthcare practitioners and professional organizations, according to an article published in The Annals of Internal Medicine.

Kenneth G. Castro, MD, of Emory University, Atlanta, Georgia, and colleagues noted that The Washington Post reported on 7 words to be avoided by the CDC in official budget documents, including “vulnerable,” “entitlement,” “diversity,” “transgender,” “fetus,” “evidence based,” and “science based.”

The authors argue that should the 7 words be banned, it could give rise to at least 7 harmful consequences, or “7 deadly sins,”

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A summary of these consequences is as follows:

  • A break in the CDC’s “Pledge to the American People” to base all public health decisions on the highest quality scientific data
  • Violation of the Plain Writing Act of 2010, which requires federal agencies to improve accountability to the public by promoting clear communication
  • Self-censorship resulting from political messages that could limit implementation of community services
  • Lack of integrity in the practice of public health epidemiology
  • Curtailment of key actions through the world aimed at ending epidemics of HIV, malaria, tuberculosis, hepatitis, and other diseases
  • Similar restrictions in other agencies
  • Curtailment of joint development of evidence-based and science-based guidelines and policy statements

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On December 17, 2017, Brenda Fitzgerald, MD, director of the CDC, stated on her Facebook page that the agency had no “banned words” and will continue to “talk about important public health programs” and “use the best scientific evidence available to improve the health of all Americans.”

The authors commend Dr Fitzgerald for her stance and argue that US citizens, elected government representatives, healthcare practitioners, and professional societies such as the American College of Physicians must remain vigilant to ensure that language is not limited and that the CDC is held to its “Pledge to the American People.”


Castro KG, Evans DP, Del Rio C, Curran JW. Seven deadly sins resulting from the Centers for Disease Control and Prevention’s seven forbidden words [published online January 8, 2018]. Ann Intern Med. doi: 10.7326/M17-3410