Continual changes in expert knowledge, consumer trends, and technical know-how mean that the publishing industry always faces a wealth of new challenges.
However, at Healthline Media, one ongoing challenge is particularly pertinent to us as copy editors: Striking the balance between search engine optimization (SEO) and our house style.
Healthline Media, who recently became the number one health publisher in the world, has three properties: healthline.com, medicalnewstoday.com, and greatist.com. Each has slightly different objectives and ways of reaching them, but they share a mission, a vision, and a set of core values: to create a stronger, healthier world through empathy, inclusivity, and reliability.
We provide real health information with a human approach to empower people to own their well-being. By cutting through the confusion with straightforward, expert-reviewed, person-first experiences, we hope to be a go-to source of health information for all.
We know that people rely on the internet to answer their health questions. In regions where medical insurance is expensive or a harmful stigma surrounds certain conditions and symptoms, the internet can be a person’s only ally. This motivates us to make our content as informative as a healthcare professional and as empathetic as a friend.
But how do we ensure that our content stands out in a cluttered space?
First, we have to write friendly, accessible content. Then, we need to check several technical tick boxes that allow search engines and health architects alike to discover this content
Both conscious language and SEO are important to our mission and success. Together, these strategies allow us to bring high quality content to those searching for it. However, they can come into conflict.
For example, what happens if a keyword is noninclusive or not empathetic? Do we maximize its use throughout the article to appear higher up the search engine results page (SERP), or do we ignore it on the basis that it doesn’t fit with our brand?
We also have to remember that what people search is outside our control. So, do we ignore search terms that we think demonstrate unconscious bias, or do we produce the content regardless because everyone deserves to know how to improve their health and well-being?
Our pillars of conscious language
Conscious language is by no means a new concept. Over time, we at Healthline Media have been able to develop our own robust approach.
We’ve built three strong pillars that we believe represent our stance on inclusivity: keeping the reader in mind, avoiding assumptions, and challenging stereotypes. But what do each of these mean for our language and tone?
Keeping the reader in mind
We put our readers first, tailoring our perspective to create actionable content for all. For example, every piece of content on medicalnewstoday.com uses a neutral, unbiased, third-person voice. This can facilitate multiple types of reading. For instance, our reader might be a person seeking health information for themselves, their partner, a friend, or even a colleague about whom they are concerned.
We believe that everyone should have access to the information they seek, and that it should be free from assumptions about their identity.
Just as we strive to connect with everyone who turns to us, we also seek to illustrate that there’s no “one-size-fits-all” reader. Our articles avoid making assumptions and sweeping generalizations. We stay away from language that implies that our content only speaks to people who fit traditional “norms.”
This is particularly important in the health sphere; generalizing our audience leaves us open to omitting vital information that some people may need to make life-or-death decisions.
Do all married couples consist of one man and one woman? No. Does everyone in the United States identify as American? Definitely not. Does everyone with a cesarean section scar come home from the hospital with a baby? Sadly, no.
Stereotyping is harmful. It sends a message to readers that a brand or piece of content only caters to people within societal norms. But by remaining conscious of stereotypes and challenging them, we can speak to everyone—regardless of identity, background, or circumstances.
Making delicate language choices
These pillars provide us with some strong guiding principles for content creation. But how can we break them down into actionable pointers for our writers and editors to enable them to produce empathetic health content?
Identity-first vs. person-first language
One of our most significant conscious language decisions was to adopt identity-first language when discussing specific conditions and the people who live with them.
For context, all three Healthline Media properties typically default to person-first language—that is, putting the person before any condition they have. This means opting for “a person with diabetes” instead of “a diabetic person,” for example. We do this because we recognize that most conditions don’t change or define a person’s identity, and because it would be flouting one of our key pillars to imply that they do.
However, we take all reader feedback very seriously. By listening to the concerns of our audience and those of wider communities, we’ve learned that some do feel defined by their condition and are proud of it. They don’t feel as though they need treatment or a cure, and they see their condition as a key part of their being. We listened to these communities and decided to adopt their identity-first language preferences.
Currently, we have this guidance in place for autism, blindness, deafness, and dwarfism. We continue to monitor different community preferences and are always ready to adapt our approach when the need is there.
Always the active, never the passive
We want to be a person’s ally as they figure out how to take their health into their own hands. To do that, our content should be actionable—a goal we can only achieve by using the active voice (and discouraging the passive).
For example, in medicalnewstoday.com’s article about emotional abuse, using the active voice means that the responsibility always lies with the person who is being abusive, not with the person they are abusing. Take a look at these two sentences:
Active: “They may remark that the other person is crazy.”
Passive: “The person may be called crazy.”
The second sentence assumes the mental state of the person receiving the abuse, while the first seeks to place more of an emphasis on the harmful effects of name calling. Which perspective is more important for a reader seeking comfort, advice, or information? The first, we feel. If our reader is receiving the abuse, we want them to know that it’s not their fault. If our reader is responsible for the abuse, we want them to recognize their behaviors for what they are and learn to quell them.
More than anything, these examples seek to illustrate how important the active voice is for highlighting agency and responsibility.
Keeping it gender-neutral
Making our content accessible for everyone, regardless of identity or background, is essential. That’s why the majority of our articles use gender-neutral terminology.
Take medicalnewstoday.com’s article on vaginal cancer. Not everyone with a vagina will identify as a woman, so using gender-neutral terms, such as “person” and “people” instead of “woman” and “women,” ensures that every reader can feel accepted and cared for during a potentially scary time of their life. This is also another example of how we actively challenge stereotypes and assumptions.
However, using more inclusive terminology that the public may not yet have adopted or be searching for can pose SEO challenges.
There’s no point in having great content if people can’t find it! To provide people with the health information they’re looking for, our content needs to feature prominently on the major search engines. This makes it easy for readers to find our content and, as a result, the answer to their search query.
Maximizing SEO, therefore, requires a different approach and the help of our specialist colleagues.
Making each article SEO-friendly
The SEO team researches what people have been looking for on Google. They’ll note which topics are relevant to users and whether or not we already have an article that covers each of them in detail.
Any SEO-vetted health topics missing from our existing content go on that month’s list of new articles.
The editors will then spend some time “scoping,” which involves looking at the highest ranking existing articles for those keywords and gathering information about what they cover. They also note what isn’t covered, so that we can fill these gaps in our articles.
As copy editors, we always have one eye on boosting our SERP ranking. We do this by considering:
General strategies to improve SEO
We also use some overarching strategies to help our content perform well.
Our updates team works with our SEO experts to keep our older content fresh, relevant, and useful. They return to earlier articles and re-edit them, making any necessary changes to the layout, facts, medical terms, and preferred language. Continually updating and improving our content means that it not only continues to perform well but still provides value to the reader.
Our medical surveillance team focuses on important changes to medical advice and official guidance. The health landscape is always changing, and this process prevents us from giving people out-of-date, and potentially damaging, advice.
In addition to researching keywords for new content, our SEO team keeps an eye on how our existing content is performing. They learn from what does well and what underperforms, using their findings to help us improve our SEO and, as a result, our article quality.
Finding the right balance
By now, the challenges we face in attempting to balance SEO and conscious language are, we hope, starting to become clear: SEO relies on precise keywords that don’t always align with our preferred conscious language terminology. And when these principles come into conflict, it can be a delicate balance to strike.
Fortunately, we have some measures in place for when we receive a keyword that uses inaccurate or unacceptable terminology. We will still use the keyword to create an article, of course—people are searching for it and need the information—but we may replace the original term with a more empathetic version after the first few mentions.
For example, we might swap “miscarriage” for “pregnancy loss” or “alcoholism” for “alcohol use disorder.” Using the exact keyword initially enables Google to rank the page and people to find it. Switching to a friendlier version of the term a little further into the article creates an effective balance between conscious language and SEO while also addressing the needs of both.
This technique also paves the way for accuracy. For example, healthline.com has an article that uses the title tag “crippling depression,” since this was what the users who needed help were searching. There are two major problems with this: This is not a medically accepted diagnosis, and the term “crippling” has several negative associated connotations. Nevertheless, people are searching for this term, so there is a need for information about it.
As soon as we can, we note that, “People who have experienced severe depression sometimes say it feels ‘crippling,’” before moving on to call it “debilitating” or “overwhelming” throughout the rest of the article.
As with most rules, however, this one isn’t set in stone. It is occasionally necessary to defer to the exact SEO keyword—no matter how problematic—to ensure that people can find and relate to our content.
This often occurs with keywords related to gender, such as, “What are the symptoms of a heart attack in women?” and “HIV symptoms in women.” As we mentioned above, our typical approach is to use gender-neutral terminology. In these contexts, however, that makes little sense. By trying to address all possible symptoms across all sexes and genders, we would miss the intent of the article, hindering its ability to perform well on the SERP and rendering it less than useful for those who did manage to find it.
For keywords such as these, we do sometimes have to put our conscious language preferences to one side. But if that’s the price we have to pay to get vital, science-backed medical information to those who need it most, so be it.
Our plan going forward
The challenge of balancing conscious language and SEO is continuous, not least because Google updates its algorithm regularly and because language is ever-evolving.
Therefore, we always need to be looking ahead to ensure that we don’t stray too far from either approach.
We have a few strategies in place to achieve this. First, we have a growing collection of point-of-view documents that clarify our position on the language relating to specific areas of health. These focus on how to discuss the relevant topic in an empathetic and inclusive way.
In addition, our copy edit team has recently started a new quality control project in which we put on users’ hats and review the previous month’s articles. The metrics we consider include both SEO and empathy. This allows us to track our performance over time and ensure that our articles remain strong in both areas.
We will also continue to listen to people living with certain conditions to ensure that our language evolves as necessary to align with their preferences.
By using these approaches alongside our strategies for making each article visible, useful, and empathetic, we hope to continue to work toward our mission of being people’s most trusted ally in their pursuit of health and well-being.