mental health

From Cllr James Baker's website
Want to bring out the pedant in me? Invite me to help fight the stigma attached to mental health. Then watch me shout: "There is no stigma attached to mental health! There is a stigma attached to mental illness!"

I have these little shoutings fairly regularly these days--because I live in England, the home of mental health stigma.






From the Corpus of Global Web-Based English (GloWBE):


It doesn't matter which preposition you use, if it's a stigma and there's mental health nearby, it's probably British:


Yes, yes, some of those mental healths will have nouns after them like problems or professionals, but in BrE, most of them don't. For instance, for the 12 British stigma around mental health examples, only two follow up with problems or issues. For the others, it is just mental health that carries the stigma:



Now, when people ask me to give money for cancer or child abuse, I object that I don't want cancer or child abuse to have my money. Simple pedantry for pedantry's sake, because I'm 100% confident that the people collecting money really mean that it's money to fight cancer or child abuse. And so I thought it was with the British and mental health--they're saying it that way, but they obviously mean 'the stigma about not having mental health' rather than 'the stigma about mental health'. But it's phrased so often in this way in BrE that I wonder: maybe they didn't obviously mean that. Maybe there is a stigma about mental health. There seems to be a stigma about talking about one's own mental health, and there is (relative to American sensibilities) a stigma against pursuing mental health (e.g. seeing a therapist).

I'm being a bit facetious here, but the phrasing does go with the stereotype of the British stiff upper lip. A stigma about admitting to any mental state at all...

When I looked into mental health and mental illness a bit more, I was surprised to find that the number of mentions of mental illness were about even in BrE and AmE (in GloWBE still). But the British mention mental health much more:

Why? A clue is in the number of nouns that follow mental health. The green parts in these tables are the phrases that are statistically much more American (left) or much more British (right):

Many of the BrE ones have to do with how the National Health Service is structured, but also you can see here ways of not saying mental illness: mental health problem(s), mental health difficulties, and even mental health illness(es). AmE has some odd ones (from a pedantic point of view too): mental health symptoms (do we ever talk about symptoms of physical health? No. Illnesses have symptoms, not health) and mental health benefits (if the meaning of benefits here is the same as in disability benefits, then it's a benefit for not being healthy).  (Note stigma shows up again in the BrE list.)


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Theresa and other sibilant names

The appointment of a new Prime Minister in the UK has led to both national and international crises in pronunciation. How do you say Theresa?

The national crisis, within the UK, is the problem of whether the second syllable is pronounced 'ree' or 'ray' ('ree' it turns out, for this particular Theresa) and whether the first syllable is truncated (no), as this passage from a Buzzfeed article (helpfully jpegged by author @jamesrbuk) explains:


Language Log looked at that vowel yesterday.

The international crisis is: what's going on with that 's'?  In American English, the 's' means /s/, but note that the Buzzfeed article didn't even mention the possibility of (mis)pronouncing it with an /s/. In British English, it's a /z/.

Theresa is not alone. There are other s-ful names that British English routinely pronounces with /z/, and American English usually pronounces with /s/. These include:

  • Denise
  • Leslie / Lesley (which British folk will tell you is the feminine spelling--Americans don't follow that distinction) and the truncated form Les
  • Wesley
  • Lisa sometimes (hear here - this is the only UK voice I've found on name-pronouncing sites)
  • Joseph sometimes (compare here)
  • Louisa? (I only recently learned that other people say LouWEEza, whereas I always said lewISSa. Maybe I'm just a weirdo, but I'm an American weirdo. Here's some discussion. About Louisa, not about whether I'm a weirdo. That matter has been settled.  Louise has a /z/ in both countries.)
For comparison, here are a British and an American actor saying Wesley. The American /s/ is very pronounced, the British consonant less so:




But—and this is a big BUT—these are names, so anything can happen. Names are subject to fashions and to individual whimsy. In particular, I suspect that the /s/ in the 'sl' names varies in America. In fact, I know it does in Wesley. The name (for the same character) is pronounced on Big Bang Theory with a definite /z/. Since the /s/ pronunciation is used by the character's own mother, this just seems disrespectful. ;)




In on-line conversations, I've seen Americans calling the /z/ version of 'Theresa' "posh". (They were American, so maybe posh isn't the word they used, but it was the meaning.) That may be because of the association with British accents or the Frenchness of the /z/ (as in Thérèse).


I can't say that I ever noticed any /z/ pronunciations of Theresa while growing up in America. Mother Theresa had an /s/ and so did the Theresa I went to school with. She used to ask if she could carry my lunch box for me to show that we were friends. When we'd get to the corner where we should part ways, I'd ask for my lunchbox back and she would laugh and cross the street that I wasn't allowed to cross and run away with my lunchbox. Yes, the use of habitual verb forms there indicates that it happened more than once. She always promised that it wouldn't happen again if I just trusted her...

 Alicia and Marcia are another couple of names that often throw me when I hear them in the UK. Whereas the Alicia I grew up with was "aLEEsha", in the UK it's "aLISSeeya". There is bound to be variation in the US on these, especially since in Spanish Marcia would have a "seeya" pronunciation.

There are, of course, many other names that are pronounced differently in the two countries. On the theme of national leaders' names, I have another post on Barack Obama. You might find discussion of some of the others by clicking on the names tag.  Important to note here that the /z/ in these names is not particularly related to the /z/ that's used in a lot of British nicknames. While Theresa may become Tezza, the z in that case is coming (believe it or not) from the /r/, just as it does for Jeremy —> Jezza. I've another post on that phenomenon.


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leafy

David Cameron and his house in 'leafy' Holland Park
Daily Express




Brits sometimes tell me that the problem with American politics is that the system of checks and balances, with the separate executive and legislative branches, means that changes are hard to make. My experience of politics in the UK since 2010 leaves me feeling that changes are too easy to make. Have an election and the next thing you know, things that have been built up over years can be thrown away. Get a new cabinet and within the year school curricula may change, departments of the civil service are closed, public properties are sold off. Because it's so much easier to destroy than to build, the recent Conservative (and coalition) governments (approx. AmE administrations) have wreaked change that undoes generations' worth of work and that will affect many generations beyond the current decade. But perhaps the most surprising thing for Americans watching the news is how quickly David Cameron had to move out of 10 Downing Street, the Prime Minister's official residence. On the 8th of July, there were two candidates to replace Cameron, and the winner of their contest would be decided on the 9th of September.  Three days later, one of the candidates dropped out, and so the remaining candidate was (almost) automatically appointed head of the ruling party, and therefore the next prime minister. She could have been made prime minister that day, but the queen was out of town, and you can't become prime minister without the monarch's ceremonial say-so*.  So two days later, on Wednesday, Theresa May was made Prime Minister, which meant she got to move into 10 Downing Street right away. None of this two months' warning that residents of the White House have.

But that's all just preamble for this tweet from Tony Thorne:

Sounded right to me, but I had a quick look.

My first question was: Which things are described as leafy in AmE and BrE? This result from GloWBE shows us just nouns after leafy for which there are sufficient numbers for some statistical analysis.

 My second question was, if Americans don't say leafy suburb, what do they say?



The software isn't searching for meanings, it's just searching for any adjectives right before suburb. As it happens it's given us some near-synonyms, for leafy in BrE is code for 'affluent'. Tony clarifies:



It works as code better in the UK than in the US for geographical reasons. The UK has far fewer trees than the US, and the way cities are built means that there are few trees within them. In the US, the poor neighbo(u)rhoods in a medium-sized city may well have trees (of course denser cities have fewer).  I live in a nice part of town in Brighton and our street/road has almost no trees. And of course, no lawns. And little in the way of (BrE) front gardens/(AmE) front yards. (It would have had a few more trees in the past, but Brighton lost many to the Great Storm of 1987 and to Dutch Elm disease.)

The numbers for leafy suburb in the US are not zero, as Julie Lawson notes:

I noted in reply that the Washington Post is a hotbed of Britishisms. (It's been coming up a lot as I do the research for my book.) None of the six in the GloWBE corpus are from the Post but at least three are from DC-area writers/sources, so it may be fairly local to the area.

The semantics of suburb are not quite the same in the US and UK. (But I'm going to have to leave that for another day.)  I've just shown suburb in the table above because if you search for suburb* with a wild-card at the end, you get suburban and suburbanite and it all gets a bit messy. But if we look at the plural alone, we're informed a bit more about American society...





*Interesting side note: say-so has been around since the 1600s, but OED says "In 19th cent., chiefly U.S. and Eng. regional (midl.)." It now seems to be general English again. 

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infections and itises

So last time, I wrote about disease versus infection following the phrase sexually transmitted, and I started thinking (again) about how we talk about medical things--technical or non-technical? In the book I'm writing (for you!), I've touched on it a little with respect to bodily functions:

Sitting in my doctor’s waiting room, I’m amused and a bit astonished to find posters about what to do if there is blood in your pee or poo.* The equivalent American public-service advertisements say urine and stool. In the medical context, America avoids being crude by sounding more scientific, and Britain uses baby-talk.
* Make an appointment with your doctor immediately!
The discussion hits on things like BrE waterworks ('urinary tract') and back passage ('rectum') and  classes given to foreign nurses in the NHS on British slang--aka British euphemism. (It's a bit of the book that looks at the stereotype of Americans as euphemists, so yes, there's a lot of attention in the other direction.)

The "Americans use overly technical terminology" aka "Americans like jargon" stereotype that I contribute to in the quote above is one worth taking apart as well. I've been encouraged in that stereotype when I hear friends talk about their chest infections where I tend to have bronchitis. But then they're also talking about having cystitis (my poor, unhealthy friends), which I hadn't heard of before moving here. An infected cyst? Ew... No, it's a bladder infection. In AmE I'd call it a UTI (urinary tract infection). (The NHS website tells us that cystitis is a common type of UTI, so the terms are slightly different--but that's the case with bronchitis and chest infection too.)

So far, we're tied: Itises: BrE 1, AmE 1. Infections: BrE 1, AmE 1.

So I thought I'd have a look at which things Americans and Brits call infections and which they use Medical Greek -itis names for.

 The tables below are the statistically "most American" (left) and "Most British" (right) nouns that come before infection in the GloWBE corpus. (If you click on the table, it should get bigger.)
"Most American" and "Most British" words preceding infection
What you can notice there (if you can read the small print) is that the "more British" preceding nouns include things that can get infected (wounds, chests, throats), whereas the "more American" ones tend to be the microbes that do the infecting. In AmE, I think I'd say someone has an infected wound rather than that they have a wound infection. And one kind of wound infection you can have is a staph infection (in the US list), which is a very familiar term from my AmE childhood (we were constantly being told that gym mats were very dangerous). I don't know that I've ever heard staph infection in the UK.

In the BrE column you can also see urine infection, another BrE way of saying urinary tract infection. This one names neither the pathogen nor the organ, and always strikes me as a bit odd. Urine might have germs in it, but can urine itself be infected?

BrE has more throat infections because Americans are more likely to say they have strep throat. In my experience, scarlet fever is heard more in BrE these days (which is not to say you never hear it in AmE). When my child was diagnosed with it (in the UK), I really felt like I'd been taken back to Victorian times. She wasn't all that sick. But when I looked it up and found that it's the strep germ, I thought: maybe you hear scarlet fever more often in UK because AmE has strep infection.

Some of the numbers up there, though, are art{e/i}ifacts of the corpus. AmE has 56 instances of HSV infection but all of them come from a single website (virologyj.com), so we shouldn't take too much from that. American, like British, English would typically call that herpes. HBV infection is found on a greater range of sites, but they are mostly medical journals and such. Laypeople would generally say Hepatitis B.

But that does seem to sum up the difference between the AmE table and the BrE table: a lot of the AmE infection cases are use of medical jargon in a medical context--staph infection was the only one I knew as a layperson. Whereas in BrE the body-part+infection cases are terms that non-medical people would use when talking about their maladies.

If we look at the infections that American and British English have in common, we can see  that Americans do talk about infections too, sometimes with body parts, even.


But what about -itises? Is it mostly Americans using the fancy words? No, but there again maybe some effects here of one source being over-sampled in the corpus. Here I'm showing what came up as 'most American' (left) and 'most British' (right), with a bit of the 'neither one nor the other' showing in white. This is going to be very hard to read on a phone (sorry!), but I'll write up the highlights below.


I've given a comment in red if (a) the things are not diseases, but just coincidentally spelled with -itis, or (b) if it's a spelling issue. Though oesophagitis shows up in the British list, it's not because Americans don't use an -itis name for the problem, but because we spell it esophagitis. (Click here for my old post on oe/e spellings.) The British list is lengthened by a misspelling of arthritis and having two spellings for tonsil(l)itis.

After discounting those, the British list is still a lot longer than the American one, but I'm very much suspecting some bad corpus effects here. Tonsillitis, colitis, dermatitis, gastroenteritis, appendicitis, pancreatitis--I or members of my family have had all of these and that's just what they were called in the US. The numbers for these diseases are greater than expected in the British part of the corpus--but they're hardly absent in the American part. For example, note that there are 756 AmE occurrences of meningitis--which is here counting as "rather British", while only 16 AmE hits for phlebitis make it "very American". Some of these cases are going to seem "more British" or "more American" to the software just because the corpus happened to hit on some websites that talked about these things a lot. But I think what we can say from this exercise is that we have no particular evidence for British English avoiding -itis words, despite its greater use of body-part+infection.

Still there are a few itises worth mentioning for BrE/AmE interest. One is labyrinthitis, which I had an unfortunate encounter with this spring. When I described my symptoms (the room going upside-down and inside-out every time I turned my head left), lots of British friends said "Oh, that's labyrinthitis. I've had it. It's horrible!" But it was not a word that my American friends seemed to have at their fingertips--to them it was an inner-ear infection. (Why do Brits seem to get it more often, though?)


Conjunctivitis shows up on the British list, though it is a word that Americans use too. But Americans have another informal term for the problem: pink-eye. That will push the US conjunctivitis numbers down. (There are a few UK hits for pink-eye--with or without the hyphen, but a lot of US hits.)

In the white part of the table--where the numbers are similar for AmE and BrE -- are the two itises that are earlier in this post: cystitis, which I've experienced as more British, and bronchitis, which I've experienced as more American. Because the corpus is imperfect, I'm not going to totally discount my experience on these. But it would be interesting to hear if others (particularly transatlantic others who can compare) think I'm off my rocker...

I was surprised to see only one made-up disease in the list: boomeritis on the AmE side. (It was the name of a book--click on the word to learn more.) I would have bet that (AmE) senioritis would appear. (As it happens, there were only two US examples of it in the corpus--most are Canadian.) To quote Wikipedia:

Senioritis is a colloquial term mainly used in the United States and Canada to describe the decreased motivation toward studies displayed by students who are nearing the end of their high school, college, and graduate school careers.
For a minute there, I was worried that I expected senioritis to be there because I am OLD and UNCOOL. But I'm happy to report that in both the Corpus of Historical American English and in Google Books, the rate of senioritis use has only gone up in the decades since I was a high-school/college senior. Not happy for the teachers who have to teach these seniors, but happy that my vocabulary is not a complete dinosaur--yet.

If you're interested in other disease names, do have a look at the medicine/disease tag--thanks to (a) having a small child and (b) being a complete hypochondriac, quite a few have come up over the years--but there are still many more to cover in future.

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STD, STI

Is a Manchester sexual health clinic
trying to tell me something?
I just feel that I should say this up front: there is nothing autobiographical about this post. There. Got that out of the way. The topic only came up because I was in a conversation that involved an allusion to leaflets in doctors' (AmE) offices/(BrE) surgeries

Those leaflets are sometimes about (AmE, old-fashioned) social diseases. In either country it's possible to find references to  Sexually Transmitted Diseases or STDs or  Sexually Transmitted Infections or STIs. Is there a difference? Not really. To quote one (US) site on the matter:
STI stands for sexually transmitted infection, and many people, mostly the medical community, have begun transitioning from “STD” to “STI” in an effort to clarify that not all sexually transmitted infections turn into a disease. For instance, the vast majority of women who contract HPV (human papilloma virus) will not develop the resulting disease cervical cancer. In fact, most cases of infection will clear up within two years. Additionally, people who use this term believe that it also eliminates some of the shame that’s been associated with the acronym “STD.”
The UK seems to be far ahead of the US in adopting the "new" term.

The GloWBE corpus has about 5 times as many STD(s) in AmE as STI(s), but about 1.2 times as many STIs in BrE as STDs. The numbers for the non-abbreviated forms were not as strongly separated by country, but there were still more sexually transmitted diseases in the US and infections in the UK.

GloWBE is useful because relatively current and country-coded, but  it's counting up phrases from the web and there's no guarantee of the Britishness of someone writing a comment on a British news site (etc.). I wanted to check further because the UK numbers weren't as stark as I had expected. The friend in the aforementioned conversation has a nurse for his partner, a (UK) nurse, and his experience/impression was that in the medical profession it is almost always STI in the UK. That's been my impression too.

So, I searched for the terms on the National Health Service (UK) website and found about 4 times as many sexually transmitted infection(s) as sexually transmitted diseases but similar numbers of STI and STD. This seemed to be because almost whenever the NHS site uses the abbreviation, they use both abbreviations, as in "Sexual health testing for people with symptoms or who have had sex with someone who has a confirmed STI/STD" on a list of clinic services. In some cases, when I clicked through on a hit for STD there was no visible STD on the page, just STI. Which is why, boys and girls, it is generally better to use a corpus rather than Google for getting word-frequency counts. Some SEO magic seems to be going on on there.

On the National Institutes of Health (US) website there are twice as many sexually transmitted diseases as sexually transmitted infections.

Was STI coined in the UK? Not necessarily, but it's hard to tell. Only sexually transmitted disease (first citation, 1962) is in the OED. Searching Google Books, I find instances of sexually transmitted infection going back at least as far, but there's no clear separation between US (red) and UK(blue) books at the start of the term's history.



Why has STI caught on more in the UK? Some possibilities:
  • A more enlightened approach to sexual health? 
  • Better management of terminology due to the dominance of the National Health Service in delivering patient information and treatment?
  • It fits better with other names for illnesses in the dialect?
In terms of the last point, a first thing to wonder is whether STD is more popular in the US because Americans are more used to calling such things diseases, as in venereal disease. The answer seems to be "no". Venereal disease is and was just as well used in BrE, as far as I can tell.

What about the word infection, is that more common in BrE more generally? The answer is complicated, so I've decided to make that a separate post. It's half-written, so it might even be the next one!

And I leave you with what may be my favo(u)rite disease joke, from Cyanide and Happiness:

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the fourth of July

When I (or a guest blogger) have talked about dates here, it's mostly been about how dates are written. (One exception was about how we say the year.) One thing we've not really talked about is how we read dates out loud.

I've been struck by the mismatch a couple of times when British people have tried to "go American" and put the day after the month. In one case, it was The Telegraph on complained-about Americanisms on the BBC. One of these was July 5. And I thought: but Americans hardly ever say July 5. We write it, but in the context of a sentence we'd pronounce that date as July 5th. Not It's on July 5, but It's on July 5th.

The same happens in BrE. People write 5 July, but they pronounce the 5 as the ordinal version: fifth. People don't go about saying "My birthday is five July". So, I've never understood: when people complained about July 5 on the radio, had they heard someone say July five, or is that their way of writing that someone said July fifth?

It happened again today, when @BoswellAffleck forwarded to me a tweet in which someone else wished Americans a "Happy July 4". Maybe the tweeter was saying that to himself as July 4th, but if I were to write it, I think I'd write "Happy July 4th", since it's in an expression that's addressed to some particular people; not a fact of when something happened, but the name of a day. July 4 might be what I write at the top of a letter, but if I put it in a phrase like that, I think I'd have to write the th in order for it to look like it sounds.
Trumbull's The Declaration of Independence (1819)

It's OK to wish someone a Happy July 4th (especially if you're trying to save characters on Twitter), but it's still not super-idiomatic American English. The holiday that falls on that day has two official names: Independence Day and the Fourth of July. In wishing people a happy one, it's clearer to use the name of the holiday.

British folk sometimes ask me about the Fourth of July. If Americans write the date as July 4 (and 7/4 when expressing the month as a number), why is the fourth in front of the month in this case?

They probably ask about that one in particular because they don't hear all the other times Americans say the date that way. But we do have and use the option to say other dates that way too.  My Englandiversary is on the 6th of January or January 6th. I could say either, but the 6th of January sounds more formal to me. The formality might just be due to the length of it--and maybe particularly that definite the. The is something of a marker of more formal English.

At this point, a table might be a good idea.


today's date AmE BrE
07/04/2016 yes --
July 4th yes sometimes
July the 4th legal contexts yes
04/07/2016 -- yes
4th July -- yes [but more written]
the 4th July -- yes [but more written]
the 4th of July yes yes


I used the Corpus of Contemporary American English and the British National Corpus to check on these (though I used *th instead of a particular number and June instead of July, because the holiday's name would skew the results)--and that's how I found the "legalness" of [month] the [ordinal] in AmE: all of the examples seemed to be from courtrooms or reporting on legal matters, as in "the evidence will prove that Kato last saw the defendant on the night of June the 12th at 9:35 at the latest".

In general, the table shows that each national dialect wants to do something "extra" if it puts the date on the "other" side of the month from that which it occurs in writing the date numerically. If the date is put after the month in BrE, it needs a the. If it's put before the month in AmE, it needs a the and an of. These extra words are marking these expressions as 'not the default way to express the date' in those countries.

In British English, dates like the 4th June are written much more than they're said. More often the pronounced version has the of in it. Not only does the of help to avoid the ambiguity between 'the fourth day in June' and 'the fourth June in a series', it gives the date a nicer melody: spoken English doesn't like to have two stressed syllables in a row. The of breaks up the stressfest.

How did we end up putting the day on opposite sides of the month? It's one of those where American has the older form. It says July 4, 1776 at the top of the Declaration of Independence because that's how people wrote dates back then. Putting the date before the month came to Britain in the late 19th century, influenced by other European countries. (I'm going to assume "especially France", because British English loves nothing more than a bit of Frenchifying.) 

And why is the holiday the Fourth of July rather than July Fourth? I suspect it has to do with that sense of formality that the longer form conveys and the the.  It's not just some date, it's the date.
(I now have The Twelfth of Never stuck in my head.)

For more on why Americans tend to call the holiday by the date, rather than Independence Day, see this article on Slate.


And I can't leave this post without noting Nigel Farage (UK Independence Party) urging
"let June the 23rd go down in history as our independence day". 

First: note that date after the month. Does June the 23rd sound more formal or ceremonial than the 23rd of June in a BrE context? Would love to hear British thoughts on the relative formality of the ways of saying dates.

Second: Whenever I heard the Leave [the European Union] campaigners claiming that date as "Independence Day", I thought: Is that what all this is about? Are these guys just jealous that they don't have a holiday with a [orig. AmE] kick-ass name like the US has?  I'm asking a bit as a joke, but a part of me thinks that it's not far off the mark.

(The timing of the new Independence Day film, opening in the UK on the day after the EU referendum, meant that lots of people were using the film's poster instead of images of actual people fighting for actual independence in the actual world. It is all rather surreal.)

And third, this table. I haven't been able to find who first put it together and posted it  (if you know, let me know and I'll add a credit)--I've seen it on many friends' Facebook pages.

(The table is from Wikipedia, but I'm not sure who added the question and circulated it.)

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Abbr.

AmE = American English
BrE = British English
OED = Oxford English Dictionary (online)