Wordcraft at Camp: Healthcare versus Health Care

Carl A. Kirton, PhD, DNP, MBA, RN, FADLN, FAAN

Guest Counselor

Wordcraft at Camp offers bite-size lessons on language, clarity, and scholarly style from the counselors at Writer’s Camp.

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When reviewing the final edits for my dissertation, my advisor noted that my use of healthcare varied. Sometimes I wrote healthcare as one word; other times I used health care as two words. Her advice was simple: be consistent and choose one form.

My response—offered with confidence, because how could an editor not know this?—was that I was not being inconsistent. The choice depended on how the word was being used. However, I learned that even though there are distinct choices for using each word, that is not always what directs your decision for usage.

Quick Definition

When healthcare is spelled as one word, it is a closed compound. When written as two words—health care—it is an open compound. These are known as orthographic variants.

In Practice

Orthographic variants are different spelling, compounding, and inflectional forms of a word that may appear differently—even within the same manuscript.¹ Consider the following article title:

“Mental Health Care for Medical Staff and Affiliated Healthcare Workers During the COVID-19 Pandemic.”² In this single title, both forms—health care and healthcare—appear, illustrating how orthographic variants can occur even within the same article, sentence, or in this case, title.

Orthographic variants can be a source of confusion for authors, editors, and copyeditors. These differences arise for a variety of reasons, including cultural shifts, historical developments, and sometimes even financial considerations. In 2022, the editor-in-chief of Health Affairs wrote humorously:

“As a journal, we pay authors by the word. Given the frequent usage of the term [healthcare] in our pages, we have calculated that collapsing health care into healthcare will save us $3.46. Since we expect other journals to follow suit, we conservatively calculate the aggregate savings throughout the health sector to be $89.23. Based on our recently published paper on national health expenditures in 2020, this translates into 0.0000000021637% of annual US healthcare spending. We are excited to do our part to bend the health care cost curve.”³

Some writers and editors distinguish between health care and healthcare, using the open compound to refer broadly to services that support health and well-being, and the closed compound to refer more specifically to organized medical services focused on diagnosis and treatment.⁴ In this interpretation, the two forms reflect differences in meaning rather than simple spelling preferences.

However, style guides often treat these forms as interchangeable and recommend one version for the sake of consistency. When writing for a journal, organization, or academic program, authors are typically expected to follow the preferred style—even when doing so removes these subtle distinctions.

Style Guide Recommendations

For authors, the practical takeaway is straightforward: consider the meaning you intend, but ultimately follow the style guidance required by your journal, institution, or discipline. Consistency matters more than preference.

Compound terms vary widely by style guide. For example, the Merriam-Webster dictionary lists health care as an open compound and identifies healthcare as a variant. It also notes that the term is sometimes hyphenated when used before another noun (e.g., health-care workers).

The AMA Manual of Style recommends health care as two words, even when used as an adjective.⁵ In APA style, health care is used as an open compound when functioning as a noun and hyphenated as health-care when used as a compound modifier. For example:

• The government’s health care plan (noun)
• The patient received health-care services (adjective)⁶

The Chicago Manual of Style prefers health care in noun form and does not hyphenate the term when used as an adjective. The Centers for Disease Control and Prevention (CDC) uses the open compound health care, while the World Health Organization (WHO) uses the hyphenated form health-care. Attempting to hyphenate health care in Microsoft Word may produce a grammar suggestion recommending the closed compound healthcare.

And—for an even more extreme (or perhaps confusing) example, consider this: the Agency for Healthcare Research and Quality (AHRQ) uses the single word “healthcare” in its own name. However, standard federal and formal writing often follows AHRQ’s Plain Language guidelines by preferring the two-word form “health care” for better clarity and consistency.

Practical Considerations for Authors and Editors

Ultimately, how health care appears in your manuscript depends on several factors, including the style manual used by your journal, organizational preferences, or editorial judgment.

Some of the most respected general-interest publications—including The Washington Post, The New York Times, and the Associated Press—maintain the open compound form health care. In contrast, The Wall Street Journal announced in 2021 that it would adopt the closed compound healthcare.⁷

Most journal editors and copyeditors align their conventions with their journal’s preferred style guide. Style guides such as the AMA Manual of Style and APA generally prefer health care as two words. Other editors may adopt variants for practical considerations such as word count. Regardless of the choice, the goal is consistency within the manuscript and across the publication.

Adopting a house style promotes uniformity, consistency, and clarity for authors, reviewers, and editors.

Because consistency is key—and recalling my chair’s advice—for my dissertation, APA style it will be.

Counselor’s Tip

When you encounter health care and healthcare, don’t assume they are interchangeable. Consider whether the distinction matters for your meaning—but always check the style requirements of your target journal or organization. When in doubt, prioritize consistency and follow the required style. Clear, consistent language helps readers focus on your ideas rather than your spelling choices.

References

1. Fiveable Content Team. Orthographic changes over time. Orthographic changes over time. September 2025. https://fiveable.me/key-terms/introduction-humanities/orthographic-changes-over-time
2. Walton M, Murray E, Christian MD. Mental health care for medical staff and affiliated healthcare workers during the COVID-19 pandemic. European Heart Journal Acute Cardiovascular Care. 2020;9(3):241-247. doi:10.1177/2048872620922795
3. Weil A. Health care is now healthcare. Forefront Group. Published online April 1, 2022. doi:10.1377/forefront.20220330.958914
4. Issel LM. It’s health care, not healthcare. Health Care Management Review. 2014;39(4):269. doi:10.1097/HMR.0000000000000040
5. AMA Manual of Style Committee. AMA Manual of Style: A Guide for Authors and Editors. Oxford University Press; 2020. doi:10.1093/jama/9780190246556.001.0001
6. American Psychological Association. Publication Manual of the American Psychological Association: The Official Guide to APA Style. Seventh edition. American Psychological Association; 2020.
7. Roush C. The WSJ is now spelling healthcare as one word. Talking Biz News. Published February 11, 2021. Accessed April 6, 2026. https://talkingbiznews.com/they-talk-biz-news/the-wsj-is-now-spelling-healthcare-as-one-word/

Author: Carl A. Kirton

Carl A. Kirton is the Editor-in-Chief, American Journal of Nursing. You can reach him at carl.kirton@wolterskluwer.com

Reviewed and Edited by: Leslie H. Nicoll

Copyright © 2026 Writer’s Camp and Carl A. Kirton. CC-BY-ND 4.0

Citation: Kirton CA. Wordcraft at camp: Healthcare versus health care. The Writer’s Camp Journal, 2026; 2(2):3. doi:10.5281/zenodo.19442225