Textbooks and academic marketing journals use both terms “health care” and “healthcare.” In these writing, no justification is provided for using one term over another, and they are sometimes used interchangeably within the same book or article. However, in the fields of medicine and health, peer-reviewed journals strongly favor the two-word form of health care (Stremersch & Van Dyck, 2009). Likewise, the English language rules suggest the use of the two-word form.
The Merriam-Webster Dictionary and The Oxford English Dictionary (OED) list health care as a noun and have no listing for healthcare. By contrast, words such as childcare and eldercare are listed. Similarly, highly regarded medical dictionaries such as the Miller-Keane Encyclopedia & Dictionary of Medicine, Nursing, & Allied Health (Miller-Keane Encyclopedia & Dictionary of Medicine, Nursing, & Allied Health, 2003) and Taber’s Cyclopedic Medical Dictionary (Venes, 2021) list the two-word form. While Mosby’s Medical Dictionary (Mosby’s Medical Dictionary, 2017) has no listing for health care, it uses the two-word form for listings such as “health care consumer,” “health care industry,” and “health care provider.” In addition, major journalism and writing style guides such as The Associated Press Stylebook , The New York Times Manual of Style and Usage (Siegal & Connolly, 2015), and The New Oxford Style Manual (New Oxford Style Manual, 2012) support the two-word rule for health care. The American Medical Association Style Manual supports the term health care over healthcare, and the two-word form is followed in medical journals such as the New England Journal of Medicine, JAMA, Annals of Internal Medicine, and Health Care Management Review.
The use of the term health care is similar to the use of “dental care,” “medical care,” “emergency care,” or “first aid.” In each of these cases, two words are brought together to create new meaning—these words are called open compound words. For example, when “health” and “food” are used together in the phrase “health food,” new meaning is created. Other examples include living room, real estate, and ice cream.
Nevertheless, English is a living language and is constantly changing and adapting to the times. As with many compounds, when their use increases, the long two-word form is often shortened into one word (Juhasz et al., 2005). Words like website and airline are commonly used today with little thought but originally came into usage as two-word open compounds—web site and air line. The transition of open compounds to closed compounds is a part of the natural evolution of many languages and is often seen as modern and forward-thinking. This is likely what the publishers of Modern Hospital wanted to portray when they changed the name to Modern Healthcare back in the 1970’s. Government officials sought a similar “freshness” when the old Agency for Health Care Policy and Research (AHCPR) was renamed Agency for Healthcare Research and Quality (AHRQ) in 1999 (B. H. Gray et al., 2003).
Clearly, the use of the term “healthcare” has grown in popularity. Today, healthcare is acceptable in informal writing, and the one-word variation is largely a choice of style. Further, some dictionaries (e.g. Webster’s New World College Dictionary) have started to include an entry for healthcare. However, these entries again note healthcare as a noun, leaving the question, how does one refer to another noun related to health, such as “healthcare services” or “healthcare policy”?
Standard American English allows for nouns to be used as adjectives. Commonly referred to as a noun adjunct or attributive nouns, when two nouns are used together, it is understood that the first noun modifies the second. Thus, for example, in the phrase “paint store” the attributive noun “paint” modifies the noun “store.” Similarly, the noun “business” modifies the noun “ethics” in the phrase “business ethics.”
While the one-word form, healthcare, is generally accepted, the two-word form, health care, is the standard among professional writers and health industry leaders (Issel, 2014). As marketing continues to integrate with the health professions, the use of a common language becomes increasingly important (Cahn, 2017). Students studying the discipline should be aware of the difference, as the proper use of the term may help them be perceived as knowledgeable and reduce conceptual barriers that may exist between the professions (Cahn, 2017).
