The Ongoing Debate on Health Terms: Does Spelling Matter?
Highlights:
- Healthcare has outperformed health care in both media and online searches, signaling a preference for the compound form among journalists and the public
- Well-being leads for media usage. And although it has recently trailed behind wellbeing for search interest, the hyphenated version surpassed wellbeing this year for the first time in a decade
In medical settings, the use of standardized terminology among healthcare professionals is the norm to promote precision for activities such as prescribing, note-taking during appointments, and sharing exam results. However, among the general public and within non-clinical healthcare realms, terminology can often be a matter of semantics. Spelling variations such as health care vs. healthcare and well-being vs. wellbeing are prime examples of terms that are central to the healthcare industry but can be referred to in various ways. This conundrum isn’t just for the pedantic; it reflects broader themes of communication, searchability, and the evolution of language.
Health care originated as two separate words, reflecting the traditional grammatical construction of compound nouns in the English language. The etymology of the term reveals that its earliest known use was in the 1940s, and the combined term healthcare became more commonly used in the latter half of the 20th century. The transition toward healthcare as a single word mirrors broader trends in English toward compounding, especially in technical and specialized fields.
In the media, healthcare and health care followed nearly the exact same trendline. It wasn’t until late 2021 that a separation began to form between the two terms. Now, there is a clear lead by healthcare against health care, with the term seeing nearly three times the amount of media coverage as its counterpart during its peak. Among journalists, healthcare is by far the most used term, yet the community of editors is still divided on the official style guide. Many top-tier publications such as The New York Times, STAT, and NPR consistently use health care while others such as Forbes, Reuters, and Fierce Healthcare prefer to use healthcare. This nuance, while subtle, signals the continuing debate about whether compounding truly matters.
A quick glance at search trends shows that healthcare as a single word significantly outperforms health care among online searches. While the two generally mirror the same patterns, the disparity in popularity began to kick in after March of 2010 when both healthcare and health care hit their highest peaks. This was likely due to the signing of the Affordable Care Act (ACA), often referred to as “Obamacare,” into law, which transformed the health insurance landscape, expanding access and helping to cut the number of uninsured Americans nearly in half.. A decade later, in the midst of the COVID-19 pandemic, healthcare saw the same level of popularity, but health care did not.
Both terms have seen a consistent, gradual incline over the past 20 years and were neck-to-neck until 2014 when well-being began gaining a lead against its counterpart. The difference between the two terms became noticeable when well-being saw a drastic uptick in May of 2020 at the start of the pandemic but resumed its pre-COVID trajectory afterward. In September of last year, well-being barely surpassed wellbeing for the first time in a decade.
During the pandemic, both well-being and wellbeing saw similar usage trends in the media. However, in the past couple of years, well-being has significantly outpaced its counterpart, indicating a preference among journalists for the hyphenated form. Our guess is that while wellbeing is frequently used colloquially, the increasing preference reporters have for the hyphenated version might stem from an effort to adhere to the high editorial standards set by publications and the requirement for grammatical correctness in public communication. Spelled with a hyphen in both the Merriam-Webster and Cambridge dictionaries, this version is the oldest known form of the term, with Merriam-Webster noting its first recorded use in 1561, nearly five centuries ago. Oxford further supports this, tracing the term well-being to a 16th-century calque of the Italian concept “benessere”. The second chart below illustrates the prevalence of well-being over wellbeing and well being in books published in English since 1800, highlighting its longstanding dominance in literature.
(Source: https://writingexplained.org/wellbeing-or-well-being)
While well-being is generally the standard spelling, in the UK, wellbeing is not only acceptable, but it has also grown to be more popular than the hyphenated form. It’s worth noting that this spelling is also widely used across the United States even though it is not the predominant spelling. Two UK-based authors of one research paper on the wellbeing of teachers wrote that they “do not write wellbeing with a hyphen so that the concepts of ‘well’ and ‘being’ are connected as one unified concept without categorical distinctions.” When framed this way, it prompts reflections on the interconnectedness of spelling and perception of meaning, especially for healthcare terms.
What are your thoughts? Do you think the evolution of healthcare nomenclature is merely a linguistic trend, or does it signify deeper shifts in our understanding and approach to healthcare? What other healthcare term spellings have you seen debated?
