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Grammar and Usage

And vs. ampersand

In navigation menus and block headers, use the ampersand (&) to save space. In all other cases, spell out the word and. And you can use and to start a sentence.

Bureaus and offices

Check the Bureaus and Offices page for the correct spelling.


Use lowercase for generic references and capitalize specific ones.


  • The Maternal and Child Health Bureau
  • Multiple bureaus within HRSA worked on this report.

Common HRSA words

Unless it’s part of a proper noun or title, do not capitalize administration, agency, bureau, congressional, department, federal, government, governor, local, members, nation, office, report, state, or tribe.

Job titles

When to capitalizeExamples
Conveys rankAdministrator, Associate Administrator, Director, Project Director
Head of a federal institute, division, branch, or officeBureau Chief or Division Director
High-level federal officialsPresident, Senator, or Representative
Acting (if it comes before a name)Acting FDA Director Jane Jones
Secretary (if it comes before a name of an official corporate or organizational title)Secretary Jane Jones


Do not capitalize whenExamples
Generic job descriptionpublic health analyst
Acting (if it comes after a name)Jane Jones, acting director of the FDA


Report parts

When you refer to parts of a document:
Use lowercase unless the number or letter of the part follows immediately.


Correct useIncorrect use
The last chapter in the report discusses results. The accompanying figure and table show data from the project.The last chapter in the Report discusses results. The accompanying figure and table show data from the Project.
Lessons learned are in Chapter 3, and Table 4 summarizes client recommendations. Figure 6.9 shows how we spent funds, and Section D details the list of orders.Lessons learned are in chapter 3, and table 4 summarizes client recommendations. Figure 6.9 shows how we spent funds, and section D details the list of orders.


  • Use lowercase for compass directions that give geographic position or location.
    Example: the west coast of Africa
  • Capitalize geographic terms with sociocultural contexts.
    Example: North Africa
  • When naming two geographic or governmental entities together, capitalize the noun in common.
    Examples: the Allegheny and Monongahela Rivers or Loudoun and Fauquier Counties

Hyphenated words

Use lowercase for the second word of a hyphenated word or phrase, except when the word is usually capitalized, such as mid-September.


Contractions (for example: we've, it’s) are part of everyday conversation. Web content should reflect this.

Note: Avoid negative contractions (for example, don't or can't). Some people with learning disabilities rely on reading the “not” to understand what you’ve said.

Latin abbreviations

Never use e.g. (for example) or i.e. (that is). Not everyone understands what these mean.

  • Use "for example" in place of e.g.
  • Instead of i.e., edit your original sentence. Or, add a sentence that helps explain your thought.


Some of these differ from AP Style. Only use one space after closing punctuation (period, exclamation mark, question mark).

Apostrophe (')

When citing a resource from a government agency and introducing the acronym on first use, include the apostrophe with the agency name but not with the acronym.

Example: Department of Health and Human Services’ (HHS) committee on…

Colon (:)

Use a colon to introduce a list or series, usually after the following or as follows. Do not use a colon in headings.

Comma (,)

To avoid confusion, use a serial comma. Place the comma before and or or in a series.

Example: HRSA devotes its resources to programs, policies, and grants.

Ellipsis (…)

Use the ellipsis (three periods) to indicate a pause or an omission of one or more words. If you use the marks at the end of a sentence, include a closing punctuation mark.

Never begin a quote with an ellipsis. If the sentence begins after the beginning of the original statement, capitalize the first letter within brackets. Use past tense in quotes. For example, “Joe said,” instead of “Joe says.”

Em dashes, en dashes, and hyphens (—, –, and -)

Use an em dash (—) to denote sudden breaks in text or to amplify an explanation. Do not put a space before or after em dashes.

  • Use an en dash (–) to denote spans of dates in text. For example, September – October 2020.
    • We do not follow AP Style. We use a dash with spaces before and after.
    • Example: 2 – 3:30 p.m. ET
  • Use a hyphen after a prefix before an open compound word, such as pre-World War I.
  • Do not use an en dash for spans of figures. Use to.

People confuse hyphens (-) with en dashes. Use hyphens to separate compound words, such as well-being.

Note: HRSA Intranet style (for example: SharePoint) allows for spaces before and after dashes.

Quotation marks (“ ”)

Enclose closing periods and commas within quotation marks. Place other punctuation (for example: colons, semicolons, question marks, exclamation marks) outside of quotation marks, unless they belong with the quoted text.

If you add text to a quote, put it in brackets, not parentheses.

Semicolon (;)

Use a semicolon

  • Between two main clauses that are not linked by a conjunction (and, but, or, nor, for, so, yet).
  • To separate parts of a series when at least one item in the series has a comma.

Semicolons are often unnecessary. Turn long sentences with semicolons into short sentences—or use a list.

Single quotation marks (‘ ’)

Use single quotation marks to capture a separate quote or title within a quotation.

Slash (/)

  • Avoid using the slash. Spell out words like his or her (see section on Inclusive Language).
  • Instead of and/or, decide which one is best for what you’re trying to explain.
  • Do not put a space before or after a slash in a sentence.


Use one space after ending a sentence with a period, question mark, or exclamation mark. Use one space after a colon.

Word usage


When you refer to a specific presidential administration, use uppercase.


  • The Biden Administration
  • The current Administration’s policies gained traction as…
  • In the past, presidential administrations have avoided such topics.

Administrator and Associate Administrator

Capitalize when it comes before a person’s name.


  • Join Administrator Carole Johnson in welcoming her new staff.
  • The associate administrator will give a speech at the conference.


Always one word, when used as a noun.

Chairperson or Chair

Only use Chairman or Chairwoman if an organization specifies.


Use children rather than kids, except when writing for specific programs that reach out to young people.


Do not use partnership. Exception: Use partnership when it refers to a legal definition.

Comorbid and Comorbidity

These are each one word and not hyphenated.


Use lowercase except when part of a proper name.

Coronavirus disease (COVID-19)

Use severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) for the virus and coronavirus disease or COVID-19, for the disease it causes.


Use this term for both singular and plural forms. Change the verb tense depending on context.

  • Use in the singular when you refer to a body of data (for example, an entire report).
    Example: The data is clear.
  • Use as plural if you refer to more than one data point.
    Example: Some data are unclear.


This term is one word and not hyphenated.

Drug vs. Medication

Use medication when referring to their use in health treatment.

Use drug only when you refer to misuse and abuse or when you use terms such as prescription and illicit.


This term is always one word and not hyphenated.

Federal Government

Other than in headings or titles, both the “f” and the “g” are lowercase.

Health and Human Services

On first reference the Department of Health and Human Services (HHS). After that, always use the acronym HHS, and never DHHS.

Do not use United States in naming the department. For more, see the entry titled United States.

Health Care

This term is two words. In an organization name, use the word as that organization does.

Health Center

Capitalize the “h” and the “c” in proper nouns, otherwise lowercase both.

  • Health Center Program
  • Athens Health Center
  • The health centers in this area are open 24 hours a day.


Use the “slash” when referring to the Ryan White HIV/AIDS Program.

Human-caused vs. Man-made

The behavioral health field prefers the phrase human-caused to describe non-natural disasters such as shootings and other traumatic events.

Login vs. Log In

One word, not hyphenated, when used as an adjective or noun. Use two words when it's a verb.

  • Adjective use: Enter your login
  • Verb use: Log in to add an event

Metadata and Metatags

Always one word, not hyphenated.

Mpox (monkeypox)

Use mpox instead of monkeypox. Capitalize the “m” in headings and when it’s the first word in a sentence.

Online and Onsite

Always one word, not hyphenated.


Use people, never persons.


Names of seasons are always lowercase.

Self and Sub

Always hyphenate.

Examples: Self-care and sub-par

Sign up vs. Sign-up

Use sign up as a verbal phrase.

Example: Sign up for the newsletter.

Use sign-up as an adjective or noun.

Example: Select the sign-up button.


Use spokesman or spokeswoman if an organization specifies.

Teen, Teenager, or Teenage

Always one word, not hyphenated. Do not use teen-aged. Use instead of adolescent.


If you use a trademark, capitalize and punctuate it as the trademark holder does.

United States

Spell out United States in reference to the entire nation. Use U.S. as an adjective. U.S. should always use periods, except when you use it as part of another acronym (for example, USPS).


  • Health reform will bring sweeping changes to how the United States delivers, pays for, and monitors health care.
  • Under this legislation, funding was set aside for campuses, states, tribes, and U.S. territories to develop, evaluate, and improve early intervention and suicide prevention programs.

Neither the AP Stylebook nor the Congressional Directory lists the Department of Health and Human Services as an organization beginning with the words United States. Therefore, it is improper to place U.S. before the name.

The same goes for any federal agency that has a name that begins with the word department. The official title of the Department of the Interior, for instance, does not begin with United States or U.S.

However, the following organizations do have United States/U.S. as part of its title:

  • U.S. Agency for International Development
  • U.S. Commission on Civil Rights
  • U.S. International Trade Commission
  • U.S. Interagency Council on Homelessness
  • U.S. Postal Service
  • U.S. Sentencing Commission


Never use utilize in place of use.


Always capitalize the word.

Webpage or Website

These are each one word without hyphenation, and lowercase.


Use a hyphen rather than one word.

Who vs. That vs. Which

Use who to refer to human beings, including groups or categories.


  • Children who are bullied may feel socially isolated.
  • Students who struggle with depression may also struggle with their schoolwork.

Use that and which when referring to inanimate objects or animals without names.

Use that for essential clauses important to the meaning of a sentence and without commas.


  • The rats that detect landmines and tuberculosis are a specific species.
  • The dialectical behavioral therapy that doctors use as a treatment option for borderline personality disorder teaches skills that include emotional regulation.

Use which for nonessential clauses, where the pronoun is less necessary, and use commas.


  • Salmonellosis is an infection caused by the bacteria called Salmonella, which has been known to cause illness for more than 100 years.
  • The largest shark is the whale shark, which can get as large as 18 meters (60 feet).

Note: If you can drop the clause and not lose the meaning of the sentence, use which; otherwise, use that.

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