Browse this style guide alphabetically using the linked letters, or use Control+F to open a search box in your browser's window.
A
a.m., p.m.
Lowercase with periods. Use a space between numbers and letters:
3 a.m.
ABBREVIATIONS
STATE NAMES
Use two-letter postal code abbreviations in addresses only; spell out names in running text. An exception to this rule is when referring to current or former S/THOs in running text. In these cases, set the designation in parenthesis after the person's name in this format: (SHO/THO/alumni-postal abbreviation).
Karyl Rattay (SHO-DE)
Carlos Mellado López (THO-PR)
Mylynn Tufte (alumni-ND)
United States
Use U.S. when modifying another term. Spell out completely when it stands alone as a noun.
A complete history of the United States; the U.S. Congress
Reference the ASTHO Style Guide entry on Places and Regions for additional information.
accreditation
Public Health Department Accreditation is a voluntary process that measures a health department’s performance against a set of nationally recognized, practice-focused, and evidence-based standards. It assesses the department’s ability to carry out the ten Essential Public Health Services, manage an effective health department, and maintain strong and effective communications with the governing entity.
ACRONYMS
Only introduce an acronym if it will be used three or more times.
The following organization acronyms can be employed on first use without needing to write out the full name:
ACA
APHA
CDC
CMS
EPA
FDA
FEMA
HHS
HRSA
NACCHO
SAMHSA
NGA
USDA
WHO
WIC
Otherwise, when introducing an acronym, use full name on first reference followed by acronym in parentheses:
Pacific Island Health Officers Association (PIHOA)
Do not use "the" before acronyms and abbreviations.
A OR AN FOR ABBREVIATIONS AND ACRONYMS?
When using an indefinite article before an acronym or abbreviation, use pronunciation (of the acronym as a word), rather than spelling, to determine if you should use a or an. Use a for acronyms that begin with a consonant sound and an for acronyms that begin with a vowel sound.
This means:
Abbreviations that begin with a consonant but have a vowel sound (e.g. MRI [EM-ar-eye]) should use an.
Abbreviations that begin with a vowel but have a consonant sound (e.g. UNICEF [yoo-NUH-sef]) should use a.
Reference the ASTHO Style Guide entry on Acronyms for additional information.
Act, act
Capitalize when part of a formal name:
Civil Rights Act
Names of congressional acts are not italicized or underlined.
ADDRESSES
Comma before NW, SE, etc. and no periods:
855 Emory Point Drive, NE
Suite C-100
Atlanta, GA 30329
Administration, administration
Capitalized when referring to a political administration, lowercase in all other instances:
The Biden Administration released a statement today...
Members of the Administration spoke at the conference.
Reference the ASTHO Style Guide entry on Commonly Used Terms for additional information.
adverse childhood experiences (ACEs)
Potentially stressful or traumatic incidents that harm social, cognitive, and emotional functioning and undermine the safe, stable, nurturing relationships and environments children need to thrive.
allostatic load
The cumulative burden of chronic stress and life events. Colloquially this phenomenon is described as the "wear-and-tear" on a person's body or mental state.
alumna, alumnae, alumni, alumnus
For male graduates, use alumnus (singular) and alumni (plural). For female graduates, use alumna (singular) and alumnae (plural). For male and female graduates together, use alumni.
However, when referring to former S/THOs use alumni, regardless of gender.
Amy Acton (alumni-OH) and John Wiesman (alumni-WA) spoke at the conference last week.
Reference the ASTHO Style Guide entry on Referring to State and Territorial Health Officials for additional information.
Also see entries for SHO and THO
among
Not amongst
AMPERSAND
Generally avoid the symbol (&), spell out “and.”
Exception: organization titles, or in headers where space is limited:
Michigan Department of Health & Human Services, AT&T
APOSTROPHE
CONTRACTIONS
Merriam-Webster’s lists many common contractions, along with alternative spellings and, where appropriate, plurals:
dos and don’ts, singin’, rock ’n’ roll
POSSESSIVES
The possessive of most singular nouns is formed by adding an apostrophe and an s. The possessive of plural nouns is formed by adding an apostrophe only, except for a few irregular plurals that do not end in s (e.g., children).
When the singular form of a common noun ending in s is the same as the plural (i.e., the plural is uninflected), the possessives of both are formed by the addition of an apostrophe only:
The species' nutrition-poor diet contributes to its vulnerability.
When the singular form of a common noun ending in s is different from the plural, the possessive is formed by adding an 's:
The virus's adaptability presents a challenge for researchers.
If the singular form of a proper noun ends in s, the possessive is formed by the addition of an apostrophe only:
Kansas' state motto is ad astra per aspera, which translates to, "to the stars through difficulties."
Pronouns that need no apostrophes in the possessive form: mine, ours, your, yours, his, hers, its, theirs, whose.
Reference the ASTHO Style Guide entry on Apostrophes for additional information.
Also see entry for LETTERS
Association of State and Territorial Health Officials (ASTHO)
Unless otherwise instructed, use the acronym ASTHO for all written and verbal communications. Do not include the word "the" when using our acronym.
ASTHO is the national nonprofit organization representing public health agencies…
Press releases are an exception to this rule and should always spell out the organization's name in full the first time it's used. Other exceptions to this rule may include, but are not limited to, funding materials, co-branded documents, letters addressed to Congress, and legislative alerts.
Reference the ASTHO Style Guide entry on Organizational References for additional information.
at risk, at-risk
Avoid using this term, per ASTHO's Communicating with a Health Equity Approach guidance. This entry is for informational purposes only.
at risk (phrase): in a situation where one is exposed to harm or danger
The more adverse childhood experiences (ACEs) a person has, the more at risk they are for underemployment and poverty later in life.
at-risk (adjective): vulnerable, especially to abuse or danger
Social workers sometimes use the term "at-risk youth" when referring to young people who have suffered trauma.
Style Guide or Reference Guide?
This resource should be used as a supplement to the ASTHO Style Guide and has been crafted to incorporate and build on its contents. When in doubt, or in need of greater detail, please refer to the Style Guide.
B
back end, back-end
back end (noun): Heidi is working on the back end of the site.
back-end (adjective): Optimizely is the back-end platform.
backward
Not backwards
bi-monthly
Not bimonthly. Acceptable for either twice a month or every two months.
bill
Lowercase. Bill names should not be in quotes or italicized.
BLOG, BLOG POST
Blog refers to the overarching site or page.
Blog post (or, less commonly, blog entry or article) refers to an individual story or item that is posted on the blog.
BOOKS
Set book titles in italic type:
The Immortal Life of Henrietta Lacks by Rebecca Sloot uses the extraordinary history of HeLa cells to explore questions about medical ethics through the lens of race and poverty.
Reference the ASTHO Style Guide entry on Italics for additional information.
Also see entry for TITLES
BRACKETS
Use inside of parentheses, or in the middle of a quote to show editorial intrusion:
"ASTHO partnered with IA² [International Association for Indigenous Aging] to create these resources..."
BRAND/ORGANIZATION NAMES
Use, with capitalization, when necessary to avoid ambiguity. They do not have to be followed by a registration or trademark when capital letters are used. Otherwise use generic forms.
American Roentgen Ray Society
Marc explained that members of the society fund several research scholarships for doctors in the early stages of their training.
Reference the ASTHO Style Guide entry on Titles and Organization Names for additional information.
BULLETS
Do not use semicolons at the ends of list items. Put a period after each line or statement unless it is a very short item.
The symptoms to watch for are:
- coughing
- fever
- loss of smell and taste
Reference the ASTHO Style Guide entry on Punctuation for additional information.
BUNDLE
As it relates to ASTHO’s agreement with CDC: the Bundle is a 5-year cooperative agreement comprised of a collection of projects funded by various offices within the Centers for Disease Control and Prevention (CDC). Within the 5-year Bundle, projects begin on Aug. 1 of each year and end on July 31 of the following year.
C
capacity building, capacity-building
capacity building (noun), capacity-building (adjective)
ASTHO CAPACITY-BUILDING PRODUCTS
For complete information visit the my.ASTHO page on CB/TA process and products.
Official ASTHO product names are plural as a group, but most are made singular when referring to an individual product. There should not be a space between ASTHO and the word following it, however the second word should be set in italics.
ASTHOExperts
Blog posts, podcast episodes, and videos that provide a platform for thought leadership and expert opinion from a subject matter expert on a state/territorial health priority and/or emerging topic.
ASTHOBrief
A 1-to-2 page (front/back) report developed by ASTHO that provides a summary of a key topic, program, policy, or research finding of interest to state and territorial health agencies (S/THAs).
ASTHOReport
A research report, white paper, or annotated bibliography that provides recent, in-depth research on a topic of importance and interest to S/THAs, and provides usable, actionable information for S/THAs and partners.
ASTHOConnects
A webinar or seminar conducted over the internet, open to all S/THAs or a discrete group, that provides a platform for expertise and information sharing for state and territorial health officials (S/THOs) or agency staff on a topic or issue of S/THA interest.
ASTHOLearning Opportunity
ASTHO's learning opportunities equip S/THOs and their staff with the knowledge and skills necessary to respond effectively to the challenges of a dynamic public health landscape. Examples include conferences and expert convenings, workshops and trainings, and microlearning.
ASTHOLearning Community
Learning communities are unique cohort-based learning experiences that ASTHO offers its member agencies to achieve sustainable change and improvement, within a specific topic area, though action. There are four learning community models:
Learning Labs
Learning Labs support knowledge development through social learning and building social networks through peer-to-peer connection around a specific topic, opportunity, or challenge.
Communities of Practice & Project ECHO
- Communities of Practice support learning through in-depth opportunities to develop skills and knowledge through case presentations and application of tools and techniques to advance a goal.
- Project ECHO is a topic-specific, knowledge-sharing, all-teach, all-learn, virtual convening model consisting of an ASTHO hub team (facilitator, producer, and coordinator), a core of subject matter experts, and a group of state health agency teams.
Innovation Incubator
Innovation Incubators support agency teams in experiential learning through the piloting or testing a practice, approach, tool, or policy that is new to their agency or the field to advance a shared goal.
Policy Academies
Policy academies, as a learning community model, build the capacity of state and territorial health agency (S/THA) leaders and staff to navigate the policy development process. A Policy Academy familiarizes its participants with the policy development process and increases their ability to identify, analyze, design, adopt, implement, and evaluate public health policy.
ASTHOSite Visit
A platform (in-person, virtual, or hybrid) through which ASTHO provides proactive, jurisdiction-specific capacity building support and subject matter expertise.
ASTHOToolkit
A collection of evidence-based and promising programs, practices, and resources that serve as an adaptable, implementation-focused roadmap and tactical resource for S/THOs and health agency staff to achieve strategic public health objectives.
Reference the ASTHO Style Guide entry on Capacity Building and Technical Assistance Products for additional information.
Also see entries on CB/TA and ASTHO TECHNICAL ASSISTANCE
capital, capitol, Capitol
capital (noun): city that serves as the official seat of a government; financial assets; the uppermost element of a column in architecture; uppercase letter
capital (adjective): excellent; vital; punishable by death
capitol (noun): the building in which a legislative government meets
Capitol (proper noun): refers specifically to the building in Washington, D.C., where the U.S. Congress meets
CAPITALIZATION
ARTICLES AND REPORTS
Generally, capitalize the first and last words in titles and subtitles, and capitalize all other major words (nouns, pronouns, verbs, adjectives, adverbs, and some conjunctions).
Also see entry for TITLES
HEADERS
Capitalize both words in a hyphenated header:
Multi-State Learning Community
REGIONS
Capitalize regions of the United States: East, West, North, South, Northeast, Northwest, Mid-Atlantic, Midwest, Southeast, Southwest (lowercase when referring to general directions)
TRADE NAMES
Kleenex, for example
Reference the ASTHO Style Guide entry on Capitalization for additional information.
CB/TA
Stands for capacity-building/technical assistance. This is ASTHO’s organizational framework that guides our capacity building and technical assistance offerings. CB/TA is a core functional area through which ASTHO achieves priorities in its strategic plan. The CB/TA framework allows ASTHO to systematically track, monitor, and evaluate CB/TA activities and regularly solicit feedback on delivery and value for continuous quality improvement.
For complete information visit the my.ASTHO page on CB/TA process and products.
Also see entries for ASTHO CAPACITY-BUILDING PRODUCTS and ASTHO TECHNICAL ASSISTANCE
CDC
When using this acronym in writing, omit "the":
Earlier today CDC issued a statement…
check-in, check in
check-in (noun): Schedule a check-in with the rest of the team.
check in (verb): Check in with the team on the status of our project.
CIO
When used in regard to ASTHO's agreement with CDC, this refers to funding awarded by the Centers, Institutes and Offices of CDC. CDC has a list of all CIOs on their website.
cleanup, clean up
cleanup (noun): a river cleanup
clean up (verb): clean up the river
climate change
Refers to changes in the state of the climate and associated impacts at global, regional, and local levels. These changes can involve shifts in averages (e.g., gradually rising temperatures, or “global warming”) as well as increases in extreme weather and climatic variability.
Also see entry for global warming
close-up, close up
close-up (noun, adverb, adjective):
The photograph was a close-up.
He took a close-up photograph.
close up (verb):
He will close up the shop at noon.
cluster
Refers to an aggregation of cases of a disease that are grouped in place and time and are suspected to be greater than the number of cases expected (even though the exact number of expected cases may not be known).
Also see entries for pandemic, epidemic, and outbreak
COLON
Use one space after colon.
Use colons to introduce a list or series of ideas:
Before the hurricane, the clinic collected many essential supplies: bottled water, cooking fuel, canned food, clothes, and blankets.
Capitalize the first word after a colon if it is followed by a proper noun or is a complete sentence. Otherwise, use lowercase.
In addresses, use it when what follows isn’t part of the sentence:
Send it to this address:
ASTHO, Suite 450
Send it to
ASTHO, Suite 450
Reference the ASTHO Style Guide entry on Colons, Semicolons, and Periods for additional information.
combating
Not combatting
COMMA
SERIES
Items in a series are normally separated by commas. When a conjunction joins the last two elements in a series of three or more, a comma—known as the serial or series comma or the Oxford comma—should appear before the conjunction. If the last element consists of a pair joined by and, the pair should still be preceded by a serial comma and the first and.
Al wanted to rescue dogs, cats, and birds.
The available side dishes included french fries, salad, and mac and cheese.
When items in a series themselves contain internal punctuation, separating the items with semicolons can aid clarity:
In the last year she visited Tel Aviv, Israel; Toronto, Canada; and Oaxaca, Mexico.
PAIRS
Whenever a comma is used to set off an element (such as “1969” or “Tennessee” in the two examples below), a second comma is required if the phrase or sentence continues beyond the element being set off:
July 20, 1969, is the date of the first moon landing.
Sixteenth Avenue in Nashville, Tennessee, is better known as Music Row.
NUMBERS
In most numerals of 1,000 or more, commas are used between groups of three digits, counting from the right. No commas are used in addresses and years (though years of five digits or more do include the comma).
CDC has reported 1,261 cases of measles so far this year.
The artifacts date back to 35,000 BC, not 3500 BC, as originally thought.
DATES
In the month-day-year style of dates, commas must be used to set off the year. Where month and year only are given, do not use a comma before the year.
On April 10, 2015, I had a great day.
Back in August 1983, things were great.
If a month-year or month-day date is used as an adjective, no hyphen or comma is needed:
February 2020 financial statement
RELATIONSHIPS
Set off a personal name with commas when the person is the only one bearing the relationship:
Wendell’s oldest son, David, walked by.
Omit a comma if more than one person bears the relationship.
His son David is running late. (He also has a son named Philip.)
NAMES
Do not use a comma before Jr., Sr., etc.
Do not use a comma before Inc., Ltd., etc. in a business name.
NOTE: If the person or company prefers to use a comma, you may do so.
INTRODUCTORY CLAUSES
Only use after a single introductory word if a pause is needed:
First, fasten your seatbelt.
Luckily we found her keys.
Offset items with commas for clarification:
Mary Young, of Burlington, owns this company.
ADJECTIVES
Use a comma to separate two or more adjectives preceding a noun:
They are an engaging, vivacious person.
We sat quietly through a long, frustrating, boring lecture.
Separate two or more adjectives if each modifies the noun alone:
It was a long, cold winter.
Do not use a comma before the final adjective in a series if the adjective is thought of as part of the noun:
It was a clear, cool, sunny May day. (NOT: It was a clear, cool, sunny, May day.)
Cass is a kind, bright, funny young woman. (young woman is considered one word.)
I stood next to the tall white fir. (white fir is one species’ name.)
If one of the words in a series modifies another word in the series, do not separate them by a comma:
Alex wore a bright green vest. (Bright modifies green.)
Do not use a comma to separate adjectives that must stay in a specific order:
Danielle watched several young children play tag.
QUOTATIONS
Use a comma instead of a period at the end of a quote that is followed by an attribution: “We named our new puppy Cosgrove,” he said.
Use a comma to introduce a complete one-sentence quotation in a paragraph: As the old adage goes, "An ounce of prevention is worth a pound of cure."
Do not use a comma if the quotation ends in a question mark or exclamation point: “Where did you go?” she asked.
WHICH
Use comma with “which”: The bill, which was approved by Congress...
SERIES
Use after penultimate item in a series.
Reference the ASTHO Style Guide entry on Commas for additional information.
Compacts of Free Association (COFA)
Public laws establishing a special relationship between the United States and the sovereign nations of the Republic of Palau, Federated States of Micronesia, and Republic of the Marshall Islands. Under these laws, the U.S. government agreed to provide economic and technical assistance, ensure U.S. military defense support, and allow unrestricted travel to/from the United States for these non-resident freely associated state (FAS) citizens. In return, these FAS agreed to give the U.S. government unlimited and exclusive use of their land and waterways for strategic purposes.
Some economic assistance provided through the COFA is set to expire in 2023 and 2024, respectively. The military and travel components of the COFA continue in perpetuity.
Also see entries for freely associated state and island area or island jurisdiction
COMPARISONS
“such as” used for giving examples, examples are usually set off by commas:
Many coastal cities, such as Baltimore and New Orleans, are known for excellent seafood.
complement, compliment
complement: complete or enhance
compliment: flattery or free
comorbidity
When more than one disease or condition is present in the same person at the same time. Conditions described as comorbidities are often chronic or long-term conditions.
COMPOUND WORDS
Check Merriam-Webster’s for preferred spellings.
Congress, congress
Always capitalize in U.S. context.
Lowercase when not part of a proper name.
Possessive form: Congress'
Congress, members of
Lowercase when writing member (or members) of Congress.
Use the gender-neutral “representative” or “senator” instead of “congressman.”
Senator should be capitalized when referring to a specific senator by name. Lowercase if plural or referring to a general senator.
Follow the same rules for representative.
ABBREVIATIONS
Rep., Reps., Sen., Sens. (as formal titles in running text)
CONGRESSIONAL HEARINGS
When referring to a specific Congressional hearing (often in the context of a member's testimony) set in roman type and capitalize as you would any other title. Do not use italics or quotation marks (unless they are part of the official name).
Also see entry for TITLES
COURT CASES
Court case names should be written in roman type. Do not use italics, underline, or quotation marks. When writing out the name, use v. to abbreviate “versus.”
Also see entry for versus
COVID-19
Preferred spelling is all caps. Coronavirus is also acceptable, depending on the context, but keep in mind that it is a general term that refers to an entire family of viruses.
SARS-CoV-2 is the name of the virus that causes COVID-19 (a relationship similar to HIV and AIDS).
CREDENTIALS
See entry for DEGREES, LICENSURES, CERTIFICATIONS
D
DASHES
EM DASH
Use sparingly to create pauses for the reader (when the comma just won’t do); do not use spaces between em dash and adjoining words. Use an em dash to:
Emphasize a point: Just as she expected—the game was a blowout.
Indicate a breaking off of a thought: I wouldn't go—but that's just me.
Introduce a summary in a sentence: Ambition and hard work—these are the ingredients of success.
Replace parentheses: The relationship between three works—The Odyssey, The Iliad, and Circe—will be discussed.
Do not use a double dash (--) as a substitute.
EN DASH
Use to connect numbers such as dates, times, and page numbers. But the word to, never the en dash, should be used if the word from precedes the first element in such a pair. Similarly, and, never the en dash, should be used if between precedes the first element. Use spaces between the en dash and the words around it.
11 – 11:15 a.m. ET, from 11 a.m. ET to 11:15 a.m. ET
March – October 2018, between March and October
Reference the ASTHO Style Guide entry on Dashes and Hyphens for additional information.
Also see entry for HYPHEN
DATES
Use month-day-year format
Certain months are spelled out in all cases: March, April, May, June, July.
The remaining months should be abbreviated (Jan., Feb., Aug., Sept., Oct., Nov., Dec.) only when they are used with a specific date.
Spell out all month names when they stand alone or only appear with a year:
The worst of flu season is usually December – February.
The first recorded case of COVID-19 in the United States was in January 2020.
Do not write days as ordinal numbers:
Sept. 19
NOT: September 19th
If a month-year or month-day date is used as an adjective, no hyphen or comma is needed:
February 2020 financial statement
Reference the ASTHO Style Guide entry on Dates for additional information.
data
Use for singular and plural
decision-maker
Not decisionmaker
DEGREES, LICENSURES, CERTIFICATIONS
Do not use Dr. (or similar salutations) in front of names.* Write academic degrees, professional licensures, and certifications in capital letters without periods (e.g., MD, MPH, RN, PhD, MS, MBA, MPH, DDS, DO) after the degree holder's full name. Use a comma to separate the credentials from the holder's name.
Anthony S. Fauci, MD
Use the degree, licensure, or certification in the first reference. Use last name only in subsequent references.
When listing credentials, start with the highest permanent degree (typically this is an advanced academic degree). Professional licenses follow academic credentials. Temporary or non-permanent credentials (such as those that must be renewed by a state or other governing body) come next.
*NOTE: Historical figures are an exception to this rule (e.g., Dr. Martin Luther King Jr.).
Reference the ASTHO Style Guide entry on Academic Degrees, Licensures, and Certifications for additional information.
DELPH
Stands for Diverse Executives Leading in Public Health, a joint venture by ASTHO and the Satcher Health Leadership Institute at Morehouse School of Medicine. This leadership development program is designed to enhance the capacity and strengthen the networks of mid- to senior-level governmental public health professionals from identity groups that are under-represented in public health leadership.
DIALOGUE
See entry for QUOTATIONS
DIRECTIONS
Generally lowercase north, south, east, and west:
eastern rat snake, southern states
Capitalize if referring to a specific region:
the East Coast, North Africa, Southeast Asia
DISEASES
Generally speaking, diseases are neither capitalized nor italicized. However, in cases where diseases contain a proper noun, that noun is capitalized.
syphilis
cholera
dengue fever
hepatitis A, hepatitis B, hepatitis C
West Nile virus
Ebola virus
Zika virus
Lyme disease
Type 1 diabetes
An exception to this rule is international scientific names for orders, families, subfamilies, and genera (also see entry for ITALIC)
Reference the ASTHO Style Guide entry on Diseases for additional information.
disproportionate, disproportionately
Not disproportional, disproportionally
E
e-cigarette (also: e-cig, electronic cigarette)
Refers solely to devices in which a nicotine-containing liquid (or a liquid without nicotine and other active ingredients) is vaporized and inhaled. Considered a direct alternative to combustible cigarettes.
If used at the beginning of a sentence only the E is capitalized. (In titles, both E and C are capitalized.)
SYNONYMS
E-cigarettes, e-cigs (more informal), electronic cigarettes. Some stakeholders may also use the term ENDS (electronic nicotine delivery systems).
Also see entry for vape
e.g., i.e.
e.g. means “for example.” Use to give a few examples, not a comprehensive list. When employing e.g., do not also use etc., there is already an understanding that the list is not exhaustive.
Healthcare professionals are concerned that falling vaccination levels will mean a rise in cases of communicable diseases (e.g., mumps, measles, flu).
i.e. means “in other words.” Use for clarification.
The siblings attended one of the last games in the old stadium, i.e., Turner Field.
Follow with a comma, do not italicize in the abbreviated form.
Reference the ASTHO Style Guide entry on e.g. and i.e. for additional information.
Earth, earth
Capitalize when referencing the planet, lowercase when referencing soil:
It's the largest animal on Earth.
The gardener dug their trowel into the earth.
ELLIPSIS
As a general rule ASTHO communications should be written in complete sentences, ellipses (a series of three dots) will largely be used in the context of quotations.
Ellipses can be used to indicate a pause within a quoted sentence:
“And the winner is…Moonlight”
Use at end of an incomplete sentence:
“I wish you would…”
Use four dots when an ellipsis ends a sentence—three for the ellipsis and one for the period (full stop):
“It is a far, far better thing that I do….”
To show an omission of a word or words (including whole sentences) from a quoted text:
“Managing an effective response to public drinking water emergencies is essential to maintaining…and protecting public health.”
Use a period and an ellipsis at end of a complete quoted sentence:
“The safety and efficacy of vaccines is paramount to protecting the health of the American public and to building confidence in our state and territorial immunization programs.… Leadership must use the best available science to guide vaccine distribution decisions and timelines.”
Do not hyphenate
epidemic
Refers to an increase, often sudden, in the number of cases of a disease, above what it normally expected in that population or area.
Also see entries for pandemic, outbreak, and cluster
evidence base, evidence-based
evidence base (noun): The evidence base supporting these interventions is growing.
evidence-based (adjective): ASTHO promotes evidence-based interventions.
EVIZIO
Brand name. Only use if referencing this specific autoinjectible product. Otherwise use “naloxone,” which refers to the name of the generic medication.
Also see entry for naloxone
EXCLAMATION POINT
Place outside quotation marks when punctuating the entire sentence:
I couldn’t believe it when Claudia calmly said “I quit”!
Place inside quotation marks when punctuating only the quoted matter:
He loudly yelled “let's go!”
An exclamation point absorbs a period or question mark:
Can you believe they yelled “fire!”
Executive Leadership Forum (ELF)
The Executive Leadership Forum includes members of the Senior Deputy, Chief Financial Officer, State Legislative Liaison, Public Health Lawyer, HR and Workforce Development Director, and Chief Medical Officer peer networks. The Executive Leadership Forum was formed to provide a platform to support and cultivate key skills to enable better communication, management, and collaboration so health agencies can be more effective in protecting, assessing, and improving the health of people within their jurisdictions.
F
face-to-face
Adverb and adjective form
factsheet
One word
farther, further
Use farther for physical distance:
Connor is too tired to run any farther.
Use further for abstract and figurative applications:
Let's discuss this further.
federal
Lowercase, unless it's part of an official title:
In most instances the federal government has less power than state governments.
The Federal Communications Commission fined the network for allowing profanity.
fewer, less
Generally speaking, fewer is used when referring to an entity that is counted (e.g., slices of pizza), less is used for things that are measured (e.g., less patient):
Fewer than 40% of respondents...
The sequel is less cheerful than the original.
flyer, flier
Use flyer for a person in an aircraft and for handbills:
Ella used her frequent flyer miles for the trip to Oklahoma.
They distributed flyers about healthy aging.
Use flier if called for in specific idiomatic phrases:
He took a flier. (Meaning: he took a big risk.)
follow up, follow-up
follow up (verb): Please follow up with her after the holidays.
follow-up (noun, adjective): Schedule a follow-up appointment.
FOREIGN TERMS
Italicize if not in Merriam-Webster’s.
FRACTIONS
Spell out fractions, hyphenate the words when used as a compound modifier:
one-half inch
Also see entries for MEASUREMENTS and NUMBERS
freely associated state (FAS)
Three independent island nations that have ratified a Compact of Free Association (COFA) with the United States.
Residents of these nations are not U.S. citizens but are incorporated into some U.S. domestic programming. For example: the FAS are eligible for some discretionary grant funding from HHS. Citizens of the FAS are also able to join the U.S. military. In December 2020, FAS migrants based within the United States became eligible for Medicaid and Medicare services.
MEMBER STATES:
Federated States of Micronesia
Republic of the Marshall Islands
Republic of Palau
Federated States of Micronesia and Republic of the Marshall Islands entered into a joint COFA with the United States in 1986; Palau entered into its own COFA with the United States in 1994.
Reference the ASTHO Style Guide Appendix B: Referring to States, Territories, and Freely Associated States for additional information.
Also see entries for Compacts of Free Association, island area or island jurisdiction, territory, territories, THO
front end, front-end
front end (noun), front-end (adjective)
front line, frontline
front line (noun), frontline (adjective)
G
global warming
Refers to increasing temperature trends across Earth, but more generally may encompass an array of climate change impacts, including increasing climatic variability and extreme weather at local to global scales.
Also see entry for climate change
government
Lowercase
Also see entry for federal
H
headshot
One word, when referring to a person's portrait
heads-up
Not head's up or heads up
HEALTH DEPARTMENTS
Capitalize the full, formal name of the department of health (Texas Department of State Health Services), but not parts of the name (department, department of health) when used in general statements.
When abbreviating health department names, use the abbreviation recognized and used by the state or territory (e.g., DSHS for Texas Department of State Health Services).
Reference the ASTHO Style Guide entry on Referring to Health Departments for additional information.
Also see entries for SHA and THA
health equity
Health equity is when everyone has a fair and just opportunity to be as healthy as possible in a society that values each member equally through focused and ongoing efforts to address avoidable inequities, historical and contemporary injustices, and the elimination of disparities in health and healthcare.
Health in All Policies (HiAP)
A strategy for addressing the complex factors that influence health and equity. It focuses on employing a collaborative approach that integrates and articulates health considerations into policymaking across sectors to improve the health of all communities and people.
healthcare
Not health care
hemisphere
Capitalize with Northern, Southern, Eastern, Western
Lowercase when it stands alone.
homepage
Not home page
hot spot
Not hotspot or hot-spot
HYPERLINKS
WEB/DIGITAL PRODUCTS
Linked text should be descriptive enough to stand on its own without the context of the subject matter around it. This practice increases accessibility of our content since most screen readers allow users to jump directly from link to link.
If possible, try to avoid linking each word in a running list.
All links should include alt text. If the link is to another webpage the alt text should contain the name of the page the link opens, as well as the site on which the page lives. If the link opens either a PDF or triggers the automatic download of a file, that should be noted in the alt text.
HARD COPY PRODUCT
URLs are occasionally included in printed materials. When putting URLs in these resources it is not necessary to include the https://. And whenever possible use a "friendly URL." (That is a URL that's short and easier for users to manually enter. An example is astho.org/covid-19.) To get a friendly URL for ASTHO properties, please contact the web team.
Reference the ASTHO Style Guide entry on Hyperlinks for additional information.
HYPHEN
Compound adjective usually isn't hyphenated when it follows the noun: Their teeth are razor sharp; BUT: They have razor-sharp teeth. (Also see entry for -like)
Use a hyphen to join two or more words used together as an adjective before a noun, except if modifying words ends in -ly: fast-spreading virus; BUT: nobly driven enterprise
Do not use hyphen when the two words are not followed by a noun: short-tempered politician; BUT: the politician has a short temper.
Well developed is not hyphenated unless used as adjective
Use with “like” if word would be difficult to read: bell-like not belllike
With numbers: a spool of 4- to 6-pound fishing line; Use a three-inch-wide strip of paper.
Use hyphen between numerator and denominator of fractions: one-fifth the size, unless one already has a hyphen: four and four-fifths
Reference the ASTHO Style Guide entry on Dashes and Hyphens for additional information.
Also see entry for DASHES
I
ID
Short for identify (verb), identification (noun); not I.D. or i.d.
inch
See entry for MEASUREMENTS
informatics
Public health informatics is the effective use of information and information technology to improve population health outcomes.
internet
Lowercase unless at the beginning of a sentence
insular area
Do not use this term (per CDC style guidelines). This entry is for informational purposes.
A Department of Interior designation that refers to many of the U.S. jurisdictions that are not part of a state or federal district (i.e., the District of Columbia). Typically used to refer to the U.S. territories and freely associated states, exclusive of Puerto Rico.
Also see entries for freely associated state, island area or island jurisdiction, and territory, territories
is, are
Capitalize when used in headlines (because they are verbs)
Use “is” when two separate subjects are treated as one entity (if message is unclear, consider rewriting the sentence):
The water and the stuff it carries is called sewage.
island area or island jurisdiction
CDC-approved terms used to describe any U.S. jurisdiction that is not part of a state or federal district (i.e., the District of Columbia). Typically used to refer to the U.S. territories and freely associated states.
ASTHO MEMBERS IN THE ATLANTIC
Puerto Rico
U.S. Virgin Islands
ASTHO MEMBERS IN THE PACIFIC
American Samoa
Commonwealth of the Northern Mariana Islands
Federated States of Micronesia
Guam
Republic of the Marshall Islands
Republic of Palau
Reference the ASTHO Style Guide Appendix B: Referring to States, Territories, and Freely Associated States for additional information.
Also see entries for freely associated state and territory, territories
ITALIC
Set standalone works, such as the following, in italic type:
titles of books, magazines, newspapers, reports, songs, species names
On the Mode of Communication of Cholera, Public Health Weekly
foreign terms not found in Merriam-Webster’s, except place names and proper nouns, italicizing each time unless occurrence is frequent
Use to define unfamiliar words followed by comma and explanation or more common word:
The librarian suspected the student was a biblioklept, or book thief, because rare volumes always went missing after his visits.
Punctuation following italics should also be in italics to avoid having letters touch: “Ready or not, here I come!” Isabel called.
Reference the ASTHO Style Guide entry on Italics for additional information.
Also see entry for QUOTATION MARKS and TITLES
J
JOB TITLES
In running text, capitalize if it precedes a name, otherwise lowercase:
Chief Executive Officer Michael Fraser
Michael Fraser, chief executive officer
In standalone text (such as the Member Directory), always capitalize:
Rachel Levine, MD
Secretary of Health
Pennsylvania Department of Health
ELECTED OR APPOINTED OFFICIALS
When identifying an elected official, use lowercase for the title except when it directly precedes the individual's name. Use the abbreviation Gov. only when referring to governors by a proper name. Otherwise, lowercase governor. Use Rep., Reps., Sen. and Sens. as formal titles before one or more names. Spell out and lowercase representative and senator in other uses.
Acting should be treated as part of the formal title:
Acting Commissioner Deidre Gifford, MD, MPH
Arthur San Agustin, acting director of Guam's Department of Public Health and Social Services
MILITARY RANK
Use AP Style when abbreviating military rank, this includes members of the U.S. Public Health Service Commissioned Corps (USPHS).
In running text, capitalize a military rank when it is used as a formal title, before an individual's name. Identify the service branch, unless it is clear from context.
The surgeon general, USPHS Vice Adm. Vivek H. Murthy, MD, MBA, will be speaking at the event...
As an admiral and a graduate of the U.S. Naval Academy, Michael Gilday...
If the individual is retired, make note of that before their rank, but after their service branch:
U.S. Army Retired Gen. Johnnie Wilson
Reference the ASTHO Style Guide entry on Titles and Organization Names for additional information.
Also see entry for Congress, members of and President, president
L
ASTHO Leadership Institute (ALI)
A cohort-based leadership development program for new state and territorial health officials.
-like
Usually solid: shrewlike, unless the word is easier to read with hyphen: bell-like not belllike. (Check Merriam-Webster’s for accepted hyphen usages.)
Also see entry for HYPEN
LENGTH
See entry for MEASUREMENTS
LETTERS
Letters as letters are italicized:
The word “letter” has two ts.
Letters used in expressions are not italicized:
ABCs, ps and qs, straight As
LINKS
See entry for HYPERLINKS
LISTS
Avoid using a and of when listing materials:
bucket, NOT a bucket
half cup flour, NOT half cup of flour
Reference the ASTHO Style Guide entry on Lists for additional information.
login, log in
login (noun): use your login credentials to continue
log in (verb): log in to view your account details
M
makeup, make up
makeup (noun): the composition of something; cosmetics
make up (verb phrase): to compose; to invent; to arrange; to apply cosmetics; to reconcile
NOTE: make-up, with a hyphen, is considered an archaic version of "makeup"
MAGAZINES
Use italics when referring to a publication, such as Health Affairs.
Reference the ASTHO Style Guide entry on Italics for additional information.
Also see entry for TITLES
MEASUREMENTS
Metric conversions: List metric conversions in parentheses after given measurements; generally only use one decimal place; round up or down to nearest tenth.
one to two inches (2.5 to 5 centimeters) in length
Medicaid
Proper noun, capitalized
member, members
ASTHO’s assembly of members consists of the 59 chief health officials from each U.S. state, territory, Washington, D.C., and three freely associated states. On some occasions a member will appoint a designee to interact with ASTHO on their behalf.
Reference the ASTHO Style Guide entry on Referring to State and Territorial Health Officials for additional information.
Also see entries for SHO and THO
mid-
Use hyphen with decades and months:
mid-1950s (not mid 1950s or mid-1950’s), mid-June
midnight, midweek, midsummer
mock-up, mock up
mock-up (noun): Review the mock-up and make a decision
mock up (verb): Andy will mock up a sample agreement
more than, over
more than 25 cases, not over 25 cases
over the threshold, but not over 15 cents
MONEY
When writing whole dollar amounts do not use decimals or zeros:
$52
Use a commas between groups of three digits:
$87,000
Also see entry for NUMBERS
MOVIES
Set movie titles in italic type:
Outbreak was released in 1995.
Reference the ASTHO Style Guide entry on Italics for additional information.
Also see entry for TITLES
my.ASTHO
my.ASTHO is a closed community which serves two purposes: the first as our staff intranet (the place where you find staff announcements, policies, and information) and the second as a discussion space and information repository for our members.
N
naloxone
Medication used to reverse opioid overdoses. Typically administered via injection in a large muscle. Use this unless specifically referencing a brand name iteration.
Also see entries for NARCAN and EVIZIO
NARCAN
Brand name. Only use if specifically referencing this nasal spray product. Otherwise use "naloxone," which refers to the name of the generic medication.
Also see entry for naloxone
nonpartisan
One word, no hyphen
nonprofit
One word, no hyphen:
ASTHO is a 501(c)(3) nonprofit organization
NUMBERS
Generally spell out cardinal numbers between zero and nine, as well as million, billion, trillion, and so forth.
Use numerals for 10 and higher, compound fractions, decimals, and negative values.
Exceptions: half, quarter, three-fourths, three-quarters
Do not start a sentence with a numeral. If a number starts a sentence, spell it out (years are an exception to this rule).
ORDINAL NUMBERS
Spell out first through ninth, as well as thousandth, and so on. For 10th and above, do not use superscript.
OK to mix spelled out numbers and numerals in text, except when only separated by one word:
An average hunting group has five hawks, but it might have only two or as many as 18.
The tree can grow 8 to 10 feet tall.
Use comma in thousands: 2,632
Also see entry for COMMA
MONEY
When writing whole dollar amounts do not use decimals or zeros:
$52
Use a commas between groups of three digits:
$87,000
Also see entry for COMMA
PERCENTAGES
Always use the numeral and % sign in all copy.
Percentages are usually expressed as numerals in writing (exception: one percent).
Use the % symbol in charts and tables; in parenthesis when citing data or numbers in text:
Twelve participants (52.2%) shared feedback via phone and 11 participants (46.8%) completed a web-based survey.
FRACTIONS
Spell out fractions less than one in text, using hyphens between the words:
One-third of respondents were not in favor of implementing the proposed law.
TIME
Spell out any number that precedes o’clock
Reference the ASTHO Style Guide entry on Numbers for additional information.
Also see entries for DATES, PHONE NUMBERS, and PERCENTS
O
Ocean, ocean
Capitalize when part of a proper noun (e.g., Atlantic Ocean), lowercase when used as a general noun
OK
Capitalize, no periods
on, onto
jump onto (on top of)
log on to (“log” and “on” go together)
one-pager
Not one pager
only
Should be as close as possible to term modified:
It takes only seconds to make.
NOT: It only takes seconds to make.
outbreak
Carries the same definition as an epidemic, but is typically used when referring to a more limited geographic area.
Also see entries for pandemic, epidemic, and cluster
outcompete
One word, no hyphen
over
See entry for more than, over
P
p.m.
See entry for a.m., p.m.
pair, pairs
Treat pair as plural unless it really sounds wrong:
Two pairs of ice skates.
A pair of mockingbirds have finished singing.
pandemic
Refers to an epidemic that has spread over several countries or continents, usually affecting a large number of people.
Also see entries for epidemic, outbreak, and cluster
PERCENT
Always use the numeral and % sign in all copy.
Except at the beginning of a sentence, or with the number one, percentages are usually expressed in numerals. In nontechnical contexts, the word percent is generally used; in scientific and statistical copy, the symbol % is more common.
Reference the ASTHO Style Guide entry on Percentages for additional information.
Also see entry for NUMBERS
PERIOD
Use a period at the end of a declarative sentence, a sentence containing an indirect question, and a sentence that is technically a question but meant as a command.
A period precedes a closing quotation mark.
Use only one space after a period at the end of a sentence.
PHONE NUMBERS
Use hyphens, no parentheses:
202-371-9090
PLURALS
If Merriam-Webster’s lists more than one spelling, generally use the one listed first.
PO Box
No periods
policy-making, policy-maker
Not policymaking, policymaker or policy making, policy maker
POLITICAL PARTIES
Capitalize both the name of the party and the word “party” if it is customarily used as part of the organization's proper name, i.e., the Democratic Party, the Republican Party. Lowercase these words when they refer to more general political ideology or philosophies.
prefile, prefiled
Not pre-file, pre-filed
To file (something) in advance. At ASTHO this is usually used in the context of state legislature bills.
President, president
Capitalize when referring to a formal title before one or more names:
President Joe Biden
former Presidents George W. Bush and Barack Obama
Lowercase for all other uses:
The president's FY22 budget proposes a massive investment in public health infrastructure.
Reference the ASTHO Style Guide entry on Elected or Appointed Officials for additional information.
ASTHO PRODUCTS
See entry for ASTHO CAPACITY-BUILDING PRODUCTS
PRONOUNS
Use "it" with a collective subject:
When each team stakes a claim, it...
Have each team try to answer this question about its area...
He, she, and they are all accepted gender pronouns. Write clearly to eliminate ambiguity.
Victor assured me that he bought the tickets to Hawaii.
Emmy is on her first ski trip in decades.
Professor Yoon indicated that they would release final grades soon.
Capitalize all pronouns in titles.
PRONUNCIATION
Use capital letters to indicate stress; place pronunciations in parentheses:
naloxone (na-LOX-own), archipelago (ark-a-PEL-a-go)
PROPER NOUNS
Capitalize names of particular people, places, and things:
That’s when Mom asked me to make dinner. (But: Fall is my dad’s favorite season.)
proportionate, proportionately
Not proportional, proportionally
PUNCTUATION (MULTIPLE)
Use only one terminal punctuation mark per sentence. When two or more marks of punctuation are called for at the same place in the sentence (not counting parentheses, brackets, dashes, and quotation marks), only the strongest is retained.
From strongest to weakest:
exclamation point, question mark, interrobang, period, dash, colon, semicolon, comma
The period in an abbreviation is retained before all marks of punctuation except for the period ending the sentence:
Washington, D.C., the nation's capital, has many interesting museums.
Most of the Smithsonian museums are located in Washington, D.C.
Retain a question mark or exclamation point at the end of a title and use other punctuation as required, even if it results in multiple punctuation—except at the end of a sentence, when the final period should be omitted.
Reference the ASTHO Style Guide entry on Punctuation for additional information.
Also see entries for COLON, COMMA, DASHES, EXCLAMATION POINT, PERIOD, QUESTION MARK, and SEMICOLON
Q
QUESTION MARK
Place outside quotation marks when punctuating entire sentence; place inside quotation marks when punctuating only quoted material. If both the quotation and the sentence are a question, put the question mark inside the quotation marks.
Also see entry for COMMA, EXCLAIMATION POINT
QUOTATIONS
Omit comma before quoted material if very short.
QUOTATION MARKS
Place quotation marks around titles of articles, chapters, essays, and other shorter works.
Use around words or phrases when used in a non-literal way:
The scales overlap to form a tough, weatherproof “suit of armor.”
Use when suggesting, saying, or writing words:
The name “Sally” was written on the paper.
Quotes within quotes should be set in single quotation marks:
“I told him the word ‘owl’ was easy to spell,” she said.
Omit a closing quotation mark if the quoted material continues to the following paragraph.
Reference the ASTHO Style Guide entry on Quotation Marks for additional information.
R
rather than
The verb form before the conjunction determines the verb form that follows (i.e., make verbs parallel):
The teacher instructed their students to research the subject, rather than just give the answer to them.
NOT: The teacher instructed their students to research the subject rather than just giving them the answer.
Representative, representative
See entry for Congress, members of
roll-out
Not rollout
S
-size
Used to form an adjective, i.e. dinosaur-size
The -ed words convey the idea of actual action: a low-priced car conveys idea of actual pricing of car, whereas the low-price field conveys idea of field where prices are low.
saltwater, salt water
saltwater (adjective): Mary loved saltwater taffy
salt water (noun): the fish live in salt water
Scout
Capitalize for proper names:
Girl Scouts, Eagle Scout
Otherwise lowercase:
Bob was an Army scout during WWII
SCIENTIFIC NAMES
Italicize bacterial and viral taxa at the level of family and below. Capitalize family and genus, lowercase species and below.
Consult CDC's resource on Scientific Nomenclature for detailed information on abbreviations, formatting, and use of italics and roman type when discussing bacteria, viruses, fungi, genes, proteins, restriction enzymes, and influenza.
Reference the ASTHO Style Guide entry on Scientific Nomenclature for additional information.
sea level rise
Not sea-level rise
seasons
Lowercase
Senator, senator
See entry for Congress, members of
SEMICOLON
Lowercase word that comes after semicolon, even if it is a complete sentence.
Always place outside of quotation marks.
Reference the ASTHO Style Guide entry on Colons, Semicolons, and Periods for additional information.
SHA
Refers to a state health agency. Also used when referring to Washington, D.C.
When using a shorthand reference to both state and territorial health agencies, use the abbreviation S/THA. Always include the slash.
SHO
Refers to a state health official (including Washington, D.C.). Use of this term is typically confined to targeted communications, such as Pulse or Public Health Weekly. It is also used in internal documents.
Nirav Shah (SHO-ME) introduced keynote speaker, U.S. Surgeon General Jerome Adams (alumni-IN) at the event.
When using a shorthand reference to both state and territorial health officials, use the abbreviation S/THO. Always include the slash.
Reference the ASTHO Style Guide entry on Referring to State and Territorial Health Officials for additional information.
Also see entries for state health official, THO, alumni, and member, members
since
Use comma before "since" when it means because:
The hardest part was staying awake, since we were meeting at midnight.
sometime, sometimes, some time
Use sometime to refer to an unspecified point in time:
Brittanye will be logging off sometime in the next hour.
Use sometimes as a synonym for "occasionally":
Sometimes I have to go to meetings on the Hill.
Use some time when expressing an unspecified amount of time or as a synonym for "awhile":
Because of the pandemic, no one has been working in the ASTHO offices for quite some time.
SOMH, SOMHs
Stands for State Office(s) of Minority Health. A designated department within a state or territorial health agency that is dedicated to improving the health of racial and ethnic minority populations, and removing existing health disparities, through better public health practices.
SPACING
Use one space, not two spaces, between sentences.
State, state
Spell out state names when they stand alone, even when they are in a list.
Abbreviations are acceptable when it follows a city name or when listing a public official’s state affiliation:
Steven Stack, MD, MBA (SHO-KY)
Capitalize nicknames of states: The Green Mountain State
Lowercase in all other instances: Washington state, the state of Wisconsin, the 7th state
COMMONWEALTH STATES IN THE U.S.
Four states (Kentucky, Massachusetts, Pennsylvania, and Virginia) are legally commonwealths rather than states. Make the distinction only in formal uses.
Tobacco is grown in the state of Kentucky.
The commonwealth of Kentucky filed a lawsuit.
RHODE ISLAND
Officially the state of Rhode Island. Formerly, "the State of Rhode Island and Providence Plantations." Voters approved the change in the November 2020 election.
Reference the ASTHO Style Guide entry on States for additional information.
state health official
Lowercase.
Also see entries for SHO and member, members
syndemic
Two or more co-occurring population-level health threats; societal-level conditions or circumstances that facilitate the perpetuation of these health threats; and the synergistic interaction of these threats to produce an excess burden of disease at the population level.
T
T-shirt
Not tee shirt
ASTHO TECHNICAL ASSISTANCE
For complete information visit the my.ASTHO page on CB/TA process and products.
ASTHO has defined two technical assistance (TA) categories to track and evaluate targeted, jurisdiction-specific support provided at the request of a S/THO or S/THA staff.
SOLICITED TECHNICAL ASSISTANCE
TA requests solicited by ASTHO in a particular topic area as part of a project workplan (for example, as part of a learning community, or as a result of jurisdictions responding to a menu of options).
ON-DEMAND TECHNICAL ASSISTANCE
“One-off” inbound TA requests that are not solicited though particular project work.
ASTHOStat
Formerly one of ASTHO's technical assistance offerings. This product line has been discontinued in favor of a new approach that breaks TA requests into the two separate categories above.
Also see entries for ASTHO CAPACITY-BUILDING PRODUCTS and CB/TA
TEMPERATURE
Use Fahrenheit scale; if used within an international context, Celsius conversion may be provided in parentheses following Fahrenheit temperature
territorial health official
Lowercase.
Also see entries for THO and member, members
territory, territories
Portions of the U.S. that are not within the limits of any state and have not been admitted as states. At ASTHO, the term is used to refer to the five jurisdictions listed below.
MEMBER TERRITORIES
American Samoa
Commonwealth of the Northern Mariana Islands
Guam
Puerto Rico
U.S. Virgin Islands
Each of these five jurisdictions engages slightly differently with the U.S. government. For example, residents of American Samoa are the only territorial residents who do not have U.S. citizenship, this lack of citizenship influences American Samoans’ ability to vote in U.S. elections and their eligibility for some jobs.
Residents of the Northern Mariana Islands are the only territorial residents eligible for Supplemental Security Income payments (a form of disabilities benefits). Each territory’s Medicaid/Medicare payment structures are slightly different.
In a strictly legal terms, only three of the jurisdictions above have “territorial” status: American Samoa, Guam, and the U.S. Virgin Islands. The other two are “commonwealths,” which are afforded a slightly higher degree of internal political autonomy than territories.
Reference the ASTHO Style Guide Appendix B: Referring to States, Territories, and Freely Associated States for additional information.
Also see entry for island area or island jurisdiction
that, which
If you're working with a clause that could be omitted, use which:
The man's car, which had given him trouble for months, was stolen last week.
Use commas around which when not essential to meaning of sentence. But don't use commas around that when phrase is needed.
THA
Refers to a territorial health agency. Also used when discussing freely associated states.
When using a shorthand reference to both state and territorial health agencies, use the abbreviation S/THA. Always include the slash.
THO
Refers to a territorial health official, it also applies to health officials from the freely associated states. Use of this term is typically confined to targeted communications, such as Pulse or Public Health Weekly. It is also used in internal documents.
Esther Muña (THO-CNMI) described efforts used in the Pacific Islands to improve health and well-being.
When using a shorthand reference to both territorial and state health officials, use the abbreviation S/THO. Always include the slash.
Reference the ASTHO Style Guide entry on Referring to State and Territorial Health Officials for additional information.
Also see entries for territorial health official, SHO, alumni, and member, members
till
Short for until; not 'til or til
TIME
Do not distinguish between Standard and Daylight Saving Time, unless it is directly relevant to the content.
When spelled out, designations of time zones are lowercased (except for proper nouns).
eastern time; ET
Greenwich mean time; GMT
Numerals are used when exact times are emphasized. Do not use zeroes to denote minutes for time "on the hour." Lowercase a.m. and p.m. (Also see entry for a.m., p.m.)
It’s 11:47 p.m. and my flight still hasn't taken off.
Noon and midnight are acceptable for 12 p.m. and 12 a.m., respectively.
With o’clock, the number that precedes it is always spelled out. (Also see entry for NUMBERS)
It’s five o’clock somewhere.
Their plane arrived at eight o’clock in the morning.
When listing a range of times, use a hyphen in between the times. Do not insert a space before or after the hyphen.
The reception is from 1-2 p.m.
The meeting will be held 9:30 a.m.-4 p.m.
Reference the ASTHO Style Guide entry on Times for additional information.
TITLES
ARTICLES AND HEADLINES
Generally capitalize all words (nouns, pronouns, verbs, adverbs, and adjectives) except conjunctions and prepositions of three letters or fewer, articles, and the to of infinitives unless aesthetically displeasing. Don't capitalize a, an, and, at, but, by, for, in, of, on, or, so, the, to, and up. Capitalize Too and Yet. Prepositions are capitalized when they are part of a verb, such as "believe in," "brought up," or "take off."
Capitalize the first and last words in titles and subtitles, and capitalize all other major words (nouns, pronouns, verbs [including is, are], adjectives, adverbs, and some conjunctions)
Lowercase the part of a proper name that would be lowercased in text, such as de or von.
Capitalize both parts of hyphenated words in title if the words would normally be capped:
Multi-State Learning Community
Reference the ASTHO Style Guide entry on Italics for additional information.
Also see entries for ITALIC and QUOTATION MARKS
toolkit
One word
toward
Not towards
TRADEMARKS
ASTHO is a registered trademark (®)
As of the time of publishing, ASTHO has no other trademarks. However, to find out if something has been trademarked since this guide was published, search the U.S. Patent and Trademark Office.
travel
One "l" when adding suffix: traveled, traveling, traveler
TV
Capitalized, no periods
For TV show titles, see entry for TITLES
U
underrepresented
Not under-represented
underserved
Not under-served
United States
Do not abbreviate when used as a noun
Can abbreviate to U.S. when it modifies something
U.S. Food and Drug Administration
Reference the ASTHO Style Guide entry on Places and Regions for additional information.
upside down, upside-down
upside down (adverb): The child was hanging upside down on the playground.
upside-down (adjective): The upside-down child hung from the playground.
U.S.-Affiliated Pacific Islands (USAPI)
Refers to ASTHO's territorial and FAS members in the Pacific
TERRITORIES
American Samoa
Commonwealth of the Northern Mariana Islands
Guam
FREELY ASSOCIATED STATES
Federated States of Micronesia
Republic of the Marshall Islands
Republic of Palau
Also see entries for freely associated states, island area or island jurisdiction, and territory, territories
V
vaccines
They work.
Always use the full word, never vax or vaxx.
vape, vaping
Refers to all cigarette-shaped devices with which liquid is vaporized and inhaled. This includes nicotine (e-cigs), as well as products containing THC, CBD, and other non-nicotine active ingredients.
Also see entry for e-cigarettes
VERBS
Keep together as much as possible
You also can go...
NOT: You can also go…
versus
Preferably spelled out in running text; where needed, generally abbreviate to vs.
For legal cases, abbreviate to v.
Also see entry for COURT CASES
virion
A complete virus particle. The main function of a virion is to deliver its DNA or RNA genome into a host cell for replication and transmission.
W
Washington, DC; Washington, D.C.
Washington, D.C. is preferred over District of Columbia (use comma and periods in running text). No periods for DC when used in an address listing.
Reference the ASTHO Style Guide entry on Places and Regions for additional information.
webpage
One word
website
Not web-site or Website
WEIGHT
See MEASUREMENTS
well-being
Not wellbeing or well being (unless literally describing as a being as well)
which
See entry for that, which
workers' compensation
Not workers compensation or worker's compensation (unless referring to the compensation that an individual worker receives)
World Wide Web, web
Capitalize when referring to official name of system
Lowercase web is acceptable in most instances
wrap-up, wrap up
wrap-up (noun), wrap up (verb)
write up
Two words, no hyphen
Y
YEARS
Do not use apostrophes for decades:
1960s (not 1960’s)
Include each entire year when describing a range:
2019 – 2023
Reference the ASTHO Style Guide entry on Years for additional information.
year-end
Hyphenate
year-round
Hyphenate (adjective and adverb)