Almanac Style Guide

The CHCF Health Care Almanac is made up of two kinds of products. The first is a series of graphic publications that provide data and analysis on aspects of the health care market, such as costs, disparities, providers, quality of care, and insurance. These are data-heavy chartbooks. The second are market reports focused on particular regions in California that also contain data and analysis.

All Almanac products, and data snapshots not part of the Almanac series, should follow these resources in this order:

This style guide
CHCF’s Style Guide
CHCF’s Guidelines for Submission of Publication Drafts
The Chicago Manual of Style, 17th ed. (Numbers in parentheses link to CMOS Online.)
Merriam-Webster Collegiate or Unabridged Dictionary (M-W)
The Indigo Book, for legal citations

Click the links in the entries below for more detailed guidance.

Excel Links

To keep things simple for readers, Excel files need to be self-contained. So if the Excel file you will submit as an Almanac contains links to other files (“external links”), you have two options:

If the external data aren’t needed for calculations or look-`ups, break all the external links (in Excel’s Data tab, click the Edit Links button, then the Break Links button).
If the external data are needed, copy the external data from external files into new sheets in the Almanac file and adjust all references to point to the new sheets. Then break all the external links.

Either way, afterward, ensure that all cells that referenced external files are still complete and correct.

Spacing

Please avoid using multiple spaces (even in comments), including after colons or periods. There is always a better way to align, indent, or arrange text and figures.

In Word, use the tab and indentation features (avoid multiple tabs too).
In Excel, to easily indent cells, use the Increase Indent button (to learn how, watch this two-minute video tutorial).

Titles and Subtitles

Locations. Spell out California and United States.
Date ranges. Use to: 2013 to 2015. Do not append a P to projected years.

Charts

Date ranges. Ensure that the date ranges in the chart and title match up. If a chart includes some but not all projected figures, append a P to the projected years (e.g., 2030, 2040, 2050 but 1990, 2010, 2030P) and add this note: P is projected.
Empty cells in tables:
- Not applicable (measure doesn’t apply): leave blank
- No data (measure applies but data unavailable): — (em dash) (Tip: copy and paste it from here.)
- Zero: 0
If a dash is used, add this note: Where a dash appears, no data were available.
Footnotes. Use these symbols in this order: *, †, ‡, §, #. (Tip: copy them from here and paste them into the worksheet.) In the footnote, separate the symbol and the text with a space.
Numbers
- In legends. Use punctuation to signify ranges, “less than,” “n and above,” etc.: <18, 18–49, 50+.
- Percentages. Except at the start of a sentence, use the percent sign. Also, percent needs a preceding number: 39 percent. Otherwise, percentage is correct: the percentage of respondents.
- Precision. Use the same degree of precision in a data range, even if it means using trailing zeroes: 13.4% and 17.0% (not 13.4% and 17%).
- Ranges. Ensure that number ranges don’t overlap. For example, 50+ includes 50, while >50 doesn’t, so use, for example, 18–49, 50+ (not 18–49, >50).
- Statistics
  - Population, subpopulation. Use an italicized uppercase N to represent population (sample) size, an italicized lowercase n to represent subpopulation size:
    - Californians with cancer (N = 15,578)
    - Californians with lung cancer (n = 4,137)
  - Significance. Use an italicized p , spaces around the <=, and no leading zero: (p <= .05).
Race/ethnicity. Refer to the Race/Ethnicity section of CHCF’s main style guide for details.

Sidebars

Abbreviations. Because we provide downloadable chart files without the sidebar text, any abbreviations must be defined in the charts, footnotes, notes, or sources: Note: FPL is federal poverty level.
Ages. Use digits for 10 and up: age two, five- and seven-year-olds, 9- to 17-year-old children, people age 65 (not aged), age 65 and older.
Data, unadjusted. For data gathered through unadjusted sources, such as CHIS or CPS (but not CalSIM or enrollment data from administrative agencies such as DHCS):
- To each applicable chart page add this note: The survey data used in this chart rely on self-reported insurance status. See the Methods / About the Data section elsewhere in this report for a full explanation of how this could impact findings.
- Also, to the Methods / About the Data section add this note: The survey data used in this publication rely on self-reported insurance status. When asked by survey researchers about health coverage, some undocumented immigrants who have restricted-scope Medi-Cal may respond that they have Medi-Cal coverage. Restricted-scope Medi-Cal, which covers only emergency and pregnancy-related services, is not comprehensive coverage. If these undocumented adults reporting Medi-Cal were instead considered uninsured, the number of Californians without insurance would be higher.
Fractions
- Spelling out, hyphenation. Spell out and hyphenate simple fractions as nouns, adjectives, and adverbs: four-fifths of the doctors, a two-thirds majority, one and three-quarters.
- Subject/verb agreement. Use singular verbs for singular subjects: two-thirds of the public says so. Use plural verbs for plural subjects: one-fourth of respondents say yes.
Not shown. When assertions don’t appear in the current chart, use “(not shown)”: In 2004, 11% said yes (not shown).
Numbers
- Commas. Use commas for numbers of at least four digits except page numbers, addresses, and years: 1,541 physicians agreed, 1438 Webster St.
- Equations. Use spaces around equal signs, arithmetic operators (but not values such as <60), and the like: Adjusted patient days = total gross patient revenue ÷ gross inpatient revenue × number of patient days.
- Spelling out
  - Small and large numbers. Spell out one through nine; use numerals for larger numbers. For very large numbers with a decimal, use numerals and words: 4.6 billion.
  - At the start of a sentence. Except for bulleted text, either spell out a number or reword the sentence.
    Eighty-six respondents answered every question.
    Every question was answered by 86 respondents.
    but
    - 86 respondents answered every question.
Subject/verb agreement. Singular subjects take singular verbs: one in four counties is rural, more than one in five participants is unmarried.
Percentages
- Spelling out. Use numerals, except at the beginning of a sentence, and don’t hyphenate even in adjectival form. Use the percent symbol (%) except when spelling out numbers at the beginning of a sentence. Use less (not fewer) zZZand more as modifiers.
  - Less than 35.6% responded.
  - Twenty-six percent of patients agreed.
- Subject/verb agreement. Use a singular verb if the noun is collective: 40% of the electorate is Latino. Use a plural verb if the noun is an ordinary plural: 15% of participants are women.
Race/ethnicity. Refer to the Race/Ethnicity section of the main style guide.
Spacing. Use one space between sentences and after colons. Avoid using more than one space in a row for any reason. Tip: In Excel, press Alt+Enter to start a new line in a cell.

Footnotes (*)

Symbols. Use these symbols, superscripted in the text, in this order: *, †, ‡, §, #. (Tip: copy them from here and paste them into the spreadsheet.)
Placement. Place footnote symbols after periods, commas, colons, semicolons, and quotation marks but before dashes.
Spacing. In the footnote, separate the symbol and the footnote’s text with a space.

Notes

Note vs. Notes. Use Note for one sentence, Notes for multiple sentences.
For a pie chart, 100% bar chart, or table with percentages and their total, add this note: Figures may not sum due to rounding.

Sources (¹)

General
- Links in Excel. In the Excel file, in the cells below the cell that lists sources, add each source’s link, one per cell, in the order they appear in the source list. Leave a blank row for any source that has no link.
- Italics versus quotation marks. Use italics for report titles and landing pages; use roman type and quotation marks for blog posts, journal or news articles, and web pages.
- DOIs. To improve the longevity of links, whenever available (mostly for journal articles), use a Digital Object Identifier (DOI) link. A DOI or DOI link is often shown on an article’s web page. The format is this: https://doi.org/[DOI]. For example: https://doi.org/10.28530/fj05472g
- PDFs and other files:
  - Landing pages. Because links to files tend to change more than links to pages, whenever possible, link to a file’s landing page and not directly to the file.
    Exception: If there are so many files on the landing page that a reader may find it difficult to find the source, link directly to the file.
  - Download indicators. If no landing page is available (see previous item), append a space and a parenthetical indicator, in roman type, that the link will cause a file to open on the reader’s computer: End-of-Life Care in California (PDF), CHCF.
- Multiple sources. Do not use multiple note numbers.^2,3 Instead, combine multiple sources into one note, separated by semicolons, plus and before the final source:
  2. Dan Forth, “How Doctors Treat: A Survey,” Journal of Care Measurement 128, no. 2 (Sept. 2015), www.jcm.com; and Jordan Fu, “Health Care in Rural Japan,” Asian Health 24, no. 3 (March 2011).
Formats. See the Citations and References section of CHCF’s main style guide for details and examples.

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