Health-adjusted life expectancy (HALE) is the average number of years that a person can expect to live in full health—that is, not hampered by disabling illnesses or injuries. Commonly referred to as healthy life expectancy (HLE), it is a measurement used by the World Health Organization (WHO) in assessing the health and well-being of a country.
Not to be confused with lifespan (the maximum amount of years a species can live—currently over 120 for humans) or life expectancy (the average length of life for a population), HALE takes into account years lived in less-than-full health due to disease or injury.
History
HALE combines mortality and morbidity data of a country or region to estimate the expected years of life in good health for the average person in that area. The WHO began compiling this data into tables in 1999 using estimates of patterns and trends in all-cause and cause-specific mortality.
Working in conjunction with the United Nations Population Division (UNPD), the WHO releases updated HALE tables for its 180-plus member states every two years. Individual countries often break down HALE into regions, states, and communities.
Uses
HALE estimates are used to predict future health service needs, evaluate existing health programs, and identify trends in countries across the globe. The data is used by public health officials in creating policies to address inequalities in health programs and services across different regions.
A standard summary measure of population health at both the international and national levels, HALE is used by the WHO to measure a country’s effectiveness in reducing the burden of diseases.
Worldwide, substantial resources are devoted to decreasing the incidence, duration, and severity of diseases and chronic health conditions. Effective public health policies devoted to preventing or managing various health conditions result in improved overall quality of life and increased HALE.
HALE at age 60 increased by 1.6 years for males and 1.5 years for females all over the world between 2000 and 2019 (before the COVID-19 pandemic). According to the World Health Organization, this could be attributed to:
- Reducing smoking and the use of tobacco products
- Providing better access to water, hygiene, and sanitation
- Improving air quality
How HALE Is Calculated
HALE takes into consideration several different data points, like mortality rates and health status information, to estimate healthy life expectancy.
HALE represents the expected number of remaining years of life spent in good health from a particular age (typically birth or 65 years), assuming the rates of mortality and morbidity remain unchanged. HALE data is often also separated out by gender and race.
The available data can vary from country to country but commonly includes objective and subjective health status indicators that measure physical health, mental health, and functional status, along with self-perceived health scores based on national health surveys.
Sullivan’s Index
The most commonly used method to determine HALE is the Sullivan method, which is computed by subtracting the probable duration of disability or inability to perform important activities from the life expectancy.
Also known as disability-free life expectancy (DFLE), Sullivan’s index results in prevalence-based life tables that studies show provide a clear and consistent population health outcome measure for evaluating the success of investments in healthcare.
Multistate Life Tables
Another method of formulating HALE, the multistate life table method allows individuals to move between different health states over time. These can include things like smoking status, hypertension, and diabetes.
A study comparing the Sullivan’s index to the multistate tables found they both produce similar results at ages 60 and 70, but the multistate tables provide higher HALE estimates at age 90 and over.
HALE Around the World
Globally, in 2021, the average healthy life expectancy for someone age 60 was 74.7 years in 2021 (men: 73.8 years; women: 75.6 years).
Regionally, people living in the Western Pacific had the longest healthy life expectancy of 76.6 years, while those living in South-East Asia had the shortest health life expectancy of 72.2 years.
| HALE by Global Region, at age 60, 2021 | |||
|---|---|---|---|
| Region | All | Men | Women |
| Americas | 75.2 | 74.2 | 76.2 |
| Europe | 75.7 | 74.5 | 76.8 |
| Western Pacific | 76.6 | 75.4 | 77.8 |
| Eastern Mediterranean | 72.9 | 72.5 | 73.1 |
| South-East Asia | 72.2 | 71.7 | 72.7 |
| Africa | 72.6 | 72.2 | 73.0 |
In the United States, the average healthy life expectancy at age 60 in 2021 was 75.7. Men had a HALE of 74.8 while women’s HALE was 76.5.
Race also contributes to healthy life expectancy in the United States. A Lancet Regional Health Americas study of data from 2009 to 2019 showed that at birth, Asians had the highest HALE of 72.3 years, followed by Latinos (68.5), Whites (65.9), Blacks (63.4), and American Indian/Alaska Natives (60.7).
We don’t have 2019 statistics for each state, but a study providing data from 2016 shows that HALE ranges by state from 70.3 in Minnesota to 63.8 in West Virginia.
| U.S. States With the Highest HALE at birth, 2016 | |
|---|---|
| State | HALE |
| Minnesota | 70.3 |
| Hawaii | 70.1 |
| California | 69.9 |
| Washington | 69.1 |
| Vermont | 69.0 |
| U.S. States With the Lowest HALE at birth, 2016 | |
|---|---|
| State | HALE |
| West Virginia | 63.8 |
| Kentucky | 64.3 |
| Oklahoma | 64.5 |
| Alabama | 64.6 |
| Mississippi | 64.9 |
COVID-19 Impact on HALE
The global pandemic of COVID-19 had a significant impact on the steady increases of global healthy life expectancy seen between 2000 and 2019. During this time frame, HALE at birth rose by 5.4 years to 63.5 years.
However, COVID-19 caused the healthy life expectancy to fall back to the level of 2012, which was 61.9 years—a decrease of 1.6 years total.
A World Health Organization report from 2025 explains that the reasons for this decline are due to increased mortality rates directly and indirectly from COVID-19, related anxiety disorders, and depressive disorders.
How COVID-19 impacts future years of good health remains to be seen, as the long-term effects are still being studied. One study found that two years after infection, COVID-19 increased the risk of diabetes, lung issues, blood clots, and other conditions. Another study suggests that one-third of people who recover from acute COVID-19 infections may have both physical, mental, and cognitive health issues a year after their infection.
A Word From Verywell
Health-adjusted life expectancy estimates are used to make predictions about specific populations. While it can provide hints about how long you can expect to live in good health, it won’t give you a definitive answer.
Take steps to increase your years in good health, such as getting regular exercise, eating more plant-based foods, and keeping routine doctor appointments and regular physicals.
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