Healthy Life Expectancy
Also known as: HALE, Health-Adjusted Life Expectancy, Disability-Free Life Expectancy
Healthy life expectancy partitions ordinary life expectancy into the years a person can expect to live in good health and the years expected to be lived with disability or ill health. Building on the life table, the classic Sullivan method weights each age interval's person-years by the prevalence of good health, so the resulting expectancy answers not just 'how long will people live?' but 'how many of those years will be healthy?'. It has become a headline summary of population health, reported by the World Health Organization as HALE and tracked alongside life expectancy to judge whether longer lives are also healthier lives.
Key highlights
- Combines mortality and morbidity into one interpretable indicator of years of healthy life.
- The Sullivan method needs only a life table and cross-sectional prevalence data, which are widely available.
- Directly reveals whether gains in longevity are healthy or unhealthy years (compression versus expansion of morbidity).
- Adopted by the WHO and OECD as a standard population-health summary, giving it broad comparability and policy traction.
Intuition
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How it works
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When to use it
Use healthy life expectancy when you need a single summary that combines mortality and morbidity to compare population health across countries, subgroups, or time — for instance to assess whether rising life expectancy is accompanied by more healthy years. The Sullivan method is preferred when you have a life table and cross-sectional health-prevalence data but not longitudinal transition data. Assumptions: the prevalence of ill health reflects a stationary process consistent with the life table, the health measure is comparable across the populations compared, and the cross-section adequately represents current conditions. Do NOT use the simple Sullivan method when health states change rapidly or when you need to model recovery and transitions between health states — a multistate life table is then required; and do NOT compare figures based on different health definitions or survey instruments, since the morbidity component is highly sensitive to how 'healthy' is defined.
Strengths & limitations
- Combines mortality and morbidity into one interpretable indicator of years of healthy life.
- The Sullivan method needs only a life table and cross-sectional prevalence data, which are widely available.
- Directly reveals whether gains in longevity are healthy or unhealthy years (compression versus expansion of morbidity).
- Adopted by the WHO and OECD as a standard population-health summary, giving it broad comparability and policy traction.
- The Sullivan estimate uses cross-sectional prevalence, which reflects past as well as current conditions and is not a true incidence-based measure.
- Results are highly sensitive to the definition and measurement of 'healthy', so cross-survey comparisons can be misleading.
- It assumes a stationary relationship between prevalence and the life table that may not hold during rapid health change.
- The simple method cannot represent recovery or movement between health states, which requires a multistate model.
Common pitfalls
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Applications
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Frequently asked
What is the Sullivan method?
The Sullivan method computes healthy life expectancy by weighting the person-years in each age interval of a life table by the age-specific prevalence of good health from a cross-sectional survey, then re-cumulating. It is the simplest and most widely used way to produce health expectancies because it needs only a life table and prevalence data, not longitudinal transition rates.
How does HALE differ from disability-free life expectancy?
Disability-free life expectancy applies a 0/1 split — years are counted as either fully healthy or not at all — whereas HALE applies graded health-state valuations between 0 and 1, so years lived with partial disability count partially. HALE therefore reflects the severity of ill health, while disability-free life expectancy reflects only its presence or absence.
Why can healthy life expectancy fall while life expectancy rises?
If survival improves mainly by keeping people alive in poor health, the extra years are unhealthy years, so total life expectancy rises faster than healthy life expectancy — an expansion of morbidity. Conversely, if disability is postponed faster than death, healthy life expectancy rises faster — a compression of morbidity. Comparing the two trends is precisely what makes the measure valuable.
Sources
- 1.Sullivan, D. F. (1971). A single index of mortality and morbidity. HSMHA Health Reports, 86(4), 347–354.
- 2.Preston, S. H., Heuveline, P., & Guillot, M. (2001). Demography: Measuring and Modeling Population Processes. Blackwell.ISBN 9781557864512
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Cite this page
ScholarGate. (2026, June 22). Healthy Life Expectancy. ScholarGate. https://scholargate.app/demography/healthy-life-expectancy