Dr. Toshi Is In! "What is HALE?"

Dear Dr. Toshi,

Recently, I heard of something called "Health Adjusted Life Expectancy (HALE)." What is that?

HALE stands for Health Adjusted Life Expectancy, which I'll call health expectancy. But before going into that topic, I'd like to ask you a question. Why do you go see your doctor? And why do you think doctors and providers ask you to be seen regularly even when you're feeling well?

Of course, when you get sick or don't feel well or get injured, you go to a doctor or other healthcare provider or to a hospital. You want to get the problem fixed. But what about going to the doctor when you're feeling well? Why do we have to get health screening tests like a colonoscopy, mammogram, cervical cancer screening (PAP smear) as we get older even though we may feel just fine? Why do we do that? Some people think it's because the doctors, other providers, and hospitals just want money, and it's actually just a waste of time and money. I can understand why someone might feel that way.

So, let's talk about "Healthy Expectancy" today, which has a lot to do with why you should see your doctor or other provider regularly even when everything is going well.

No one knows about his or her future, and no one knows when their life will end. Even well-trained doctors in fields like oncology (cancer medicine) aren't good at predicting this for individuals. There are many factors that determine your medical conditions and your health, including your activities (including exercise, smoking, alcohol, etc.), the environment you live in (which might be stressful, or have exposure to toxins, etc.), and your genes (so choose your parents wisely! ;-). So, as you can see, you have control over many of these things. You and I would want the best possible likelihood to have a long, healthy life.

I'm sure you've heard of "life expectancy." Older people who look into Social Security certainly have seen this term for planning purposes. In fact, there is a Social Security website where you can get an estimated life expectancy calculated for yourself based on a lot of statistical data collected in research. (If you're interested, you can to go a website called "Life Expectancy Calculator" at https://www.ssa.gov/oact/population/longevity.html. You don't have to be a certain age to use this calculator; you can even use it for newborn babies! Now, this is just a general, statistical life expectancy – how many years you may expect to live based on general population data. It doesn't take into consideration your genetics, your environment, or other important factors like smoking, exercise, your weight, or medical conditions you may have.

"Health Adjusted Life Expectancy (HALE)" (health expectancy) is a little different. It's the "average number of years that a person can expect to live in full health." Just be aware that it's the "average number of years" for a population, but it's different for each individual depending on the personal factors I mentioned above.

As you might have guessed, a person's health expectancy is shorter than their "life expectancy." In the US in 2020, life expectancy at birth is 75.2 years old for men and 80.5 years old for women. (By the way, it went down a little in 2020 from 2019. Population researchers think it's due to COVID-19 as well as a surge in drug overdoses from opioids.)

In 2019, health expectancy at birth in the US was 65.2 years old for men and 67.0 years old for women. That means that for an average person who is just born can expect to have full health for that many years and continue to live with health problems for 10-13 more years after that. There is another health adjusted life expectancy called, "Health Life Expectancy at age 60." That's the average of number of years of full health left at age 60 for someone who is healthy when they're 60, and that is 15.6 years for men and 17.1 years for women. In other words, if you made it to 60 years old in good health, you can expect to continue to be in full health for that many more years on average.

So, all this is about the likelihood of having a long, healthy life. And when you talk about a longer, healthier life, preventive medicine becomes extremely important. Your primary care physicians and providers can help you stay healthy.

Dr. Toshiko ("Toshi") Luckow, MD, is a Family Physician at the West River Health Services Hospital and Clinics.