A healthy bottom line: healthy life expectancy as an outcome measure for health improvement efforts

UMMS Affiliation

Department of Family Medicine and Community Health

Publication Date


Document Type



Attitude to Health; Databases as Topic; Databases, Factual; Health Behavior; Health Promotion; *Health Status; Health Status Disparities; *Health Status Indicators; Humans; Life Expectancy; Medical Record Linkage; Mortality; Socioeconomic Factors; United States


Community Health and Preventive Medicine | Preventive Medicine | Primary Care


CONTEXT: Good health is the most important outcome of health care, and healthy life expectancy (HLE), an intuitive and meaningful summary measure combining the length and quality of life, has become a standard in the world for measuring population health.

METHODS: This article critically reviews the literature and practices around the world for measuring and improving HLE and synthesizes that information as a basis for recommendations for the adoption and adaptation of HLE as an outcome measure in the United States.

FINDINGS: This article makes the case for adoption of HLE as an outcome measure at the national, state, community, and health care system levels in the United States to compare the effectiveness of alternative practices, evaluate disparities, and guide resource allocation.

CONCLUSIONS: HLE is a clear, consistent, and important population health outcome measure that can enable informed judgments about value for investments in health care.

DOI of Published Version



Milbank Q. 2010 Mar;88(1):30-53. Link to article on publisher's site

Journal/Book/Conference Title

The Milbank quarterly

Related Resources

Link to Article in PubMed

PubMed ID