Reflections on the technical pathways for integrating healthy life expectancy into the national health assessment system
10.19428/j.cnki.sjpm.2026.260067
- VernacularTitle:健康预期寿命纳入国民健康考核体系的技术路径思考
- Author:
Liang ZHOU
1
;
Dan ZHOU
1
;
Hui WANG
1
Author Information
1. School of Public Health, Shanghai Jiao Tong University, Shanghai 201318, China
- Publication Type:Journal Article
- Keywords:
healthy life expectancy;
Healthy China Strategy;
national health assessment system;
digital health;
governance mechanism
- From:
Shanghai Journal of Preventive Medicine
2026;38(8):573-580
- CountryChina
- Language:Chinese
-
Abstract:
Integrating healthy life expectancy (HLE) into the national health assessment system is a key institutional arrangement for advancing the Healthy China Strategy from a disease-centered to a health-centered paradigm. From 2000 to 2021, China's life expectancy (LE) increased by an average of 0.39% annually, while HLE increased by 0.36%. The absolute gap between LE and HLE widened from 7.7 to approximately 10.4 years, and the HLE/LE ratio declined slightly from 89.2% to 87.7%, reflecting an expansion of morbidity. These data reveal that the current LE-oriented assessment system has institutionalized an incentive structure that overemphasizes diagnosis and treatment while neglecting prevention and rehabilitation, representing one of the key institutional roots of the slower growth in HLE compared to LE. However, integrating HLE into the assessment system faces four systemic barriers, including inconsistent indicator definitions and measurement standards, difficulties in attributing intervention effects, fragmented cross-sectoral governance, and unclear pathways to achieving health equity. Accordingly, a “stratified, classified, and multi-dimensional” HLE assessment framework has been constructed, clarifying the three-level assessment hierarchies (national-provincial-municipal/county) and multi-departmental responsibility allocation, and proposing some digital-intelligent support pathways including artificial intelligence (AI)-assisted dynamic monitoring, digital twin interventions, healthy city intelligent ecosystems, and AI equity initiatives, so as to provide a referential pathway for advancing HLE from a monitoring concept to a governance tool.
