Health in games

Replacing health can lead to deeper immersion, clearer understanding an interesting depth.

· 8 min read
Health in games

This is part of my series about my design for a systemic story game. I will be reflecting on aspects of Horizon Forbidden West, how it differs from Horizon Zero Dawn, and what I would like to see in a future systemic story game. Topics sorted in order of appearance. Starting at the beginning.

The concept of health points comes from old tabletop games such as Dungeons and Dragons. It's a simple abstraction of the real world complexities. With computers keeping track of the game, it should be possible to do something much more interesting.

Health bar as user interface

For a typical action game where you are trying to stay alive, the health bar serves as a clear indication to the player of how close you are to death. Even if the game uses a more intricate simulation of several factors, we would still need to aggregate all that data to help the player gauge the situation.

Most people learn to filter out things on screen that's not relevant to the current situation. When things get chaotic, it's easy to miss important information about the state of the player represented by bars and icons in the corner of the screen. New players will often understand the meaning of the UI and will have no time to try to understand what it means while there are dangers in the game.

Game UI can be flat, diegetic, spatial or meta. The traditional health bar in the corner of the screen is an example of flat UI. Example of Diegetic UI in Horizon is when Aloy will turn her head towards things you can interact with. Herbs you can pick up will have blue butterflies flying around them. Machines will display their current state by the color of their lights and their sounds. The interaction markers such as grappling points are an example of spatial UI.

In a third-person game, where you control a character that you also can see on screen, you embody the character but also look at it from the outside. The screen is not the eyes of the character, but some effects modify the screen as if it’s connected to the character. When the character gets blinded, you will experience a similar effect. That is meta UI. When Aloy is close to death, the corners of the screen will display a red haze, and you will feel her heartbeat through haptic feedback.

I personally hate Game interface elements popping up on the screen calling for attention. I usually turn off everything I can to the point where the screen only contains the beauty of the world. Aloy in Horizon will turn her head towards things you can interact with. Herbs you can pick up will have blue butterflies flying around them. Machines will display their current state by the color of their lights and their sounds. I like the system where I have access to the information on demand, by touching/swiping the touchpad.

There could be a lot of diegetic and meta UI that could replace the need of a health bar, such as blurred vision, limping, noises of pain, marks on the body and clothes, damaged equipment, breathing, heartbeats and more.

The Infamous games don't have a health bar. In the Second son, you will get smudges at the end of the screen, then desaturated colors, and then audio changes with vibrations indicating how close to death you are. Uncharted has a similar system, except that it’s actually a luck meter. The more close calls you have in short succession, the closer you are to your luck running out, resulting in the next bullet actually hitting you.

The logic of health points

Having healthpoints is not realistic. There are games where you can magically fully restore health by a potion. Yet, when your companion gets hurt, you have no ability to just use one of your potions to heal them. And at certain points in the story, you get knocked out and have to spend several moments or days or weeks recovering. You could have easily handled much worse injuries in normal gameplay. There is a disconnect between the story and the gameplay.

There are lots of games that don't have or at least expose health as a number of points. In the 1985 game Ghosts 'n Goblins, you will start out almost naked, but can find and put on a suit of armor. That armor will protect you from one hit but you will also lose the armor.

I want to clear up three different concerns in choosing how to design the game mechanics of healing. The first is the simulation of the real world. The second is to have the mechanic understandable with feedback communicating states and changes between states making the player understand the situation. The third is to have a depth of interconnectivity that will give rise to more interesting combinations than anyone can ever grasp.

Simulation is interesting in itself but could easily be boring. A game will bend the physics of the world to suit the gameplay and story. Simulating details beyond the comprehension of the player is useless. The point of simulation is how it creates a relation to the known world. We can connect what happens in the game with knowledge and experience from our life and from other stories and games. There are still so many aspects of stories that haven't been converted to game mechanics.

What does it mean to have 100 health points? How does it differ from 99 or 101? It’s not clear what it means for the player and it’s not deep. When you hit an enemy you want to know what it actually did. You want a reaction and also see the difference. That will also let you know what the enemy still can do and how close it is to surrender. Giving the enemy 100 hit points would mean having 100 different animations and textures. – The practical hitpoints translate to the number of hits it takes to defeat an enemy. As a rule of thumb. You should never have to hit the enemy more than three times before you can visibly see the change.

I like the design in Horizon Zero Dawn where the machines have lots of parts. You will have to remove protective plating to expose vulnerable parts, and usually make the machine stand still in order to find the right angle and hit the right spot. All the damage is predictable. The randomness only comes from the difficulty to actually hit the right spot due to movement. I would have liked the game to develop this aspect even more by not having large pools of hit points but rather many parts for different functions, like sight, mobility, and so on, that can be disabled by using the right weapon in the right spot.

More interesting than hitpoints is the actual states and parts. Some of them can be timed. You could have a boss with no hitpoints. First you knock its shield off. Then you stagger it. Then you knock it down. Then you defeat it. It will try to counter you and strike back, but do so in different ways depending on its state. And it will stand up and pick up its shield if it gets the chance. Rather than hitpoints, it could have levels of stress and tiredness. You could add other stuff, but the point is that the player can learn the state of the enemy without the need for hitpoints. And the same goes for the player health.


I’m proposing to replace the basic health points with a combination of systems connected to the world you can interact with. It would open up more possibilities to try out different combinations of things to affect your state. You could use more of your prior world knowledge to form ideas about how things might work and what to try.

So it’s not about realism for its own sake. An action oriented game could be frustrating if the player would lose mobility due to injury. The system should not take away from the fun of the game. Making a mistake resulting in an injury should not take away from your survivability. And you should not have to do boring stuff, like gathering healing herbs and resting, just because you weren't perfect in the last encounter.

I often see players run through lakes and jump down cliffs just because it entails slightly less effort than taking a couple of steps to the side and going over the bridge or taking the stairs. Behaving like that outside of battle or time sensitive situations should at least decrease the level of comfort. It should take a long time to dry out clothes and running in wet shoes should increase the risk of abrasions. Doing stuff like that should be visible in the mood of the character, taking her out of the “well rested” state. Discomfort should build up slowly, just as a nudge for players wanting the immersion, without hindering those who choose to ignore it. That is, let players run/fly everywhere if they want, but I would love the game to recognize when I’m taking care of my avatar. The game should recognize and reward things you would do if this was real, while still enabling doing awesome stuff and not take away from the fun of combat.

Generic health-points can be replaced with things like stamina, pain, stress, stagger, daze, bleeding, and so on. Stamina that starts generating after a couple of seconds is loosely based on ATP. You can find suitable connections to the real world through blood oxygen, pressure, sugar, hydration, nutrients, cortisol, adrenaline, endorphins, glycogen and ATP.

A system of adrenaline can be used to give the player a good chance to fight back even after injuries. They have a certain number of seconds to fight back or escape, and then a certain number of minutes until they must stop and rest and take care of wounds. A sprained ankle should result in sound, animations and screen effects, but only have a small effect during the immediate battle. Horizon Forbidden West has the crushed status effect that doesn't stop the player from continuing the fight, but it does stack up future cost, as it would if you would continue to run with a sprained ankle. After the battle and a few minutes after you stopped running, the ankle will swell to begin healing, thus limiting your mobility. You will not be able to sprint, in the same way as you would actively try to keep pressure off the swollen part of the body.

The power of games is that it’s possible to cut out all the boring parts. Finding your way back to safety is interesting if there is a real risk of failure. Taking care of the injury can be interesting the first time you do it. Finding ways to heal can be an adventure in itself. But after you mastered the process, or already gathered all the things you need for it, we could just skip the details. Resting at a camp would imply taking care of injuries and equipment. Games often do this skipping of details through a skill-tree where you don’t have to go through all the steps of upkeep in the later parts of the game.

The level of detail for healing would depend on the type of game. If the game mostly consists of the same type of combat over and over again, you would probably not use this type of system. But I would love it if Horizon had a mode of play where you only could heal at a camp and only craft stuff at a bench.

For the systemic story game I would like to see, every fight would be unique and part of the story. The game will try to give the player different outcomes, in such a way that you would not have to do the same type of recovery in the same way. More on that later.


Written by Jonas Liljegren
Exploring unconventional methods in technology development to shape a better future.