This study aimed to explore the structural contributions of socioeconomic status (SES), comorbidity, and activity limitation to the healthy life expectancy (HALE) of Japanese suburban elderly. A questionnaire survey was distributed to all residents aged 65 years and older in Tama City, Tokyo, in 2001; a follow-up study was conducted in 2004; and individual vital status data from the municipal residents’ registry were tracked until 2007. In all, 7,905 respondents were included for analysis. Data analysis was performed by structural equation modeling (SEM). The data were well fit by the models, and HALE was found to be well explained by SES, comorbidity, and activity limitation (R² = .59 for men and R² = .71 for women). In conclusion, elderly people with higher SES were more likely to live longer with good self-rated health, via living with less chronic diseases and better performance in daily living activities, especially for elderly women.