Breeding for health traits contributes to sustainable production in times of climate change. Accordingly, the economic health index (HI) of the Czech Holstein was established five years ago. Since then, the breeding process has been encouraged and current population parameters should be updated to revaluate HI for the optimal structure, selection gain and index reliability. General principles of the selection index theory were applied in the study. Current economic weight of the mastitis and overall claw disease incidence were -152 and -134 € per cow and per year, respectively. Based on the optimal index construction the health traits proportion should be slightly reduced from 20% to 14%. The internal ‘claw vs. mastitis’ traits ratio in the HI could be optionally updated from 1.2 vs. 1 to 1.8 vs. 1, respectively. The expected selection gain in health traits would be -0.02 mastitis and -0.18 claw diseases incidence and the selection reliability would enhance to 80%. It can be concluded that the overall changes that the local Holstein population has gone through are of impact on the optimal HI construction and selection response. To ensure the desired selection gain and selection reliability the HI should be updated in the near future.