Does the algorithm for Geocache Health Score pull any data from "Your Unpublished Disabled Caches" (i.e. caches that are in preparation, but not yet submitted for review or published)?
In the Help Center, Geocache Health Score is described in Section 6.3, within Chapter 6 "Ownership after publication." This suggests that Geocache Health Score is based on just published caches.
Even if all of your published caches are properly maintained, however, if you have an unpublished disabled cache, when you start the process to prepare a new listing, you get the prompt page "Your Existing Geocaches May Need Attention. Before you submit a new geocache, it looks like one or more of your existing geocaches may need some attention:
[GC..... - Unpublished, Temporarily Disabled]
You may continue creating a new geocache, however, we recommend making sure your existing geocaches are in tip-top shape before you do."