diff --git a/octodns/provider/route53.py b/octodns/provider/route53.py
index 3ac9874..3359f3e 100644
--- a/octodns/provider/route53.py
+++ b/octodns/provider/route53.py
@@ -1338,10 +1338,11 @@ class Route53Provider(BaseProvider):
         self._gc_health_checks(change.existing, [])
         return self._gen_mods('DELETE', existing_records, existing_rrsets)
 
-    def _extra_changes_update_needed(self, record, rrset):
+    def _extra_changes_update_needed(self, record, rrset, statuses={}):
+        value = rrset['ResourceRecords'][0]['Value']
         if record._type == 'CNAME':
             # For CNAME, healthcheck host by default points to the CNAME value
-            healthcheck_host = rrset['ResourceRecords'][0]['Value']
+            healthcheck_host = value
         else:
             healthcheck_host = record.healthcheck_host()
 
@@ -1351,6 +1352,17 @@ class Route53Provider(BaseProvider):
         healthcheck_latency = self._healthcheck_measure_latency(record)
         healthcheck_interval = self._healthcheck_request_interval(record)
 
+        status = statuses.get(value, 'obey')
+        if status == 'up':
+            if 'HealthCheckId' in rrset:
+                self.log.info('_extra_changes_update_needed: health-check '
+                              'found for status="up", causing update of %s:%s',
+                              record.fqdn, record._type)
+                return True
+            else:
+                # No health check needed
+                return False
+
         try:
             health_check_id = rrset['HealthCheckId']
             health_check = self.health_checks[health_check_id]
@@ -1406,6 +1418,12 @@ class Route53Provider(BaseProvider):
         fqdn = record.fqdn
         _type = record._type
 
+        # map values to statuses
+        statuses = {}
+        for pool in record.dynamic.pools.values():
+            for value in pool.data['values']:
+                statuses[value['value']] = value.get('status', 'obey')
+
         # loop through all the r53 rrsets
         for rrset in self._load_records(zone_id):
             name = rrset['Name']
@@ -1424,7 +1442,7 @@ class Route53Provider(BaseProvider):
                 # rrset isn't for the current record
                 continue
 
-            if self._extra_changes_update_needed(record, rrset):
+            if self._extra_changes_update_needed(record, rrset, statuses):
                 # no good, doesn't have the right health check, needs an update
                 self.log.info('_extra_changes_dynamic_needs_update: '
                               'health-check caused update of %s:%s',
diff --git a/tests/test_octodns_provider_route53.py b/tests/test_octodns_provider_route53.py
index 01cdce3..680c9ce 100644
--- a/tests/test_octodns_provider_route53.py
+++ b/tests/test_octodns_provider_route53.py
@@ -2567,6 +2567,48 @@ class TestRoute53Provider(TestCase):
         self.assertEquals(1, len(extra))
         stubber.assert_no_pending_responses()
 
+    def test_extra_change_dyamic_status_up(self):
+        provider, stubber = self._get_stubbed_provider()
+
+        zone = Zone('unit.tests.', [])
+        record = Record.new(zone, 'a', {
+            'ttl': 30,
+            'type': 'A',
+            'value': '1.1.1.1',
+            'dynamic': {
+                'pools': {
+                    'one': {
+                        'values': [{
+                            'status': 'up',
+                            'value': '1.2.3.4',
+                        }],
+                    },
+                },
+                'rules': [{
+                    'pool': 'one',
+                }],
+            },
+        })
+
+        # status up and no health check so we're good
+        rrset = {
+            'ResourceRecords': [{'Value': '1.2.3.4'}],
+        }
+        statuses = {'1.2.3.4': 'up'}
+        self.assertFalse(
+            provider._extra_changes_update_needed(record, rrset, statuses)
+        )
+
+        # status up and has a health check so update needed
+        rrset = {
+            'ResourceRecords': [{'Value': '1.2.3.4'}],
+            'HealthCheckId': 'foo',
+        }
+        statuses = {'1.2.3.4': 'up'}
+        self.assertTrue(
+            provider._extra_changes_update_needed(record, rrset, statuses)
+        )
+
     def test_extra_change_dynamic_has_health_check_cname(self):
         provider, stubber = self._get_stubbed_provider()