Systems and methods include a computer-implemented method for determining an integrated surface-downhole integrity score for a natural flow oil well. Wellness surface parameters of a natural flow oil well are determined. Wellness downhole parameters for the natural flow oil well are determined, including parameters indicating well integrity and tubing/casing conditions. An integrated surface-downhole integrity score is determined using the wellness surface parameters and the wellness downhole parameters. An alert is provided for presentation to an operator in a user interface. The alert is provided in response to the integrated surface-downhole integrity score exceeding a threshold.