For what little it's worth in my observations: On my end, NPC health is changing appropriately in my game. I did, however, have an issue with fistfights (in this case, recovering Lilly Millet's debt) causing opponents to die. I forget if that's INTENDED or not, but flipping DyingStatesForMelee to 1 and MeleeDyingStateKnockout to 1 made that specific case no longer an outright murder, but assault. However, I don't know if that fixes a different bug I've been having, with both 1.48 and 1.49, wherein Benedict Allbright would be killed, thus failing the mission, upon hogtie when rescuing him from the river. Was funny but clearly not intended behavior to have the bounty dredged out of the water, roped up, then promptly murdered by scripted punch to the dome. Toggling the mod for that scene fixed it, obviously, but I figured I'd report the issue, as it might be as simple as including him in that story NPC exclusions list you got going.