Accelerated urbanization disturbs ecosystems and influences ecosystem structures and functions. Ecosystem health (ESH) assessments in regions undergoing the rapid urbanization process assist us in understanding how ESH changes and how urbanization specifically affects ESH. We assessed the ESH of Beijing-Tianjin-Hebei (BTH) region, China, including the ecosystem service value (ESV). In this study, we selected nine indicators and applied multiple pieces of software, including ArcGIS10.4, Fragstats4.2 and Geoda1.14 to detect the impacts of urbanization on regional ESH in 1995, 2000, 2005, 2010 and 2015. The results show that ESH in the BTH region increased from 2000 to 2015, especially in the northern parts. The improvements were due to the implementation of key ecological restoration projects protecting and re-establishing the forest in the north. Furthermore, the spatial correlation results indicate that urbanization had a negative impact on ESH in the BTH region, of which the dominant factor was the population density in 1995. The dominant factor was the construction land proportion from 2005 to 2015. We suggest that ecological restoration projects should be continued in northern regions with strong and relatively strong ESH levels to maintain high-level ecosystem health. In addition, more attention should be paid to the ESH level improvement in peri-urban areas.
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