Objective To understand the degree of coordination and the changing trends of Healthy China construction and high-quality economic development in different provincial-level administrative divisions (PLADs) of China, so as to promote the synergy of the two systemic developments.

Methods From China Statistical Yearbook, China Health Statistical Yearbook, and China National Environmental Monitoring Centre, we extracted relevant panel data of 31 PLADs in Chinese mainland from 2012 to 2021. A coupling coordination degree model of Healthy China construction and high-quality economic development was constructed for PLADs. Kernel density estimation and spatial Markov prediction model were used to explore the spatial-temporal dynamic evolution characteristics of coupling coordination degree in each PLAD and predict the evolution trend.

Results From 2012 to 2021, the average coordination index of the 31 PLADs was 0.510, with 3 PLADs having the index of intermediate and primary coordination, 10 having the index of just about coordination, and 18 having the index of mildly unbalanced coordination. From the perspective of spatial evolution, there was an obvious "gradient effect" within the economic development region-specific coupling coordination indexes, showing an east-central-west step distribution and a descending spatial distribution pattern for the eastern region (coordination index of 0.582), the national average (0.510), the central region (0.480), and the western region (0.463). In terms of temporal evolution, the region-specific coupling coordination indices continued to increase, with the central region showing the largest increase (0.120), followed by the eastern (0.116) and western (0.110) regions.

Conclusion Healthy China construction and high-quality economic development in China shows a positive trend, and the regional coordination level is limited by the lag of high-quality economic development. There is significant regional heterogeneity in the coordination level of each region. Considering the spatial effect, adjacent PLADs with high and relatively high levels will have a radiating and driving effect on PALDs with low and relatively low levels, and there is a positive spillover effect.