Objective  To construct a theoretical framework and measurement tools for a healthy living environment centered on the “production-living-ecological spaces” (PLES), thus providing a scientific and operable assessment tool for quantifying regional environmental health levels, theoretical support and empirical evidence for addressing health inequalities and advancing the strategy of common prosperity in health, and references for public health intervention policies that precisely identify environmental health risk exposure and implement spatial targeted interventions.

Methods  A theoretical framework and indicator system for a healthy living environment were established through literature review, expert consultation, and qualitative interviews. A comprehensive index of healthy living environment was calculated through a combined subjective-objective evaluation method. The evaluation effectiveness of the comprehensive index was assessed via a generalized additive model (GAM).

Results  Overall, the comprehensive index of healthy living environment exhibited a spatial pattern of being high in the southeast and low in the west and northeast. Beijing, Shanghai, Tianjin, and Chongqing had an index higher than 47.57, representing the optimal healthy living environment. The evaluation effectiveness analysis revealed a positive correlation between the comprehensive index of healthy living environment and average life expectancy, indicating that improving the living environment can enhance population health benefits.

Conclusion The theoretical model and measurement tools for a healthy living environment that is constructed from the PLES perspective are scientifically valid and effective, providing theoretical and instrumental support for achieving common prosperity in health.