Abstract

• The ECCDMM was proposed firstly to study the health of HDCs. • In the high-quality development stage of HDCs in developing countries, ecosystem quality remains a decisive factor for HDCs health, while the main influencing factor is social system development level. • In 2018, 50% of the cities in Yangzi River's high-density urban agglomeration are in a healthy state and 50% are in a sub-healthy state. Affected by various urban diseases, the sustainable development of high-density cities (HDCs) is under tremendous pressure. The health evaluation methods of HDCs, such as the emergy method and urban health index evaluation method, have difficulties in reflecting the internal mechanism of the system with non-uniform evaluation indices. The Emergy Coupling Coordination Health Diagnosis Model (ECCHDM) was proposed to study the health of sustainable cities and the design mechanisms. The Yangzi River urban agglomeration is taken as an example for practical research. Results show that: (1) ECCHDM is reliable and reasonable in investigating and evaluating the mechanism and health of urban systems; (2) In the high-quality development stage of HDCs in developing countries, ecosystem quality remains a decisive factor for HDCs health, while the main influencing factor is social system development level. (3) In 2018, 50% of the cities in the Yangzi River urban agglomeration are in a healthy state and 50% are in a sub-health state. The proposed research methods can also be applied in the planning and design of HDCs in other developing countries.

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