Chinese Cities Research Articles

Development of a complex intervention to prevent complications in patients recovering at home after transcatheter aortic valve replacement by optimizing home-based cardiac rehabilitation processes: a Delphi study

ObjectivesThis study aimed to systematically develop a nurse-led complex intervention to enhance the quality of and adherence to home-based cardiac rehabilitation (HBCR) care for patients who have undergone transcatheter aortic valve replacement (TAVR). The intervention integrated stakeholder perspectives, expert insights, empirical evidence, and theoretical frameworks.MethodsWe initially searched for initial cardiac rehabilitation strategies based on the “Behavior Change Wheel” model and literature review. The Delphi method was used in three rounds of consultations. The guidelines for the Conducting and Reporting of Delphi studies were also followed. The Delphi panel consisted of 15 experts in rehabilitation medicine, clinical medicine, cardiovascular nursing, behavioral science, community nursing, geriatric nursing, and nursing management from various provinces and cities in China. Panelists were asked to rate the effectiveness of HBCR strategies on a 5-point Likert scale.ResultsA questionnaire was sent to the members of the expert panel via email. The consensus from 15 experts led to the development of a framework in round 3. The response rates for the three rounds were 88.23, 100.00, and 100.00%, respectively. The expert authority coefficients for all rounds were 0.95. The Kendall coefficients obtained in the three rounds were 0.09, 0.78, and 0.87, respectively.ConclusionA set of strategies was developed for a comprehensive HBCR program for patients with TAVR, which can provide practical methods for relevant government departments, healthcare professionals, and patients’ families. Future research should investigate the experiences of stakeholders and assess the cost-effectiveness of implementing these strategies.

Pursuing Cleaner Skies: A Study on the Impact of China’s Environmental Protection Tax Law on Haze Pollution

Haze pollution control is integral to green development, and fiscal and taxation policies are fundamental mechanisms supporting this effort. This study leverages the implementation of China’s Environmental Protection Tax (EPT) Law as a quasi-natural experiment to assess the impact and mechanisms of the greening of the tax system on haze pollution based on panel data from 281 prefecture-level cities in China from 2012 to 2021. The findings indicate that (1) the implementation of the EPT Law significantly reduces haze pollution, with results confirmed after a series of robustness tests; (2) the EPT Law controls haze pollution through promoting cleaner industrial structure, fostering green technological innovation, and strengthening the rigidity of environmental law enforcement; (3) fiscal decentralization enhances the inhibitory effect of the implementation of the EPT Law on haze pollution; (4) the haze-reduction effect of the EPT Law is especially notable in non-old industrial bases, areas with less pressure on officials’ promotions, and areas with higher public environmental awareness. This study not only enriches research on the policy effects of the EPT Law but also contributes to the environmental sustainable development goal of greening the tax system and continuously fighting for blue skies.

Prevalence and influencing factors of medication-related burden among patients with late-life depression in typical city of eastern China: a cross-sectional study

AimTo evaluate the medication-related burden (MRB) of patients with late-life depression (LLD) and its influencing factors in China using the Living with Medicines Questionnaire-3 (LMQ-3), providing reference for reducing the MRB of those patients.MethodA cross-sectional study was conducted between September 2023 and January 2024 on 588 patients with LLD. LMQ-3 and MRB factors questionnaire were used for data collection. The distribution of variables was assessed using descriptive analysis, while analyses of Mann-Whitney and Kruskal-Wallis were performed to evaluate inter-group differences. To explore the MRB among patients with LLD and influencing factors, multiple linear regression analysis was performed.ResultsThe median (IQR) LMQ-3 score of 588 participants was 102 (18), indicating a moderate MRB level. Regression analysis revealed a significant trend toward higher perceived burden among patients aged 70–79 years old, living in rural areas, receiving more medical insurance settlements, using all cash, taking more than 5 drugs each time, and taking medicine more than 3 times a day (p < 0.05), which were risk factors for higher MRB. Conversely, patients who lived with their children, had an annual household income (including adult children) more than 50,000 Chinese Yuan, and no adverse drug reactions had lower LMQ-3 scores (p < 0.05), which were protective factors. Patients’ concerns about medicine, their lack of autonomy in medicine regimens, and the lack of communication between patients and doctors on treatment regimens were the main causes of the burden.ConclusionsResults of this study provided preliminary evidence of the MRB among patients with LLD. Age, residence, living status, annual household income, type of drug payment, quantity and frequency of medication, and adverse reactions significantly affected the perceived medication burden. It is advisable for health policy makers and health care providers to implement appropriate intervention strategies and burden reduction programs for this vulnerable group.

Identifying urban villages: an attention-based deep learning approach that integrates remote sensing and street-level images

Urbanization has been a driving force for economic growth, yet it has also caused the emergence of informal urban settlements such as urban villages (UVs), which are characterized by issues such as arbitrary land use, high-density construction, and insufficient infrastructure. In previous studies on UV detection, the semantic imbalance and feature interaction among cross-modal data have not been comprehensively considered, impacting the accuracy and interpretability of the results. In this work, a cross-modal fusion framework is proposed that integrates high-resolution remote sensing and street view images for UV detection. First, convolutional neural networks (ResNet-50) are used for feature extraction from both remote sensing and street view images. Then, an inner product channel attention module is used to dynamically adjust weights while considering multiangle views of street view images. A cross-modal feature fusion module that incorporates dilation convolution and a global-based feature fusion block is used to enhance feature interaction and fusion. The method has an overall accuracy (OA) of 0.975 for UV classification in a case study of the Guangzhou–Foshan metropolitan area in China, outperforming a set of baseline methods. The integration of remote sensing and street view images improves the OA value by approximately 2%. This work enhances the understanding of the distribution of UVs via both top-down and ground-level view data in an automatic and efficient way, providing urban planners with valuable insights to accurately identify UVs and support targeted, sustainable urban renewal aligned with the SDGs for inclusive, resilient cities.

Spatial Distribution and Mechanisms of Groundwater Hardness in the Plain Area of Tangshan City, China

Groundwater resources play a critical role in meeting the agricultural, industrial, and domestic water demands of Tangshan, a key industrial city in China. However, with the acceleration of urbanization and the overextraction of groundwater, issues related to groundwater quality have become increasingly apparent. Notably, groundwater hardness has steadily increased over the years, posing risks to human health and elevating industrial water treatment costs. This study analyzed the spatial distribution characteristics and causes of groundwater hardness using 214 groundwater quality samples collected in 2022 from the plain area of Tangshan City, employing inverse distance weighting (IDW), Gibbs diagrams, ion ratios, mineral saturation indices, and Pearson correlation analysis. The results indicate that, in horizontal distribution, high-hardness groundwater is predominantly concentrated in the southern coastal plain area, with hardness gradually decreasing from south to north. Vertically, shallow groundwater in the coastal plain exhibits significantly higher hardness than deep groundwater, with a non-compliance rate of 94.12%, while deep groundwater hardness remains markedly lower. Mid-depth groundwater (60–300 m) in the alluvial plain exhibits elevated hardness, primarily attributed to mineral dissolution and agricultural irrigation return flow. The spatial distribution pattern of groundwater hardness across the study area is predominantly governed by hydrogeochemical processes and hydrochemical environmental factors, with cation exchange adsorption and evaporation–concentration processes identified as the dominant influences. The analysis of ion sources indicates that Ca2+ and Mg2+, the primary contributors to groundwater hardness in the area, are mainly derived from the weathering and dissolution of carbonate minerals, sulfate minerals, and cation exchange processes. Therefore, an in-depth investigation into the spatial distribution and driving factors of groundwater hardness in Tangshan can provide a scientific basis for regional water resource management, pollution control, and water quality optimization. Such research also supports the development of sustainable groundwater management and optimization strategies.

Probabilistic Tsunami Hazard Assessment from Manila Trench to Shantou City in China

Manila Trench is an ocean trench that lies to the west of Luzon Island in the Philippines, which has the potential to generate a significant tsunami that could affect the coastal areas around it. This paper analyzes the tsunami hazard at the southern coastline of China, and more specifically at the city of Shantou. A Monte Carlo-type probabilistic tsunami hazard assessment (PTHA) with 5000 simulation runs was conducted using the tsunami propagation model COMCOT. A wide range of earthquake magnitudes were stochastically simulated in these zones, ranging from 7.0 to 9.0 in magnitude, and the peak nearshore tsunami amplitude (PNTA), for return periods of 100, 1,000 and 10,000 years, was determined by propagation simulations to be 0.15 m, 0.65 m and 1.75 m, respectively. Inundation simulations for the case study area, which considered various scenarios of sea level rise between the present day and the year 2100, were also conducted. The results indicate the severe influence that sea level rise could have on tsunami risks, which can provide valuable information for disaster risk managers and planners on how to develop adaptation pathways not only for this city but also for other points in the southeast coastline of China.

The Impact of Bamboo on Rainfall-Triggered Landslide Distribution at the Regional Scale: A Case Study from SE China

It is widely accepted that land use and land cover (LULC) is an important conditioning factor for landslide occurrence, especially when considering the role of tree roots in stabilizing slopes and consolidating the soil. However, it is still difficult to assess the impacts of a specific LULC type on landslide distribution. The objective of the present study is to reveal the relationship between bamboo and landslide distribution at the regional scale. We aim to answer the following question: do the areas covered by bamboo have a higher susceptibility to landslides? Wenzhou City in SE China was taken as the study area, and a landslide inventory containing 1725 shallow landslides was constructed. The generalized additive model (GAM) was employed to assess the significance of LULC and nine additional factors, all of which were generated using the GIS platform. The frequency ratio (FR) method was used to analyze and compare the landslide density in each LULC category. Machine learning models were applied to perform landslide susceptibility mapping of the region. The results show that in the Wenzhou region, LULC is the second most important factor for landslide occurrences after the slope factor, whereas bamboo has a relatively higher FR value than most other LULC categories. The accuracies of the landslide susceptibility maps obtained from the random forest and XGBoost models were 79.6% and 85.3%, respectively. Moreover, 23.8% and 25.5% of the bamboos were distributed in very-high- and high-susceptibility-level areas. The incidents and density of landslides in bamboo areas were significantly higher than those with debris flow and rock collapses, indicating a promotional effect of bamboo on slope failure in the study area. This work will improve our understanding regarding the role of geological and ecological conditions that affect slope stability, which may provide useful guidance for land use planning and landslide risk assessment and mitigation at the regional scale.

Can new quality productive forces promote inclusive green growth: evidence from China

Inclusive green growth (hereafter “IGG”), as a green and intensive development mode that considers both fairness and efficiency, environmental protection and development, is crucial for achieving sustainable development. New quality productive forces (hereafter “NQPFs”) have become a novel and significant factor in promoting IGG. This study aims to examine the connection between NQPFs and IGG. Based on the data from 283 Chinese cities between 2010 and 2021, the “CRITIC-entropy value” objective combination weighting method is adopted to establish comprehensive indicator system of NQPFs and IGG in this paper. The spatiotemporal characteristics, mutual relationship and influencing mechanism of NQPFs and IGG are evaluated based on kernel density function, panel fixed effect model and spatial Durbin model. The results show that both NQPFs and IGG in China have shown a steady upward trend. NQPFs can significantly promote IGG, and economic agglomeration and technological innovation are important approaches to their interaction. In the period of high Internet penetration and in developed cities, the role of NQPFs in promoting IGG is more obvious. There is also a double threshold effect of financial development in this promotion process. With financial development improving, this promotion effect is significantly enhanced. Our research advocates promoting IGG by enhancing NQPFs, thereby protecting the earth’s ecological environment and attaining long-term sustainability of human society.

The Symphony of Evolution: Unraveling Infrastructure Public–Private Partnerships Collaboration Networks Through Participant Characteristics

ABSTRACTUsing collaborative governance theory and stochastic actor‐oriented models (SAOMs), this study examines the co‐evolution of networks and participant characteristics in 1505 infrastructure PPP projects involving 3225 participants across 35 large and medium‐sized Chinese cities. The results show that collaborative networks are highly structured and exhibit small‐world characteristics. Furthermore, in the evolving landscape of China's PPPs, the collaboration network has shifted into three governance patterns: government‐SOEs (State‐owned enterprises) driven, SOEs‐consulting driven, and SOEs dominant. In addition, results reveal that network evolution is promoted by transitive triads, the similarity of organizational size, and geographic proximity, while it is hindered by outdegree, similarities of organizational age and type. The findings provide insights for partner selection and the involvement of governments in public service delivery and the development of governance strategies.

Comparing the impact of sexualised drug use with and without chemsex on sexual behaviours among men who have sex with men in China: a national multi-site cross-sectional study.

Background Sexualised drug use (SDU) is common in men who have sex with men (MSM). Chemsex, a form of psychoactive SDU, is a strong risk factor for sexually transmitted infections (STIs). We investigated the associations of SDU and chemsex with the sexual behaviours in Chinese MSM. Methods From 23 March 2022 to 22 April 2022, we recruited participants (male, >18 years old) via WeChat across five Chinese cities to an online cross-sectional survey on sexual behaviour preferences, pre-exposure prophylaxis, SDU, and chemsex. One-way ANOVA and chi-squared tests were used to compare sexual behaviour patterns across the groups. Results We included the responses from 796 eligible participants, who were aged 18-70 years, and mostly single. Three groups of participants were identified, the largest was the 'non-SDU group' (71.7%), followed by the 'SDU without chemsex' group (19.7%), and the 'chemsex' group (8.5%). Poppers (8.4%) were the most used drugs in the 'chemsex' group. The 'chemsex' group also had the highest number of sexual partners, and reported the highest frequency of self-masturbation (38.2%). The'chemsex' group also exhibited the highest Shannon diversity index value of 2.32 (P =0.03), indicating a greater diversity of sexual acts. For sequential sex act pairs, the 'chemsex' group was more likely to self-masturbate than perform receptive oral sex, perform receptive oral sex than self-masturbate, being masturbated or perform receptive oral sex than being rimmed by another man. Conclusion Our findings identify the urgent need for targeted HIV/STI interventions for MSM who practice chemsex.

The impact of green low-carbon finance on smog reduction and carbon mitigation: evidence from a spatial panel simultaneous equations model

ABSTRACT Mitigating smog and carbon emissions is crucial for promoting sustainable urban development. Based on a comprehensive panel dataset covering 278 Chinese cities from 2008 to 2022, this study employs dynamic spatial panel data models and dynamic panel threshold models to systematically investigate the effects of green low-carbon finance (GCF) on reducing smog and carbon emissions (RSCE), including its underlying mechanisms, spatial spillover effects, and threshold effects. The key findings are as follows: (1) The development of GCF in both local and neighboring cities significantly enhances RSCE in the respective regions. (2) While local GCF indirectly promotes RSCE through green technological innovation, the spillover effects of GCF in neighboring cities on local RSCE via green innovation are not significant. (3) There exists a notable green innovation threshold effect in the relationship between GCF and RSCE, where GCF’s impact on RSCE becomes significantly stronger after surpassing a certain level of green innovation. (4) A temporal analysis reveals that the influence of GCF on RSCE has markedly intensified as GCF-related policies have matured over time. This study provides critical policy implications for strategically leveraging GCF tools to foster high-quality, low-carbon urban development.

Population-based active surveillance of pertussis hospitalization rates in two cities of China.

Hospitalization is most common for severe pertussis cases and those with serious complications caused by pertussis. In mainland China, the immunization program consists of primary vaccinations at 3, 4, and 5 months, followed by a booster at 18 months with DTaP. It remains uncertain whether the first dose at 3 months, rather than 6 weeks as WHO recommended, may increase disease burden, as delayed immunization may lead to lagged protection. This study aimed to determine pertussis hospitalization rates by active surveillance in China, shedding light on immunization strategies for better disease control. From June 1, 2021, to May 31, 2022, two Chinese cities underwent a population-based active surveillance. Suspected pertussis cases were confirmed as pertussis cases through PCR and culture. Pertussis hospitalization rates were calculated by dividing the number of laboratory confirmed pertussis cases by the hospitalization coverage rate of surveillance hospitals and the resident population. During the study period 2021-2022, pertussis hospitalization rate in Yiwu was 2.50/100,000 (95% CrI 2.48-2.53), while in Yongcheng, it was 7.90/100,000 (95% CrI 7.81-8.00). In both cities, infants aged < 1 year had the highest hospitalization rate (215.64/100,000: Yiwu; 217.65/100,000: Yongcheng), followed by the age group of 4-5 years (16.37/100,000: Yiwu; 65.70/100,000: Yongcheng). This study revealed significant pertussis hospitalization rates in China, particularly among infants aged < 1 year, highlighting the need of timely and early immunization. The higher hospitalization rates in the 4-5-year age group emphasize the importance of targeted preventive measures for preschool children to mitigate the impact of pertussis.

Analysis of the Impact of the Digital Economy on Employment in China

As Chinas economy gradually transitions towards high-quality development, the growth of the digital economy has created numerous new employment opportunities. To verify the specific impact of the digital economy on labor demand, this paper examines both employment quantity and employment structure. Using relevant data variables from 30 provinces and cities in China from 2012 to 2022, this study applies the entropy method to develop a comprehensive index for the digital economy. This index is then used in regression analyses with total employment and high- and low-technology intensity employment. The findings suggest that overall, the development of the digital economy positively contributes to the growth in labor demand, manifested in the promotion of high-tech employment and the suppression of low-tech employment.

​Quantitative assessment of heavy metal concentrations, pollution levels, and sources apportionment in one of China's top 10 most livable cities.

Urban topsoil is not only an essential part of the urban ecosystem, but also a powerful carrier of pollutants in the urban environment. In this paper, 130 topsoil samples from urban area of Xinyang in central-eastern China were selected, the aim is to quantitatively investigate the concentrations, pollution levels, and sources apportionment of 8 heavy metals (HMs, encompassing arsenic (As), cobalt (Co), copper (Cu), chromium (Cr), lead (Pb), nickel (Ni), vanadium (V), and zinc (Zn)) via geochemical method. The main conclusions are as follows. (1) The eight HMs in the topsoil have been artificially enriched to varying degrees, which are lower than the street dust levels sampled in pairs. (2) Cu, Zn, and Pb were significantly contaminated, and As, Co, Ni, Cr, and V were relatively low levels of contamination. Overall, comprehensive pollution levels were particularly severe, with 30.0%, 39.2%, and 30.8% for slight, moderate, and serious pollution, respectively. (3) Co, Ni, V, and Cr predominantly originated from natural sources, the percentage contribution of which is 6.3%; Pb, As, Cu, and Zn were predominantly derived from traffic-derived sources, with a percentage contribution of 93.7%. Thus, the first-order source of HMs in the topsoil originates from traffic-induced activities, similar to the case of street dust. Our findings can be beneficial in providing local governments with a reference to formulate environmental pollution controls, and also provide a case study for environmental pollution control in the other livable cities in China.

Ensemble intelligence prediction algorithms and land use scenarios to measure carbon emissions of the Yangtze River Delta: A machine learning model based on Long Short-Term Memory.

Land use in urban agglomerations is the main source of carbon emissions, and reducing them and improving land use efficiency are the keys to achieving sustainable development goals (SDGs). To advance the literature on densely populated cities and highly commercialized regions, this research evaluates the total-factor carbon emission efficiency index (TCEI) of 27 cities in China's Yangtze River Delta (YRD) urban agglomeration at different stages from 2011 to 2020 using two-stage dynamic data envelopment analysis (DEA). The study carries out regression analysis and a long-short-term memory model (LSTM) to respectively filter out the factors and predict TCEI. The results indicate the following. (1) The total efficiency of 27 cities has significantly improved from 2011 to 2020, and there are obvious spatial heterogeneity characteristics. (2) In terms of stages, most cities' efficiency values in the initial stage (energy consumption) exceed those in the second stage (sustainable land utilization). (3) In terms of influencing factors, urban green space's ability to capture carbon has a notably positive correlation with carbon emission efficiency. In contrast, the substantial carbon emissions resulting from human respiration are a negative factor affecting carbon emission efficiency. (4) Over the forthcoming six years, the efficiency value of land use TCEI in the YRD urban cluster is forecasted to range between 0.65 and 0.75. Those cities with the highest performance are projected to achieve an efficiency value of 0.9480. Lastly, this research investigates the interaction between actors and land resources on TCEI, resulting in a beneficial understanding for the former to make strategic adjustments during the urbanization process.

Outdoor PM2.5 pollution levels and their degree of compliance with WHO air quality guidelines across 760 cities in China, India, and Pakistan

Outdoor PM2.5 pollution levels and their degree of compliance with WHO air quality guidelines across 760 cities in China, India, and Pakistan

Urban Management for Building-Sector Decarbonization: Focusing on the Role of Low-Carbon Policies

The building sector is a major source of anthropogenic carbon emissions worldwide. While existing studies have extensively explored the socioeconomic and technological impacts on carbon emissions generated from building operations, few have assessed the effectiveness of low-carbon policies in curbing the increasing trend of building sector carbon emissions. This study examines the impacts of low-carbon policy intensity on building sector carbon emissions using a two-way fixed effects model on a 6-year panel (2015–2020) dataset for 286 cities in China. Our findings indicate that, on average, the aggregated intensity of low-carbon policies fails to pose any significant impacts on carbon emissions from building operations. This is partly due to the variations in different types of policy. Specifically, a 10% increase in the intensity of energy conservation policy results in a 0.05% decrease in carbon emissions, whereas capacity utilization policies are associated with an increase in building-operation carbon emissions. Moreover, these policy–emission relationships vary across building types and end-use sources. In particular, energy conservation policies are negatively associated with emissions from cooking and heating, but positively related to emissions generated from appliances and cooling. In comparison, capacity utilization policies tend to encourage additional emissions from most sources. This study highlights the partial effectiveness of energy conservation policies in curbing building sector carbon emissions and underscores the need for additional efforts in tackling the rebound effects to realize building sector decarbonization.

The impact of new urbanization on water ecological resilience: An empirical study from central China.

Given the multitude of risks and challenges faced by the water ecological environment during urbanization, enhancing water ecological resilience and improving the water ecological environment have emerged as crucial topics in China's economic and social development, as well as its ecological civilization construction. This study proposes a research hypothesis on the relationship between new urbanization and water ecological resilience. Employing various econometric models such as the extended STIRPAT model, dynamic panel model, panel threshold effect model, dynamic panel mediating effect model and dynamic panel difference-in-difference model, empirical tests were conducted to examine the impact of new urbanization on water ecological resilience in central China. The findings indicate that: (1) there exists a U-shaped curve relationship with a threshold effect between new urbanization and water ecological resilience; this conclusion remains valid even after conducting several robustness tests including extreme value treatment, re-measurement of independent variables, and replacement of econometric models. (2) In regions with lower levels of new urbanization, new urbanization exerts more significant stress effect on water ecological resilience through economic scale effect, population scale effect, investment pulling effect and foreign trade effect; whereas in regions with higher levels of new urbanization, new urbanization exerts more significant positive effect on water ecological resilience through factors agglomeration effect, technological progress effect, human capital effect, industrial structure effect and marketization effect. (3) Compared to non-pilot cities, the implementation of comprehensive pilot policies for new urbanization has significantly improved the water ecological resilience of cities in central China and the promotion of new urbanization of pilot cities contributes to enhancing water ecological resilience.

COMPARATIVE ANALYSIS OF STORMWATER MANAGEMENT TECHNIQUES: CASE STUDY OF MALAYSIA, JAPAN AND THE NETHERLANDS

Climate change and rapid population growth, which lead to urbanisation, create stormwater drawbacks. Various stormwater management (SWM) concepts, such as low-impact development (LID), green infrastructure, water-sensitive urban design (WSUD), sustainable urban drainage system (SUDS), and others are the key elements that help in mitigating flooding issues. Even though the aim is similar to each other, but the techniques and other objectives developed from the concepts may contribute to the differences in the techniques or practices implemented. There is an integration of techniques that are commonly used in SWM concepts, such as green roofs, permeable pavement, and bioretention. Meanwhile, Sponge City is one of the programmes initiated by the People's Republic of China in tackling critical flooding issues in the cities of China, which follows the LID, WSUD, and SUDS techniques. In the context of Malaysia, some of the techniques have been applied; hence, better investment and awareness from the public and government should be enhanced to improve the flash flood problems in cities.

Study on the Coupling and Coordination Relationship Between Urban Living Environment and Economic Development

The coordinated development of urban human settlements and the economy is a crucial indicator for assessing regional development and is essential for achieving sustainable high-quality development. Therefore, urban planning and management need to introduce scientific concepts to achieve a win–win situation for both the economy and the environment. (1) Background: Since the reform and opening up of China’s economy, it has undergone rapid development and urbanization. However, the improvement of human settlements has not kept pace. Some regions pursue economic development while neglecting environmental construction. To achieve a win–win situation for both the economy and the environment, urban planning and management need to incorporate scientific concepts. (2) Methods: This paper adopts a literature analysis method to construct a coupling coordination model and evaluate the level of coupling coordination between urban human settlements and economic development in 31 provinces and cities in China from 2011 to 2021. (3) Results: The level of coupling coordination has gradually increased year by year, but there are significant regional differences, with the East outperforming the West. Spatial analysis reveals a positive spatial correlation, indicating that provinces with similar development levels tend to cluster together. (4) Conclusions: The degree of economic outwardness, industrial structure, and residents’ income and consumption system are the main internal obstacles, while economic strength, urbanization, technological innovation, and human capital are positive external factors.