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Terrestrial ecosystem health (TEH) is the basis of regional sustainability development. The state of TEH is an important research direction in the land science field. The purpose of this paper was to explore the development trends and influencing factors of the. By using the radial basis function (RBF), neural network model, geographic information system (GIS), and the comprehensive index method, this paper predicted the land ecological changes of Henan Province from 2007 to 2025 based on a comprehensive evaluation of the system. The results show that the TEH of Henan Province exhibited a general trend of improvement from 2007 to 2025. The predictions exhibited a tendency to fluctuate and increase, from “severe warning” to “moderate warning” and even to “no warning” state. The early warning index of the subsystem showed a fluctuating upward trend except for the press subsystem, which fluctuated between “extraordinary warning” and “heavy warning” states. The overall TEH level is improving but is largely dependent on effective corresponding measures. The health status of the land ecosystem in Henan Province is guaranteed to be stable due to improvements in rural residential incomes, mechanization levels of cultivated land, domestic sewage treatment rates, and the numbers of scientific and technological personnel per unit of land. The TEH is mainly restricted by the population densities, urbanization levels, inputs of fertilizers and pesticides, and average wastewater load factors of the land. To improve the health level of the land ecosystem, it is necessary to reduce the use of fertilizers and pesticides and to control the urbanization rate. At the same time, improving the level of forest coverage and the effective irrigation rate play a positive role in improving ecosystem health. The results provide a reference for land-use planning and management decisions.
