Ecosystem health assessment is essential for informing ecological protection and sustainable management, yet current evaluation frameworks often overlook the foundational role of natural background conditions and struggle with methodological uncertainties in indicator weighting, particularly in ecologically fragile regions. To address these dual challenges, this study proposes a novel Base–Pressure–State–Response (BPSR) framework that systematically integrates key natural background factors as a fundamental “Base” layer. Focusing on the Qinling Mountains—a critical ecological barrier in China—we implemented this framework at the county scale using multi-source data (2000–2023) and introduced a Monte Carlo simulation with triangular probability distributions to quantify and synthesize weight uncertainties from multiple methods, thereby enhancing assessment robustness. Furthermore, the Geodetector method was employed to quantitatively identify the driving forces behind the spatiotemporal heterogeneity of ecosystem health. Supported by 3S technology, our analysis demonstrates a sustained improvement in ecosystem health: the composite index rose from 0.723 to 0.916, healthy areas expanded from 60.17% to 68.48%, and nearly half of the region achieved a higher health grade. Spatially, a persistent “low–south, high–north” pattern was observed, shaped by human disturbance gradients, while temporally, the region evolved from localized improvement (2000–2010) to broad-scale recovery (2010–2023), despite lingering degradation in human-dominated zones. Driving force analysis revealed a shift from early dominance by natural and land use factors to a later complex interplay where urbanization pressure and climatic conditions jointly shaped the health pattern. The BPSR framework, combined with probabilistic weight optimization and driving force quantification, offers a methodologically robust and spatially explicit tool that advances ecosystem health evaluation and supports targeted ecological governance, policy formulation, and sustainable management in fragile mountain ecosystems, with transferable insights for similar regions globally.
Tian et al. (Mon,) studied this question.