The ecosystem health of coal cities is affected by both urbanization and coal mining activities. Exploring its impact mechanism is crucial for the development of coal cities. This study evaluates the impact of urbanization and coal mining activities on ecosystem health (EH) in the Jining metropolitan area over the past three decades through the VORS model and then proposes urban development strategies. Through analysis and discussion, the results show that: 1. The changes in EH were directly affected by urbanization, and the influence of the coal mining subsidence area on EH is not significant. 2. The influence of coal mining on EH is mainly embodied in the formation of coal mining subsidence areas, and the effect is double-sided. 3. Through the analysis of EH, the feasible direction of urban development is found. Based on this, the ecological control area is constructed, and the urban development strategy is put forward. It puts forward new ideas and the basis for the coordinated development of ecosystem health and urbanization in coal cities.