县域健康空间面临医疗资源失衡、生态压力加剧、服务碎片化等挑战。本文尝试构建“制度—空间—技术—社会”四维协同框架，提出创新健康影响评估与跨部门治理机制、重构医疗服务设施网络、构建蓝绿共生与污染防控的韧性环境基底等五大核心路径，通过规划传导机制、多元主体协作与动态监测评估三大实施策略，推动县域健康空间向普惠性、韧性化、人本化、智慧化转型。

County-level health spaces face challenges such as imbalanced medical resources, intensified ecological pressures, and fragmented services. This paper attempts to construct a four-dimensional collaborative framework of “institutional-space-technology-social” and proposes five core pathways.