In the context of implementing the national strategy of "Health China", healthy city planning, which aims to improve human health status, has caught substantial attention. This research, from the perspective of territorial spatial planning, constructs a theoretical framework that elucidates the interplay between urban spatial elements and health outcomes. It systematically explores the nexus across seven key dimensions: land use, transportation, spatial configuration, blue-green space, food environments, spatial perception, and spatial responses to public health emergencies. Within this framework, the study delineate five principal pathways through which intermediary spatial elements can positively influence residents' physical and mental health. These pathways include reducing sources of and exposure risks to pollution, encouraging physical activity, promoting healthy diets, enhancing social interaction opportunities, and ensuring equitable access to health facilities. Based on such an understanding, we further propose a "multi-faceted, multi-dimensional, multi-scale" evaluation system for healthy city planning that includes basic, additional, and potential indicators. Wherein, the "multi-faceted" aspect emphasizes creating a more comprehensive and diversified indicator system combining seven different categories of spatial elements. The "multi-dimensional" facet includes one-dimensional, two-dimensional, and three-dimensional spatial indicators. By expanding existing two-dimensional indicators and focusing on the development and refinement of three-dimensional spatial indicators, the research shifts the evaluative focus from traditional urban planes to more enriched three-dimensional spaces. The "multi-scale" aspect follows World Health Organization guidelines and adheres to the people-oriented planning concept to construct a multi-scale indicator system within the "city-community-individual" framework. The evaluation system addresses the shortcomings of existing indicator systems by focusing on human-scale dimensions and people-oriented evaluation, emphasizing geospatial measurements of health disparities, incorporating spatial responses to public health emergencies (including two aspects of indicators: providing accessible emergency services and spaces for residents, as well as enhancing spatial elements capable of eliminating or reducing disease risks), and precisely quantifying three-dimensional indicators of spatial configuration, blue-green space, and spatial perception. In practical implementation, the proposed evaluation system targets both urban and community levels. By precisely measuring the performance of diverse urban spatial elements across the five distinct health impact pathways, the evaluation system identifies controllable spatial elements and optimization paths, thereby guiding the formulation of targeted and effective health-related planning strategies. The research also plays a crucial role in facilitating the development of projects under the healthy city concept, such as establishing and refining health design guidelines for different spatial scales. Ultimately, the research would contribute valuable insights for the implementation of the "Healthy China" strategy at the urban level.