AbstractA high geological background can increase the ecological and health risks associated with crop production; therefore, it is essential to assess the heavy metals and their impact. In this study, ecological and health risk impacts of heavy metal contamination, in combination with positive matrix factorization was assessed for an area with high geological background with wheat–maize cropping system, to provide a quantitative understanding of the effects of heavy metals, enabling its prevention and control. This study revealed that the comprehensive ecological risk (RI_{wheat–maize}) is 56.21 (low), with industries being the biggest contributors (34.22%). Comprehensive health risk (non-carcinogenic) assessment showed that industrial (40.98–49.30%) and natural (23.96–37.64%) factors were the primary (particularly of Cd and Zn) and secondary (particularly of Cr and Ni) contributors, respectively in eastern China. Comprehensive health risk (HI_{wheat–maize}) for children and adults were 0.74 and 0.42, respectively, indicating that non-carcinogenic risks were at an acceptable level. Soil ingestion was the primary pathway for health risks (62.23–73.00%), especially for children. Based on soil heavy metal sources and crop systems, source-ecological risk assessment and source-health risk assessment were used to provided valuable insights on making strategies to protect human health in high geological background areas.