Understanding the coupled effects of climate variability and land use on riverine nitrogen is essential for watershed management. The climate-water relationships for ammonium (NH-N) and nitrate (NO-N) were determined by an elasticity approach and then the watershed health index was estimated using the reliability, resilience, and vulnerability framework. These methods were applied to an in-situ monitoring dataset of N concentrations measured during 2010-2017 from nine sub-watersheds in the Jiulong River Watershed, China. The results showed that temperature and precipitation elasticity of NH-N and NO-N changed substantially among various land use patterns. The N concentrations were highly sensitive to extreme climate conditions, particularly at urban and agricultural sub-watersheds. The measure of risk indicators revealed that the watershed health index varied from good health to unhealthy status. Linear regression analysis was used to analyze the interactions among watershed characteristics, climate elasticity, and watershed health. Cropland and population had strong positive correlations with climate elasticity of NO-N. Forest and elevation had strong negative associations with climate elasticity of NO-N. Watershed health significantly declined with increasing proportion of cropland and population density. This study demonstrated that human-impacted watersheds were less healthy to unhealthy and tend to be more sensitive to climate variability than natural watersheds, which is useful for efforts aimed at improving watershed management.