Significant improvements in American's health will only occur if health impacts are considered when developing policies, programs, plans, and projects, particularly in sectors that historically have been viewed as unrelated to health, such as transportation, education, agriculture, and housing. Health impact assessment has arisen as an especially promising way to factor health considerations into the decision-making process. This report discusses the need for health-informed decision-making, reviews the current practice of health impact assessment, and provides a framework, terminology, and guidance for improving the assessment of health impacts in the United States. Dr. Richard Jackson describes some key ideas from the report.