In 2010, the Minnesota Department of Health (MDH) received funds from the Centers for Disease Control and Prevention (CDC) to review the state Environmental Assessment Worksheet (EAW), part of the environmental review process in Minnesota. The purpose of the review was to discern whether climate change and health effects were being considered in the EAW. The scope of the project included an examination of the best practices of federal and state environmental review processes regarding the inclusion of human health and climate change, a literature review on incorporating health impact assessments (HIAs) into the environmental review process, a review of legislation requiring HIAs, a desktop HIA on a mixed-use project that completed an EAW in Minnesota, and a review of Minnesota’s EAW for present assessment of health and climate change impacts. As the culmination of this effort, MDH developed recommendations on incorporating health and climate change considerations into the EAW itself and the EAW Guidelines which are used to help guide preparation of the worksheet. The recommendations will be presented to the Environmental Quality Board (EQB), which oversees the state environmental review process, for its review and approval. Incorporating consideration of human health and climate change impacts within the EAW could have significant positive effects on human health and climate change adaptation and mitigation in Minnesota.