In the last decade, Pennsylvania has rapidly become the second largest producer of natural gas within the United States, the world’s largest producer. However, amidst an era of weakened federal and state regulation for oil and gas extraction, land use decision making for unconventional natural gas drilling (UNGD) in Pennsylvania has been placed squarely on local governments. Through document review of community comprehensive plans and zoning ordinances, this project aims to understand the mechanisms used to make decisions for UNGD at the local government level and understand how public health considerations are factored into decision making. Interviews of local officials, state officials, community planners, lawyers, and environmental advocates helped inform context of the debate and political arena for UNGD in Pennsylvania. State context through legislation, the Pennsylvania Constitution, Commonwealth and Supreme Court decisions, and political motivations are explored to understand the groundwork that has given local governments responsibility for UNGD policy. Socioeconomic disparities were found in the ability for some municipalities to plan for UNGD development. Municipalities without direct planning measures in place face circumstances in which UNGD infrastructure is developed within 1,000 feet of residential dwellings and public-school grounds. These communities often assume more risk in terms of adverse health impacts related to air quality, and simultaneously have more risk-adverse populations. Furthermore, hearsay, media, and personal financial gains influence local decision makers in their mechanisms for making land use policy decisions related to UNGD. The Mars Area School District in Butler County and the Ft. Cherry School District in Washington County, two school districts offered UNGD leases on school grounds, are used as case studies to understand the environmental health disparities at play in western Pennsylvania.