The study discusses the inclusion of health in the evaluation of environmental impacts to allow actors potentially involved in decision-making to determine the need and technological and geographic adequacy of projects ahead of implementation. The point of departure was a request from the Public Attorney to the Federal University of Ceará to analyze the project of a coal-fired power plant to be built within the Port of Pecém Industrial Compound in Ceará State, Brazil. The methodology included a description of the social and historical context of the area, a bibliographical study of health and environmental impacts and dialogues with affected communities, followed by an analysis of state environmental guidelines for this type of enterprise. The results shows the main categories of analysis identified and proposed additions to current regulations intended to anticipate relations between production processes, the environment and an uneven distribution of health impacts. Besides, it also assesses the need to advance the development of the approach in order to subsidize and democratize decision-making processes closer to actual circumstances in the present and near future.