This report by Earthworks examines the health and environmental impacts of oil and gas development in Pennsylvania, particularly focusing on regulatory shortcomings and the lack of adequate oversight. It highlights that the Pennsylvania Department of Environmental Protection (DEP) suffers from budget cuts and insufficient resources, leading to inadequate inspections and failure to track pollution comprehensively. The report emphasizes the need for better accountability and transparency in the regulatory process to protect public health and the environment amid rapid industrial growth.