Many of today's environmental problems are regional in scope and their effects overlap and interact. We developed a simple method to provide an integrated assessment of environmental conditions and estimate cumulative impacts across a large region, by combining data on land-cover, population, roads, streams, air pollution, and topography. The integrated assessment technique identified nine distinct groups of watersheds. Relative cumulative impact scores were highest around major urban centers, but there was not a simple or predictable spatial pattern overall. We also point out the potential applications of this approach that include distinguishing between areas in relatively poor versus good condition, identifying areas that may be more vulnerable to future environmental degradation, and identifying areas for restoration.