As a social determinant of health, transportation significantly contributes to well-being through several pathways. Researchers and practitioners have called for health indicators as one way to integrate public health concerns into transportation decision-making. However, it is unclear how indicators are used and what their impact is on policy. This case study of five cities explored how health-related indicators are being used in municipal transportation plans, whether they are institutionalized into transportation agency decision-making processes, and what influence they have on administrative decision-making. In addition, this research also explored the conceptual use of indicators as it relates to social learning and policy change. Finally, this research examined whether health framing was important to policy adoption or change.