ABSTRACT: Studies of unconventional natural gas development (UNGD) and health have ranked participants along a gradient of geographic information system (GIS)-based activity that incorporated the distance between participants' home addresses and unconventional natural gas wells. However, studies have used different activity metrics, making result comparisons across the studies difficult. The existing studies have only incorporated wells, without accounting for other components of development (e.g., compressors, impoundments, and flaring events), for which it is often difficult to obtain reliable data but may have relevance to health. Our aims were to (1) describe, in space and time, UNGD-related compressors, impoundments, and flaring events; (2) evaluate whether and how to incorporate these into UNGD activity assessment; and (3) evaluate associations of these different approaches with mild asthma exacerbations. We identified 361 compressor stations, 1218 impoundments, and 216 locations with flaring events. A principal component analysis identified a single component that was approximately an equal mix of the metrics for compressors, impoundments, and four phases of well development (pad preparation, drilling, stimulation, and production). However, temporal coverage for impoundments and flaring data was sparse. Ultimately, we evaluated three UNGD activity metrics, including two based on the existing studies and a novel metric that included well pad development, drilling, stimulation, production, and compressor engine aspects of UNGD. The three metrics had varying magnitudes of association with mild asthma exacerbations, although the highest category of each metric (vs the lowest) was associated with the outcome.