Forest health is most appropriately based on the scientific paradigm of dynamic, constantly changing forest ecosystems. Many forests in the Inland West now support high levels of insect infestations, disease epidemics, fire susceptibilities, and imbalances in stand structures and habitats because of natural processes and past management practices. Impending, potentially catastrophic fires can be avoided or modified through proactive forest health management-protecting, creating, and maintaining stand structures, processes, and species populations at viable levels across substantial landscapes. Proactive management will be less costly than fire fighting and associated rehabilitation, especially if done jointly with environmentally sound production of commodities. Management to achieve a fluctuating balance of patterns, processes, and species can begin while better information-based tools and scientific knowledge are being developed. A wider array of silvicultural and other management tools will be required for forest health management than has traditionally been used for commodity management. Specific changes that will allow forest health management include: recognizing the extent and consequences of present imbalances, decentralizing management decisions, adopting management techniques, coordinating with various landowners through incentives, funding forest health management activities, and supporting appropriate research.