The county diagnostic method is a spatially explicit, unit specific, component expanded regional environmental footprint framework for the USA designed by Bryce Lawrence to compare the influence of ecoregions on poly‐factorial environmental footprints. This 'diagnostic assessment' quantifies and compares the flows of food, water, energy, carbon, municipal solid waste, wastewater and spatial extent of ecosystem conservation. The county diagnostic fills the gap in regional environmental planning in the USA by bridging urban and state level planning.