Transportation infrastructure decisions contribute to social, economic, and health inequities in the U.S. Health Impact Assessments (HIAs) may improve understanding of potential strategies to mitigate adverse effects on quality of life from planned developments. We use the Gordie Howe International Bridge (GHIB), currently under construction in southwest Detroit, MI, as a case study to examine 15 years of community mobilization, which resulted in community benefits that included an HIA. We describe community engagement processes, household survey methods, and select findings of the baseline HIA, with a focus on their application to inform recommendations to promote quality of life. Baseline HIA results indicated significantly higher self-reported asthma rates among children living within 500 feet of trucking routes. Residents reported substantial economic (e.g., decreased home values), health (e.g., adverse outcomes, lack of health care access), and environmental (e.g., air pollution) concerns related to the GHIB. We discuss specific recommendations, based on HIA results, to reduce adverse impacts of the GHIB. These recommendations will inform ongoing community benefits negotiations. This case study provides lessons for community, academic, and government partners conducting HIAs, especially during building and operation of major infrastructure, and discusses their potential role in improving community engagement opportunities towards environmental justice.