This paper puts the issues of election integrity that arose in 2016 in context. First, I identify four integrity-related themes that have arisen in American elections since the 2000 presidential election. Second, I examine what it means to assess the health of the American electoral system. Third, I provide two frameworks for assessing the health of the election system, one that takes the perspective of a typical voter, the other that focuses on the flow of information in an election. I conclude by bringing this discussion back to the specific case of 2016, providing a preliminary assessment of the health of the election process in the most recent federal election.