By: Keerti Gopal
More Americans are being forced to breathe unhealthy air than at any other time in the past decade, according to a report released today by the American Lung Association.
Nearly half of Americans—or about 156 million people—are living in counties with failing grades for ozone or particulate matter pollution, two of the most common and dangerous air pollutants. That’s 25 million more people than in the 2024 report.
“This is drastically worse than the findings in last year’s [report] and a shocking demonstration of a trend that not only is continuing but worsening as a consequence of climate change,” reads the report, which is the 26th installment in an annual series called “State of the Air.”
Over the last decade, the State of the Air reports have shown how climate change is making it harder to fight air pollution. Wildfires, extreme heat and drought fueled by global warming are contributing to worsening air pollution across much of the country, and these threats are likely to grow in the coming years.
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Air pollution is a serious health risk that can cause and exacerbate asthma and cardiovascular diseases, reduce lung function, trigger low birth weights and even lead to early death. Research has linked air pollution to worsening dementia and cancer, and the World Health Organization estimates that air pollution is responsible for 7 million premature deaths per year—the equivalent of one death every 13 minutes.
In other words, today’s report is bad news for public health.
“More people in more parts of the country are seeing their health put at risk from unhealthy air pollution, and fewer people in fewer places are living with the cleanest air,” said report author Katherine Pruitt, national senior director for policy at the American Lung Association (ALA).
For much of the past half-century, the federal government has enacted regulations to reduce air pollution. Now, the Trump administration is rapidly dismantling efforts to track and limit hazardous pollutants, eliminating crucial data and research on air pollution and health disparities and reversing efforts to control sources of pollution that are fueling climate change and hazardous air, to the dismay of the nation’s doctors and public health experts.
The Trump administration intends to massively slash funding for the Environmental Protection Agency and is gutting funding for programs aiming to reduce racial, income and geographic disparities in environmental health. Last month, ProPublica reported that the National Institutes of Health will no longer be funding research studying the health effects of climate change, despite a rising global death toll.
This week, the EPA notified about 280 employees working on environmental justice and related civil rights issues that their jobs will be eliminated as part of a “reduction in force” process. Environmental justice, a decades-old concept, focuses on places bearing the brunt of pollution and other environmental ills—often communities of color. Another 175 workers will be reassigned to other offices.
“In practice, ‘environmental justice’ has been used primarily as an excuse to fund left-wing activist groups instead of actually spending those dollars on directly remediating the specific environmental issues that need to get addressed,” wrote EPA spokesperson Molly Vaseliou in an emailed statement. “When President Trump speaks about a Golden Age for America, that is for all Americans regardless of race, gender, creed, and background. Under the Trump Administration, EPA is affirming our commitment to serve every American with equal dignity and respect.”
This year’s State of the Air included a “clarion call” for the public to support and defend the EPA, which has been tasked with enforcing the Clean Air Act since its inception in 1970.
“The EPA is a necessity,” said Dr. Afif El-Hasan, a pediatrician in Southern California and a member of ALA’s board of directors. “It is actually part of the health care system and should be treated accordingly.”
The report also shows undeniable racial inequity in who breathes the dirtiest air. People of color make up about 40 percent of the overall U.S. population but 50 percent of those living in counties with at least one of three failing air quality grades—for short- and long-term particle pollution and ozone. People of color overall are more than twice as likely as white people, and Hispanic individuals in particular are nearly three times as likely as white people, to live in a community with three failing grades.
These exposures compound existing health disparities. People of color are also more likely to have at least one chronic condition, like asthma, diabetes or heart disease, that makes them more vulnerable to the health ramifications of inhaling polluted air.
Both the health and pollution disparities, research shows, stem from long-standing systemic racism, including redlining, disinvestment, relegation of polluting industries to communities of color and the physical toll of discrimination. Decades of grassroots advocacy resulted in federal investments in environmental justice, which sought to target race- and class-based disparities and ensure that resources are allotted to vulnerable and historically underserved communities.
Now, these efforts are under threat. EPA Administrator Lee Zeldin, who called environmental justice a “leftist buzzword,” has promised to eliminate EJ programs, which include efforts to address environmental health disparities.
“The changing climate crisis is a health crisis,” said Almeta Cooper, national manager of health justice at Moms Clean Air Force, which advocates for reduced air pollution and is one of many groups that have spoken out vehemently against the EPA cuts.
“Look at these statistics,” Cooper said of the ALA report. “These are real people whose lives are being affected, so we are very much opposed to any reduction in the ability of the EPA to do the job that they are required to do.”
The Imperiled State of the Air
The ALA report relied on EPA data from 2021 through 2023, and gave each county that monitors ozone and particulate matter pollution a grade, from A to F.
Particulate matter is a mix of tiny particles found in the air, like dust, soot, smoke and chemicals, that can enter human lungs and bloodstreams. The State of the Air focused on particles with a diameter of 2.5 micrometers or less—PM2.5—the most dangerous to human health.
Ozone is a gas molecule that, when found in the earth’s upper atmosphere, provides a crucial shield from the sun’s ultraviolet radiation. But ground-level ozone, created when nitrogen oxides and volatile organic compounds mix with sunlight, is a dangerous pollutant that can cause breathing problems and shorten life expectancy. Ozone pollution is fueled by fossil fuel power plants and vehicles and exacerbated by extreme heat, making it a growing climate threat.
According to the new ALA report, the number of people living in a community with at least one failing pollution grade include:
- More than 2.5 million children and nearly 11.8 million adults with asthma
- 6.8 million people with chronic obstructive pulmonary disease
- 9.7 million people with cardiovascular disease—the leading cause of death in the nation
- 19 million people experiencing poverty
More than 26 million people of color, meanwhile, live in a community with a failing grade on all three pollution measures, including more than 15 million Hispanic people.
While Bakersfield, California, is the U.S. metropolitan area with the worst year-round particle pollution and traffic-clogged Los Angeles is still the city with the worst ozone pollution in the nation, bad air bedevils communities across the country, the report found.
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The 2023 Canadian wildfires that triggered orange skies, for instance, drove up both ozone and particle pollution in many Central and Eastern U.S. states.
After several years of ozone pollution reduction in many parts of the country, which the report authors credit to enforcement of the Clean Air Act, this year’s report also saw a “distressing reversal of that progress,” with more than 125 million Americans exposed to unhealthy levels of ozone pollution.
Ninety-three more counties earned an “F” for ozone pollution this year than in last year’s report, and 10 new states saw one or more of their counties added to that list. In particular, ozone levels worsened in the center of the country, from the Midwest and the Plains down to Texas, likely driven by wildfires in the north and rising temperatures in the south.
“It’s been very clear that as the changing climate is creating more extreme heat events, that we are expecting to see increases in ozone,” ALA’s Pruitt said. “But the widespread nature of the bad ozone days throughout the central part of the United States was really striking.”
On the flip side, some Western states saw their ozone conditions improve compared to last year, when California’s severe 2020 wildfire season was included in the ALA’s analysis. More counties improved than worsened in California, Idaho, Nevada, New Mexico and Wyoming. California’s aggressive efforts to regulate air pollution may also be working, Pruitt said.
“Literally, the smoke has cleared away, and you can see that there has been improvement in the baseline air quality because of [California’s] ability to get some of their other sources of emissions under control,” Pruitt said.
During and after wildfires, El-Hasan sees increased asthma attacks and respiratory problems among the children that he treats in Orange County, California. He also worries that lack of health care coverage and growing vaccine hesitancy may be exacerbating the problem. Infectious diseases like the flu and COVID-19 can compromise lung function and make the impacts of air pollution more severe by lowering the body’s ability to defend itself.
“The air quality itself, when it’s poor, can compromise those natural defenses,” El-Hasan said. “But if you add on top of that lung problems from infectious diseases that could have been prevented, it increases the problem.”
El-Hasan, also a member of the Environmental Justice Advisory Group at the South Coast Air Quality Management District, urges all members of the public to take steps to reduce their vulnerability to air pollution—like using indoor air filtration systems, avoiding prolonged exposure to high-traffic areas, exercising and getting vaccinated. Advocating for greater attention to air pollution and public health by elected officials is also important, he said.
El-Hasan also emphasized the long-term financial benefits of investing in public health.
“It is incredibly costly to this country to try to manage the aftereffects of long-term damage from pollution,” he said. “If we’re considering cost … part of that is ensuring that the people of this nation are healthy.”
While the State of the Air projects dire circumstances for millions of Americans, it only highlights pollution in U.S. counties with active air quality monitoring sites. A study from Pennsylvania State University researchers, published on Monday, found that 58 percent of U.S. counties have no active air quality monitoring by the EPA. That’s 50 million people who aren’t included in the ALA’s report and don’t know what kind of air they’re breathing—meaning the state of the nation’s situation could be even worse than is known.
Rural counties, especially in the South and Midwest, are most likely to lack air quality monitoring, the study found. Counties without air quality monitoring also had higher levels of poverty, lower high school graduation rates and higher proportions of Black and Hispanic residents than those with monitors.
Researchers also found that the number of active sites nationwide changes frequently—some sites are decades old and often go offline.
“These stations are in flux all the time, and data-reporting intervals also vary, which points to the need for investment in and modernization of this infrastructure,” said Nelson Roque, the study’s lead author, in a press release.
EPA monitors are intended to be placed in locations with higher pollution levels and more population exposure, Pruitt said, so smaller, rural communities are less likely to be prioritized. The ALA and allies want to see more robust investment in monitoring across the country.
The ALA report underscores the need to protect and strengthen pollution controls and combat climate change by reducing society’s reliance on fossil fuels, Pruitt said. Even parts of the country that were benefiting from air pollution reductions for years are at risk of losing that progress, putting health at risk, she added.
“We need to stay vigilant about our efforts to protect the air pollution controls that are in place and continue to strengthen them, and that is under threat right now in the current administration,” Pruitt said.
“We clearly all need to play more of a role in getting the changing climate under control,” she added. “Air pollution isn’t someone else’s problem.”
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