Nearly 2 in 5 Americans breathe unhealthy air. Why it’s getting worse

A rising number of Americans – nearly 2 in 5 – has been living with unhealthy levels of air pollution, while the United States experienced a record number of days between 2020 and 2022 with very unhealthy or hazardous air, according to a new report.

More than 90 million people are living in places where the air quality is worse than a new U.S. standard, the American Lung Association reported Wednesday in its annual State of the Air assessment, which detailed a significant increase based on the stricter national particle pollution standard.

The total includes 72 million people who would not have been counted under the looser federal standard – reflecting the dramatic effect of the Environmental Protection Agency’s new limit, which was announced this year.

Climate change – fueling wildfires, drought and dust – is not only worsening air quality, but also making pollution increasingly challenging to combat, experts said, setting up a new reality for public health and canceling out years of gains made through the Clean Air Act.

“Not only the number of people and places affected are worsening, but the severity of the pollution itself is also worsening,” said Katherine Pruitt, report author and senior director of nationwide clean air policy for the American Lung Association.

While wildfires and other conditions continued driving the decline of air quality in Western states, the change in the federal standard also revealed historically industrialized spots in the Midwest and East that need cleaner air, according to the report.

Overall, 131 million Americans live in areas with unhealthy ozone or particle pollution – an increase of nearly 12 million compared with the years between 2019 and 2021. Covering 2020 to 2022, the report also showed that the pandemic shutdown didn’t create net improvements in air quality.

Poor air increases the risk of health ailments, lung damage and cardiovascular problems; exacerbates existing conditions; and causes premature deaths. Communities of color are disproportionately affected by these impacts – of the 30 counties the American Lung Association said had failing grades on all three of its air pollution measurements, 63% of residents were people of color.

The report tracks daily and yearly exposure to particle pollution, which is caused by things like fires, stoves, coal-fired power plants and diesel engines, and ground-level ozone pollution, or smog, which comes from pollutants emitted in the burning of fossil fuels and the use of cars, refineries, factories and so on.

“Everyone deserves to breathe clean air,” said Marvin Brown IV, an attorney for Earthjustice. “We’re talking about your own individual health; we’re talking about the health of your family.”

Stricter standards for ‘unhealthy’ air

The shift in federal standard offers an “overdue recognition” of the health risk faced in many areas of the country, the report said.

“We think those people have probably been breathing unhealthy air for a while,” Pruitt said, “but this stronger standard now allows us to more accurately convey the risk to people’s health.”

It will take until 2032 for U.S. counties to meet the new standard, the EPA has said. Fully implemented, the standard would save 6.6 million more total years of life than the previous standard, largely in the West and Midwest, the Energy Policy Institute at the University of Chicago has estimated.

Still, it isn’t as stringent as the standard recommended by the World Health Organization, said Susan Anenberg, director of George Washington University’s Climate Health Institute, noting that it doesn’t denote a “healthy” level of pollution.

“You should consider them more like speed limits, where there is still a risk below the speed limit,” she said. “Just because the standard is set at that level does not mean there are no health effects below that level.”

Meanwhile, climate change will continue presenting challenges to regulation, experts said. Reversing the factors that are causing more fire, drought and dust is far more challenging than, for instance, putting regulations on tailpipe emissions.

“It’s harder to wring more emission reductions out of the combustion processes that we’re accustomed to regulating,” Anenberg said, “and it’s more difficult to foresee how we’re going to be able to protect air quality and public health in the future.”

What’s driving higher pollution?

For six years straight, the number of people living in counties that experienced unhealthy spikes in particle pollution has increased, reaching 65 million in the time period of the report.

Seven of the 25 cities with the worst daily pollution saw their highest-ever number of unhealthy days, and the Las Vegas, Portland and Seattle metro areas had such bad declines in air quality that they moved into the top 25 most-polluted cities.

Those types of spikes are largely occurring due to extreme heat, drought and wildfires, the report said. Fires, for instance, increased the number of days with air quality rated “very unhealthy” or “hazardous,” the two highest categories, which are colored purple and maroon on the air quality index.

On an annual basis, cities in the West topped the list of the 25 most polluted, with the central California areas of Bakersfield, Visalia and Fresno remaining at the top. East of the Rockies, however, other historically polluted metro areas maintained spots on the list: Indianapolis, Detroit, Houston and Pittsburgh, among others.

Since the Clean Air Act was enacted in 1970, it has added an average of 1.4 years to the American life expectancy, said Christa Hasenkopf, director of the clean air program of the Energy Policy Institute at the University of Chicago. But even a couple of weeks of smoky air from wildfires each year can affect that.

“It’ll chip away at those 1.4 more years of your life,” Hasenkopf said. “That’s the ballpark number we’ve gained and what we could stand to lose.”

Improving ozone

While the report found particle pollution was worse over the three-year period, an improvement in ozone pollution continued, attributed to policy changes under the Clean Air Act. Three in 10 Americans live in counties with ozone levels high enough to earn them a failing grade, but that total was nearly 2.5 million fewer people than in the previous year’s report, according to the ALA.

Another marker of improvement: This year’s report saw a record low of 71 days with a “very unhealthy” air quality ranking for ozone anywhere in the country – in 2001, at its recorded peak, the ALA reported 1,563 “very unhealthy” ozone days.

“The transition of the economy away from coal-fired power plants, the dirtiest fossil fuel, and towards clean renewable sources of energy has unquestionably had an impact,” the report said.

Still, ozone pollution in many individual counties was found to have worsened over the report’s three-year period, and most places with the worst pollution are Western cities, showing that climate change is also “undercutting the progress we would have made” on ozone, the report said.

The U.S. areas with the cleanest air, measuring for both particle and ozone pollution, were Bangor, Maine; Honolulu; Wilmington, North Carolina; Lincoln, Nebraska, and the Johnson City metro area in Tennessee and Virginia.