2023 ‘State of the Air’ Report

The American Lung Association’s new “State of the Air” report finds that nearly 120 million people in the U.S., or more than one in three, live in counties that had unhealthy levels of ozone or particle pollution. Overall, air quality has improved across the nation; however, major differences exist between air quality in eastern and western states and between air pollution exposures for white people and people of color.

The Lung Association’s 24th annual “State of the Air” report grades Americans’ exposure to unhealthy levels of ground-level ozone air pollution, annual particle pollution, and short-term spikes in particle pollution over a three-year period. This year’s report covers 2019-2021.

The report found that out of the nearly 120 million people who live in areas with unhealthy air quality, a disproportionate number – more than 64 million (54%) – are people of color. In fact, people of color were 64% more likely than white people to live in a county with a failing grade for at least one measure, and 3.7 times as likely to live in a county with a failing grade for all three measures. This is an increase compared to last year’s report where people of color were 61% more likely to live in a county with a failing grade for at least one measure, and 3.6 times as likely to live in a county with a failing grade for all three measures. Differences in air quality were also seen between eastern and western states. More than 18 million residents in Western states live in counties with three failing grades and the worst 25 counties for short-term particle pollution were all located in the Western U.S.

“The good news is that ozone pollution has generally improved across the nation, thanks in large part to the success of the Clean Air Act. In this year’s ‘State of the Air’ report, we found that 19.3 million fewer people are living in areas with unhealthy levels of ozone pollution, also known as smog,” said Harold Wimmer, National President and CEO of the American Lung Association. “However, the fact is that 120 million people still live in places with unhealthy air pollution, and not all communities are seeing improvements. This is why it is crucial to continue our efforts to ensure that every person in the U.S. has clean air to breathe.”

Particle Pollution
Fine particulate matter air pollution, also known as particle pollution or soot, can be deadly. These unhealthy particles in the air come from wildfires, wood-burning stoves, coal-fired power plants, diesel engines and other sources. Technically known as PM2.5, these microscopic particles can trigger asthma attacks, heart attacks and strokes and cause lung cancer.

The report has two grades for particle pollution: one for “short-term” particle pollution, or daily spikes, and one for the annual average “year-round” level that represents the concentration of particles in each location.

Short-Term Particle Pollution
Deadly particle pollution continues to impact communities across the nation. The report finds that almost half a million more people lived in counties that experienced unhealthy spikes in particle pollution than in last year’s report. In total, 63.7 million people lived in counties that experienced unhealthy spikes in particle pollution, the most reported in the last 10 years.

Top 5 Cities Most Polluted by Short-Term Particle Pollution:

  • Bakersfield, CA
  • Fresno-Madera-Hanford, CA
  • Fairbanks, AK
  • Visalia, CA
  • Reno-Carson City-Fernley, NV

Year-Round Particle Pollution
In positive news, the report revealed that 1.5 million fewer people were living in a county that received a failing grade for annual particle pollution. A total of 18.8 million people lived in a county with a failing grade for this measure.

Top 5 Cities Most Polluted by Year-Round Particle Pollution:

  • Bakersfield, CA
  • Visalia, CA
  • Fresno-Madera-Hanford, CA
  • Los Angeles-Long Beach, CA
  • Fairbanks, AK

Ozone Pollution
Ground-level ozone pollution (also known as smog) is a powerful respiratory irritant whose effects have been likened to a sunburn of the lung. Inhaling ozone can cause shortness of breath, trigger coughing and asthma attacks and may shorten life. Warmer temperatures driven by climate change make ozone more likely to form and harder to clean up.

Although there were exceptions, ozone pollution has generally improved across the nation. 103 million people lived in an area with unhealthy ozone pollution, which is 19.3 million fewer than last year’s report.

Top 5 Cities Most Polluted by Ozone Pollution:

  • Los Angeles-Long Beach, CA
  • Visalia, CA
  • Bakersfield, CA
  • Fresno-Madera-Hanford, CA
  • Phoenix-Mesa, AZ

Cleanest Cities
The report also recognizes the nation’s cleanest cities. To make the list, a city must experience no high ozone or particle pollution days and rank among the 25 cities with the lowest year-round particle pollution levels.

Cleanest U.S. Cities (listed in alphabetical order):

  • Asheville-Marion-Brevard, NC
  • Bangor, ME
  • Greenville-Kinston-Washington, NC
  • Lincoln-Beatrice, NE
  • Rochester-Batavia-Seneca Falls, NY
  • Urban Honolulu, HI
  • Wilmington, NC

The “State of the Air” report relies on data from air quality monitors managed by state, local and tribal air pollution control authorities in counties across the U.S. Unfortunately, out of 3,221 counties in the U.S., only 922 counties are able to monitor for at least one pollutant. That means that there are more than 71 million people who live in counties where their ozone and particle pollution levels are not being monitored.

The American Lung Association is calling on President Biden to urgently move forward on several measures to clean up air pollution nationwide, including new limits on ozone and particle pollution and new measures to clean up power plants and vehicles. See the full report results and sign the petition at Lung.org/SOTA.

* “A Nation’s Air Quality Divided: New Report Reveals Growing Disparities in Exposure to Air Pollution,” Apr. 19, 2023 American Lung Association press release.

Corresponding, connected home-page-entry image: U.S. National Institutes of Health: National Heart, Lung and Blood Institute