A new report from the American Lung Association shows that more than 4 in 10 Americans live with polluted air — 135 million people living in 217 counties. This pollution hits communities of color hardest, as people of color are 61 percent more likely than white people to live with unhealthy levels of air pollution, and three times more likely to live in counties with the most polluted air.  

The lung health organization’s 22nd annual “State of the Air” report analyzed data on two air pollutants — both emitted by the burning of fossil fuels — that are dangerous to human health: fine particulate matter (or PM2.5, also known as soot) and ozone (also known as smog). The analysis covers 2017, 2018, and 2019, which represent the three most recent data sets from the U.S. Environmental Protection Agency, and are also among the six hottest years on record globally. 

Climate change and environmental justice loom large in the report’s findings. While air pollution has declined overall in the last 50 years due to regulations put in place under the Clean Air Act, the impacts of climate change could threaten those gains. Warmer temperatures driven by climate change can make ozone pollution close to the ground more likely to form. Climate change has a similar effect on short-term exposure to PM2.5 — wildfires driven by climate change can lead to dangerous spikes in the pollutant due to the smoke, and this year’s report highlighted an increase of 1 million Americans exposed to short-term spikes in PM2.5. 

Both pollutants have severe impacts on human health for the people exposed to them. Ozone pollution can cause asthma and increased risk of diabetes, while PM2.5 can cause asthma, heart attacks, strokes, and lung cancer. Worldwide, exposure to PM2.5 caused one in five deaths globally in 2018 — and 350,000 deaths in the U.S. alone. PM2.5 exposure is also associated with an increase in COVID-19 cases and mortality. The American Lung Association report doesn’t include data from 2020, and thus doesn’t account for the impacts of the nation’s air on the pandemic, but “we do know that people living in more polluted places are more likely to have bad outcomes from COVID-19,” Katherine Pruitt, national senior director for policy at the American Lung Association, told the Guardian

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California stands out as a pollution hot spot in the report — four out of the five top cities for year-round PM2.5 and ozone pollution were in California, despite the state’s reputation as an environmental leader. Los Angeles and Bakersfield, in California’s Kern County, top the charts of the most polluted cities, due in part to emissions from the fossil fuel industry. Fossil fuel extraction and refining produces both ozone and PM2.5 pollution — the harmful effects of which have long been known by the fossil fuel industry — and California currently places no limits on how close extraction sites are allowed to operate to homes, schools, and hospitals. Kern County, which tops the report’s list of counties polluted by PM2.5, produces 80 percent of the state’s oil and gas. “California has, unfortunately, always struggled at the top of all of our lists,” said Pruitt. 

The American Lung Association is calling on the Biden administration to re-evaluate air quality standards for ozone and particle pollution after they were loosened by the Trump administration and has started a petition asking President Joe Biden to clean up pollution in and direct climate investments to historically burdened communities. 

“This report shines a spotlight on the urgent need to curb climate change, clean up air pollution and advance environmental justice,” said American Lung Association president and CEO Harold Wimmer in a press release. “The nation has a real opportunity to address all three at once — and to do that, we must center on health and health equity as we move away from combustion and fossil fuels to clean, renewable energy.”

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