Mounting Air Quality Crisis: How Unhealthy Air Affects Nearly Half of Americans
The 2025 ‘State of the Air’ report reveals a sobering truth: nearly half of the U.S. population—about 156 million people—is exposed to unhealthy air, as pollution levels rise due to intersecting crises of industrial emissions, urbanization, climate change, and wildfires. With cities such as Bakersfield, Visalia, and Fresno topping the most-polluted lists, and the Bay Area ranking prominently for both ozone and particle pollution, the nation faces a cross-regional public health challenge that transcends state borders and political lines. These findings, based on pollution data from 2021 to 2023, highlight the ongoing vulnerability of American communities as they contend with the consequences of environmental neglect and policy inertia.
According to the American Lung Association’s latest analysis, 46% of Americans are now living with unhealthy levels of ozone or particle pollution, a statistic that underscores the vast scale of this growing health crisis. The report emphasizes how persistent ground-level ozone and year-round particle pollution are increasingly aggravated by record wildfires, extreme heat waves, and drought—all symptoms of accelerating climate change. The Western United States continues to bear the brunt of these challenges, yet the 2025 report also documents a worrying trend: air quality is deteriorating in the East as well, with wildfire smoke drifting hundreds of miles to leave its mark on urban and rural communities alike.
“These findings aren’t just statistics; they represent millions of families breathing air that imperils their health every single day,” said Dr. Lisa Patel, pediatrician and director at a national health advocacy group. “Children, seniors, and those with pre-existing conditions are especially at risk.”
Notably, the report indicates substantial regional disparities. For example, while Bakersfield, California once again claims the top spots for short-term and year-round particle pollution, cities like Salt Lake City-Provo-Orem have been named ninth-worst for ozone pollution, largely due to transportation, industrial activity, and fossil fuel extraction. Even cities far from wildfire hotspots, such as Detroit and Washington D.C., are experiencing rising pollution levels, with the Detroit-Warren-Ann Arbor region climbing to sixth-worst nationally for year-round particle pollution. Hennepin, Ramsey, and Dakota counties in the Twin Cities metro area now rank among the 40 most-polluted for 24-hour particle pollution, and Washington D.C. is averaging several unhealthy air days each year.
These alarming findings arrive as communities nationwide push for more robust environmental protections and equitable clean air policies. The urgency is clear: the current public health landscape cannot be separated from the ongoing climate crisis—one that demands collective, science-based solutions. As the American Lung Association’s latest assessment makes clear, the window for bold action is narrowing, and the responsibility to act equitably is more pronounced than ever.
Pollution Hotspots and Disparities: The Deepening Divide in Air Quality and Public Health
Pollution does not affect all Americans equally. The ‘State of the Air’ report makes it clear that environmental injustice is a persistent and deepening problem, with both urban and rural communities of color facing disproportionate burdens. The report underscores that Hispanic communities are nearly three times more likely than their white counterparts to live in areas receiving failing grades for all three major pollution categories—ozone, annual particle pollution, and short-term particle spikes. This stark inequity places millions of people at heightened risk for asthma, heart disease, and other pollution-linked conditions, reflecting an urgent need for targeted interventions and reparative policy action.
A look at the most-affected regions highlights the scale of these challenges. In California, the Central Valley cities of Bakersfield, Visalia, and Fresno once again top the charts, with Bakersfield cited as the most polluted city for both short-term and year-round particle pollution. Meanwhile, the Bay Area, home to heavy industrial activity, major shipping ports, and unique geographic vulnerabilities, is listed as 14th worst for ozone and 6th worst for annual particle pollution. Local factors like diesel truck traffic and port emissions create hazardous “hot spots” concentrated near lower-income and minority neighborhoods, compounding systemic health inequities.
In the Midwest, the Detroit-Warren-Ann Arbor region has seen its particle pollution levels surge—up from 10.9 to 13 micrograms per cubic meter over five years—despite ongoing regional cleanup efforts. Similarly, the Twin Cities metro, saddled with an “F” grade for air quality, faces rising rates of respiratory illness and cardiovascular risk among its most vulnerable communities. On the East Coast, areas such as Washington D.C. have not been spared; the city now averages nearly four unhealthy air days per year, with short-term particle spikes presenting new hazards for urban populations.
“We know that pollution is a matter of life and death for far too many Americans. The data are a clarion call for real change—stronger standards, greater investments in clean energy, and robust support for frontline communities,” commented Dr. Patrice Harris, former president of the American Medical Association.
The report also spotlights the expanding impact of wildfires, with plumes affecting cities hundreds of miles downwind—an issue that is as much about climate justice as it is about local emissions. Notably, even some western cities have seen modest improvements in air quality in 2023, but the overall trend remains grim, especially as wildfire smoke continues to reach the Midwest and Eastern seaboard, further eroding progress in once-cleaner regions. According to the American Lung Association, 42 million Americans now reside in counties that fail all three major pollution metrics—a figure that should prompt urgent legislative and regulatory attention.
Policy Roadblocks and the Path Forward: Urgency for Equity-Driven Clean Air Solutions
While scientific consensus and public demand for cleaner air have never been greater, persistent policy barriers threaten to stall progress. The ‘State of the Air’ report highlights major obstacles faced by federal clean air programs, including recent funding cuts and rollbacks in air quality standards. This lack of sustained investment has allowed pollution levels to rise in several regions, endangering public health and undermining the nation’s environmental commitments.
A key factor exacerbating the problem is the intensifying influence of climate change. Extreme heat, drought, and unprecedented wildfire seasons have all contributed to higher and more volatile air pollution levels, as confirmed by independent climate monitoring.
At the same time, advocates point to opportunities for hope and renewal: technological innovations in emissions control, public investment in renewable energy, and community-led air monitoring initiatives are helping to fight back against the tide of pollution. The move toward comprehensive, equity-centered policy reforms—like expanded EPA air quality standards and targeted grants for hardest-hit communities—can offer a blueprint for a healthier future. But meaningful improvement will require broad civic engagement and political will, especially in the face of entrenched industry interests and partisan gridlock.
“There is no silver bullet. But history shows that when government, communities, and individuals work together for the common good, we can reclaim the air we all share,” said Gina McCarthy (Democratic Party), former EPA administrator and climate advisor.
The long-term consequences of inaction are severe: chronic respiratory disease, increased heart attacks, developmental impacts on children, and shortened lifespans. Yet, the tools for progress are within reach. Greater public investment, science-driven policymaking, and a commitment to environmental justice are essential for breaking the cycle of pollution and inequity. As the data show, the time for incremental change has passed; what is needed now is a sustained, collective effort that elevates health, climate resilience, and justice for all Americans. The optimistic lesson from the fight against smog and leaded gasoline is clear: determined, unified action can yield real, lifesaving results.
For families across the U.S., clean air is not simply an environmental issue—it is a matter of basic human dignity and public health, demanding vigilance, advocacy, and solidarity at every level of society.