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The reveals significant disparities in air quality nationally, with people of color, low-income communities, children, older adults and individuals with underlying health conditions disproportionately affected. 

The report, released April 24, uses three scores—one for ozone, as well as one each for daily and annual particle pollution. People of color were more than twice as likely to live in a county that failed all three compared to white people. 

“Every day that there are unhealthy levels of ozone or particle pollution means that someone – a child, grandparent, uncle or mother – struggles to breathe,” Harold Wimmer, president and CEO of the American Lung Association (ALA), said in a press release. “We must do more to ensure everyone has clean air.”

D.C. and the wider �ϰ��ſ����� metro area did see improvement in this report compared to last year’s, said Laura Kate Bender, the ALA’s assistant vice president for nationwide healthy air. The District received a passing grade for ozone pollution for the first time—just barely squeaking by with a D. 

The wider region, in which the ALA includes Baltimore and Arlington as well as parts of Pennsylvania and West Virginia, did not fare quite so well.

“The broader D.C. metro did the best it’s ever done for ozone in the report—but it’s still a failing grade,” Bender said.

In fact, despite the region’s progress on ozone, it was still in the bottom 20% of all the metro areas scored in the report, ranking 44th-worst out of 228. Inhaling ozone can cause shortness of breath, trigger coughing and asthma attacks and may shorten life. The ALA press release said the lung irritant’s “effects have been likened to a sunburn of the lungs.”

The D.C. area and the city itself both received C grades for particulate matter, the other dangerous pollutant measured in the report. Importantly, this year’s State of the Air uses data from 2020 through 2022—that means last year’s wildfire smoke days aren’t included.

Further, the ALA data only breaks down air quality at the county level. That means it doesn’t capture the differences between individual census tracts or neighborhoods, and those differences can be substantial. 

In the District, residents of Ward 7’s Fort Dupont and Marshall Heights experience the city’s highest rates of pollution-related premature deaths—four times as many as there were in Georgetown East and Woodley Park, in Wards 2 and 3, according to a .

“If you live closer to a polluting source, even within a city, your air quality is probably going to look pretty different from someone who’s farther than that polluting source,” Bender said. “These [scores] are capturing the big broad trends across areas.”

Bakersfield, California; Fresno-Madera-Hanford, California; Fairbanks, Alaska; Eugene-Springfield, Oregon; and Visalia, California, counted as the top five cities most polluted by short-term particle pollution. Meanwhile, the California cities of San Jose, San Francisco, and Oakland, joined the others as the most heavily polluted by year-round particle pollution. 

The report notes that warmer temperatures driven by climate change make ground-level ozone more likely to form and harder to clean up. The top five cities most affected by ozone pollution are the Los Angeles-Long Beach area; Visalia, Bakersfield, the Fresno-Madera-Hanford area, and the Phoenix-Mesa, Arizona area.

The report also recognized the nation’s cleanest cities. To make the cleanest list for all three measures, 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. The top five were Bangor, Maine; the Johnson City-Kingsport-Bristol, Tennessee and Virginia area; Lincoln-Beatrice, Nebraska area; Urban Honolulu, Hawaii; and Wilmington, North Carolina.

Impact of Air Pollution: People of Color, Children, Vulnerable Populations

Despite comprising 41.6% of the U.S. population, people of color represent 52% of those living in counties with at least one failing grade for air quality. In counties with the poorest air quality, where failing grades are given for all three measures of air pollution, 63% of the nearly 44 million residents are people of color, compared to 37% white.

The report highlighted that approximately 68.9 million people of color live in counties that received at least one failing grade for ozone and/or particle pollution. Over 27.5 million people of color reside in counties with failing grades on all three measures, including about 16.8 million Hispanics. Additionally, 16 million people living in poverty are in counties that received a failing grade for at least one pollutant, with more than 5.4 million in counties failing all three measures.

Further, the report revealed that more than 29.2 million children under 18 and 20.6 million adults aged 65 and over live in counties with at least one failing grade for pollution. More than 9.7 million children and 6.7 million seniors reside in counties failing all three measures.

The impact of air pollution on vulnerable populations is significant. Over 1.9 million children and nearly 9.8 million adults with asthma live in counties with at least one failing grade for pollution. In comparison, more than 600,000 children and 3.1 million adults with asthma reside in counties failing all three measures. 

Additionally, about 6.0 million people with Chronic Obstructive Pulmonary Disease (COPD) live in counties with at least one failing grade for pollution, including over 1.7 million in counties failing all three measures.

“We have seen impressive progress in cleaning up air pollution over the last 25 years, thanks in large part to the Clean Air Act. However, when we started this report, our team never imagined that 25 years in the future, more than 130 million people would still be breathing unhealthy air,” Wimmer, the American Lung Association’s president, said in the press release about the report.

The report also underscored the association between exposure to air pollution and increased risks of severe illness and death from COVID-19. A 2022 study in California found that residents in the most polluted areas had a 20% higher risk of COVID-19 infection and a 51% higher risk of death than those in the least polluted areas.

The authors noted that these disparities in air quality exposure can be traced back to systemic racism in the U.S., including practices like redlining and institutionalized residential segregation. Historically, decision-makers have placed pollution sources, such as power plants and industrial facilities, in economically disadvantaged communities of color, contributing to high rates of emergency department visits for asthma and other diseases.

People of color are also more likely to live with chronic conditions like asthma and diabetes, making them more susceptible to the health impacts of air pollution. Addressing these disparities requires comprehensive efforts to improve air quality, promote environmental justice, and protect the health of vulnerable communities, the authors concluded.

In the meantime, Bender said that individuals can take action to protect their own health and the health of their communities. In addition to advocating for better policy and electing officials who prioritize clean air, people can choose to carpool or take transit when possible, which reduces both ozone and particulate matter in neighborhoods nearby. 

Bender also recommended checking air quality before going out, the way many of us check the weather. Many common weather apps already show an air quality index; another place to look is . 

“I have asthma—I’ll use airnow.gov to decide if I want to go for a run outside, or if I want to work out indoors,” Bender said. “Everyone can take steps to protect their health from poor air quality.”