Nearly 264 million people live in the 922 counties for which there is monitored data for at least one pollutant in this year’s report. The proportion of the population in those counties varies by pollutant. The majority of U.S. counties actually don’t have monitors—which means that many communities, especially rural ones, don’t have official monitored information on their air quality. It is important to note that the population numbers included in this section are only for those places that collect air pollution data, and do not reflect the entire population of these groups in the U.S. 

All of the 119.6 million Americans living in places with failing grades for unhealthy levels of ozone or particle pollution are at risk of harm to their health. But some groups of people are especially vulnerable to illness and death from their exposure. See People at Risk for more detail about the factors that contribute to increased risk

The number of people in these high-risk groups in “State of the Air” 2023 are as follows: 

  • People of color—Some 64 million people of color live in counties that received at least one failing grade for ozone and/or particle pollution. Over 13 million people of color live in counties that received failing grades on all three measures, including over 9 million Hispanics. 
  • People experiencing poverty—More than 14.6 million people with incomes meeting the federal poverty definition live in counties that received an F for at least one pollutant. Nearly 2.6 million people in poverty live in counties failing all three measures. 
  • Children and older adults—More than 27 million children under age 18 and some 18 million adults age 65 and over live in counties that received an F for at least one pollutant. Almost 4.3 million children and 2.6 million seniors live in counties failing all three measures. 
  • People with underlying health conditions 
    • Asthma—1.7 million children and nearly 8.7 million adults with asthma live in counties that received an F for at least one pollutant. More than 217,000 children and 1.2 million adults with asthma live in counties failing all three measures. 
    • Chronic Obstructive Pulmonary Disease (COPD)—Over 5 million people with COPD live in counties that received an F for at least one pollutant. Almost 630,000 people with COPD live in counties failing all three measures. 
    • Lung Cancer—More than 55,000 people diagnosed with lung cancer in 2019 live in counties that received an F for at least one pollutant. And nearly 6,900 people diagnosed with lung cancer live in counties failing all three measures. 
    • Cardiovascular Disease—More than 6.6 million people with cardiovascular disease live in counties that received an F for at least one pollutant. Some 864,000 people live in counties failing all three measures. 
    • Pregnancy—Adverse impacts from air pollution have been shown both for those who are pregnant as well as for the developing fetus. More than 1.3 million pregnancies were recorded in 2021 in counties that received at least one F for particle pollution. Of those, nearly 198,000 are in counties that received failing grades for all three measures. 

Did You Know?

  1. More than one in three Americans live where the air they breathe earned an F in “State of the Air” 2023.
  2. Nearly 120 million people live in counties that received an F for either ozone or particle pollution in “State of the Air” 2023.
  3. More than 18 million people live in counties that got an F for all three air pollution measures in “State of the Air” 2023.
  4. Breathing ozone irritates the lungs, resulting in inflammation—as if there were a bad sunburn within the lungs.
  5. Breathing in particle pollution can increase the risk of lung cancer.
  6. Particle pollution can cause early death and heart attacks, strokes and emergency room visits.
  7. Particles in air pollution can be smaller than 1/30th the diameter of a human hair. When you inhale them, they are small enough to get past the body's natural defenses.
  8. Ozone and particle pollution are both linked to increased risk of lower birth weight in newborns.
  9. If you live or work near a busy highway, traffic pollution may put you at greater risk of harm.
  10. People who work or exercise outside face increased risk from the effects of air pollution.
  11. Millions of people are especially vulnerable to the effects of air pollution, including children, older adults and people with lung diseases such as asthma.
  12. People of color and those with lower incomes are disproportionately affected by air pollution that puts them at higher risk for illness.
  13. Air pollution is a serious health threat. It can trigger asthma attacks, harm lung development in children, and even be deadly.
  14. You can protect yourself by checking the air quality forecast in your community and avoiding exercising or working outdoors when unhealthy air is expected.
  15. Climate change enhances conditions for ozone pollution to form and makes it harder clean up communities where ozone levels are high.
  16. Climate change increases the risk of wildfires whose smoke spreads dangerous particle pollution.
  17. Policymakers at every level of government must take steps to clean the air their residents breathe.
  18. The nation has the Clean Air Act to thank for decades of improvements in air quality. This landmark law has driven pollution reduction for over 50 years.
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