Lung Association Report finds Californians’ Health at Risk Due to Air Pollution and Climate Change Impacts

This year’s “State of the Air” report from the American Lung Association finds that despite decades of progress, California continues to face some of the most significant challenges in the United States for the most harmful and widespread types of air pollution: particle pollution and ozone. The health of Californians – nearly all of whom live in a county with a failing grade in this year’s report – is more urgent and more daunting due to climate change impacts including extreme heat and wildfires that continue to undermine progress.

Seven of the nation’s ten most ozone-polluted cities in the United States are in California, including the Los Angeles-Long Beach metropolitan area which ranks as the most polluted city again in “State of the Air” 2021. For particle pollution, six California cities appear among the ten most polluted by short-term spikes in particle pollution and for unhealthy annual particle pollution levels. Bakersfield ranks as the most polluted American city for unhealthy annual levels of particle pollution in “State of the Air” 2021.  

“California’s leading clean air policies have driven significant improvements, but more must be done to ensure that all communities experience the benefits of healthy air,” said Will Barrett, director of clean air advocacy for the American Lung Association in California. “California must seize current opportunities through the state budget, legislative and agency actions to invest in healthier travel and zero-emission transportation options and infrastructure that leave no community behind.” 

Eight California cities appear on all three lists of most polluted cities in the United States for unhealthy ozone days, unhealthy spikes in particle pollution, and for annual particle pollution levels: Bakersfield, El Centro, Fresno-Madera-Hanford, Los Angeles; Sacramento; Redding-Red Bluff, San Jose-San Francisco-Oakland; and Visalia.  Only Salinas, California earned the distinction of making any of the cleanest cities lists in “State of the Air” 2021, appearing on the cleanest cities list for having zero unhealthy ozone days, and tied for the 22nd cleanest city in terms of annual levels of particle pollution in this year’s report.

Ozone Pollution in California
Despite progress over the history of the report, ten California cities remain on the list of the 25 most-ozone polluted cities in the United States. The “State of the Air” 2021 showed many cities with fewer unhealthy ozone days compared with last year’s report, including the Los Angeles-Long Beach metropolitan area which continues to rank as the most ozone-polluted city in the United States. Bakersfield, Fresno and Visalia round out the top four most ozone-polluted cities in the nation, all of which improved to their fewest number of ozone days since the first “State of the Air” report in 2000. In the “State of the Air” 2021, 31 California counties earned an “F” grade - one more than in last year’s report. 

Particle Pollution in California
“State of the Air” 2021 found that year-round particle pollution levels across California were mostly improved compared with last year’s report, though several counties still saw increases. Despite improvements, eleven of the 17 American counties that fail to meet the annual particle pollution standard are in California. The report also tracked short-term spikes in particle pollution, which can be extremely dangerous and even lethal. The report found that many California communities had fewer days when short-term particle pollution reached unhealthy levels, but the ongoing impacts of major wildfires continue to degrade the air in California, where no county earns an “A,” and 39 counties have a failing grade for unhealthy particle pollution days.

The year’s report found that nationwide, more than 4 in 10 people (135 million) lived with polluted air, placing their health and lives at risk. In California, ozone and particle pollution placed the health of over 38 million residents at risk, including those who are more vulnerable to the effects of air pollution, such as older adults, children and people with lung disease. Across the United States, the report also shows that people of color were 61% more likely to live in a county with unhealthy air than white people, and three times more likely to live in a county that failed all three air quality grades. The report also finds that climate change made air quality worse and harder to clean up.

“While nearly all Californians are impacted by unhealthy air, we know that low-income communities and communities of color too often face disparities in exposures and negative health outcomes,” said Dr. Afif El-Hasan, asthma physician with Kaiser Permanente, Southern California and American Lung Association Board Member. “Greater attention and priority must be placed on environmental justice, equitable policies and priority investments that target clean-up where it is needed most.”

The Lung Association’s annual air quality “report card” tracks and grades Americans’ exposure to unhealthful levels of particle pollution (also known as soot) and ozone (smog) over a three-year period – this year’s report covers 2017-2019. The report analyzes particle pollution in two ways: average annual levels and short-term spikes. Both ozone and particle pollution can cause premature death and other serious health effects such as asthma attacks and cardiovascular damage, and are linked to developmental and reproductive harm. Particle pollution can also cause lung cancer.

Learn more about “State of the Air” at and sign the petition for the Biden Administration to promote clean air, a safe climate and environmental justice.

For more information, contact:

California Media Contact
(310) 359-6386
[email protected]

Asthma Educator Institute
, | Jul 11, 2022
Community Connections - RSV: The Illness on Every Parent's Radar This Season
, | Feb 08, 2023