Skip nav to main content.

More than 4 in 10 Americans Live with Unhealthy Air, According to The American Lung Association

The American Lung Association’s 2019 “State of the Air” report finds that an increasing number of Americans—more…

  • May 12, 2019

The American Lung Association’s 2019 “State of the Air” report finds that an increasing number of Americans—more than 4 in 10—lived with unhealthy air quality, placing their health and lives at risk.

The 20th annual air quality “report card” found that 141.1 million people lived in counties with unhealthful levels of either ozone or particle pollution, an increase of more than 7.2 million Americans since the last annual report.

Eight cities recorded their highest number of days with unhealthy spikes in particle pollution since the nation began monitoring this pollutant 20 years ago. And the nation recorded more days with air quality considered hazardous, when air quality reached “emergency conditions”—Maroon on the air quality index—than ever before.

The 2019 “State of the Air” report analyzed the three years with the most recent quality-assured data collected by states, cities, counties, tribes and federal agencies: 2015-2017.

Notably, those three years were the hottest recorded in global history. When it comes to air quality, changing climate patterns fuel wildfires and lead to worsened ozone pollution.

This degraded air quality threatens the health of Americans, especially those more vulnerable such as children, older adults and those living with a lung disease.

Short-Term Particle Pollution

  • Top 10 U.S. Cities Most Polluted by Short-Term Particle Pollution:
  • Bakersfield, California
  • Fresno-Madera-Hanford, California
  • Fairbanks, Alaska
  • San Jose-San Francisco-Oakland, California
  • Missoula, Montana
  • Yakima, Washington
  • Los Angeles-Long Beach, California
  • Salt Lake City-Provo-Orem, Utah
  • Seattle-Tacoma, Washington
  • Pittsburgh-New Castle-Weirton, Pennsylvania-Ohio-West Virginia

More than 20.5 million people lived in counties with unhealthy levels of year-round particle pollution, which is more than in the last two annual “State of the Air” reports.

Top 10 U.S. Cities Most Polluted by Year-Round Particle Pollution:

  • Fresno-Madera-Hanford, California
  • Bakersfield, California
  • Fairbanks, Alaska
  • Visalia, California
  • Los Angeles-Long Beach, California
  • San Jose-San Francisco-Oakland, California
  • Pittsburgh-New Castle-Weirton, Pennsylvania-Ohio-West Virginia
  • El Centro, California
  • Cleveland-Akron-Canton, Ohio
  • Medford-Grants Pass, Oregon

Ozone Pollution

Ozone pollution, often referred to as smog, harms lung health, essentially causing a sunburn of the lung. Specifically, inhaling ozone pollution can cause shortness of breath, trigger coughing and asthma attacks, and may shorten life. Warmer temperatures make ozone more likely to form and harder to clean up.

Top 10 Most Ozone-Polluted Cities:

  • Los Angeles-Long Beach, California
  • Visalia, California
  • Bakersfield, California
  • Fresno-Madera-Hanford, California
  • Sacramento-Roseville, California
  • San Diego-Chula Vista-Carlsbad, California
  • Phoenix-Mesa, Arizona
  • San Jose-San Francisco-Oakland, California
  • Houston-The Woodlands, Texas
  • New York-Newark, New York–New Jersey-Connecticut-Pennsylvania

Cleanest Cities

The “State of the Air” also recognizes the nation’s cleanest cities, and just like last year’s report, only six cities qualified for that status. To rank as one of the nation’s cleanest cities, a city must experience no high ozone or high particle pollution days and must rank among the 25 cities with the lowest year-round particle pollution levels during 2015-2017.

Cleanest U.S. Cities (listed in alphabetical order)

  • Bangor, Maine
  • Burlington-South Burlington, Vermont
  • Honolulu, Hawaii
  • Lincoln-Beatrice, Nebraska
  • Palm Bay-Melbourne-Titusville, Florida
  • Wilmington, North Carolina

Learn more about the 20th anniversary of the “State of the Air” report at Lung.org/sota.