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Social Determinants of Health and 1 more... less...

G4O1. Increase air quality

Air pollution

Current Value




Average exposure of the general public to particulate matter of 2.5 microns or less measured in micrograms per cubic meter

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Story Behind the Curve

Source: Last accessed 02/14/2022

U.S. Value: 8.3 (2019-2020); 7.8 (2020-2021)

Healthiest State: New Hampshire: 4.1 (2019-2020); Hawaii: 3.8 (2020-2021)

Least-healthy State: California: 12.6 (2019-2020); 12.8  (2020-2021)

Definition: Average exposure of the general public to particulate matter of 2.5 microns or less measured in micrograms per cubic meter

Data Source & Year(s): U.S. Environmental Protection Agency, 2017-2019

Suggested Citation: America's Health Rankings analysis of U.S. Environmental Protection Agency, United Health Foundation,, accessed 2022.


Air pollution is associated with heart and lung problems and even premature death. Large pollutant particles in the air can cause irritation and discomfort, while small, fine pollutants from sources such as auto exhaust or power plants can penetrate deeply into lung tissue and enter the bloodstream. The environment is also impacted by air pollution, as particles are carried from one area to another. Examples include increasing acidification in lakes and streams and changing nutrient patterns in soil. 

Exposure to fine particle air pollution, including from wildfires, has been linked to problems with respiratory and cardiovascular functions, including:

  • Decreased lung function.
  • Asthma.
  • Irregular heartbeat.
  • Heart attack.
  • Early death in those suffering from heart disease or lung disease. 

Air pollution of fine particulate matter originating from human activity was estimated to be responsible for 107,000 premature deaths in 2011. The same study found the cost to society was an estimated $886 billion. The United States Office of Management and Budget (OMB) reports the costs and benefits of federal regulations. OMB found that regulations issued between 2004 and 2014 to limit air pollution by the Environmental Protection Agency (EPA) generated between $157 billion and $777 billion (in 2010 dollars) in benefits to the U.S. economy, mainly by reducing the health risks of exposure to fine particulate matter.


Certain populations are more susceptible to health risks from air pollution: 

  • Individuals with heart and respiratory conditions tend to experience more severe side effects from pollution.
  • Older adults are more likely to be hospitalized because of high levels of air pollution.
  • Children are more likely to have complications from air pollution due to developing lungs, high activity levels and high rates of asthma.
  • Particulate pollution is associated with deaths among infants ages 28 days and older and increased NICU admissions.

There is evidence that certain populations are more likely to be exposed to air pollution:

  • Adults living in urban areas compared with those living in rural areas. 
  • Racial and ethnic minorities have been found to have higher levels of air pollution exposure, particularly in neighborhoods with high levels of segregation. Another study reported neighborhood characteristics such as racial composition and level of residential segregation played a bigger role in explaining individual exposure to air pollution than individual race or income levels. Non-white individuals were also found to have been exposed to significantly higher concentrations of nitrous oxide emissions compared with white individuals.


Healthy People 2030 has an objective to reduce the number of days people are exposed to unhealthy air. Other goals focus on reducing toxic airborne emissions and increasing the use of alternative transportation modes for commuters.

What Works


The health benefits of lower air pollution are significant. Studies have shown that decreasing the concentration of fine particulates in the air leads to a lower risk of all-cause mortality, lung cancer and death from cardiovascular disease. The EPA estimates that the Clean Air Act prevented an estimated 200,000 heart attacks, 2.4 million asthma attacks and 17 million lost workdays between 1990 and 2020. 

Air quality standards and environmental protection policies have helped reduce air pollution in the last four decades, but pollution remains high in some areas. Actions in recent years have eroded some of the progress made in the past 50 years, with industry consultants replacing scientists on the EPA’s advisory groups. This has made it more difficult for scientists to provide expert recommendations to the EPA. 

Individuals can reduce their contribution to air pollution by decreasing fossil fuel consumption or participating in local energy conservation programs. Individuals can try to limit exposure to air pollution by:

  • Monitoring local air quality at and staying indoors on days with poor air quality.
  • Avoiding long periods of strenuous exercise near busy streets and on days with poor air quality. 

Source: Last accesses 6/29/2022


According to the Chicago Tribune (Mar 26, 2021), "Indiana leads the nation in toxic pollution emitted per square mile, according to an U.S. Environmental Protection Agency report. In 2019, 882 facilities disposed of 123.3 million pounds of chemicals harmful to humans or the surrounding environment according to the Toxic Release Inventory, an EPA report published annually. Within the EPA’s Region 5 — spanning six Midwest states — Indiana ranks first in pollution, accounting for 27%, followed by Ohio, 23%, Illinois, 22%, Michigan, 16%, Wisconsin, 7% and Minnesota, 5%. Advocates have long called for Indiana to do more to curb pollution, including more funding for the Indiana Department of Environmental Management saying in 2019 it was ‘kneecapped’ by years of declining budgets. The agency’s funding fell by 20% from 2007 to 2018, hampering its ability to protect the public, according to the Washington, D.C.-based Environmental Integrity Project. The agency’s culture has traditionally been to work with businesses before issuing fines, the project said."

Source:   Last accessed 21 July 2022

Corrective Action

According to Hoosier Environmental Council Executive Director Jesse Kharbandal:

“We urge the Indiana Senate Appropriations Committee, which is now examining the state budget, to increase funding for IDEM,” he said. “The agency needs more staff, such as for the agency’s cleanup programs, so that we can reduce the chemical risks to Hoosiers from abandoned factories and existing facilities.  “We urge Attorney General (Todd) Rokita to launch an Environmental Health Initiative, in which he can transparently show on his website what he and his Assistant AGs are doing to accelerate and scale up legal enforcement efforts to reduce exposure of Hoosiers to harmful chemicals.”

Source:   Last accessed 21 July 2022

PoE  --- under Physical Environment (Last accessed 02/14/2023)

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