More than 265 million people live in the 885 counties with enough monitoring data to be assigned a grade for at least one pollutant in this year’s report. 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.
All 156.1 million people in the U.S. 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” 2025 are as follows:
- Children and older adults—More than 34.6 million children under age 18 and some 25.2 million adults age 65 and over live in counties that received an F for at least one pollutant. Close to 9.5 million children and more than 6.7 million seniors live in counties failing all three measures.
- People with underlying health conditions
- Asthma—More than 2.5 million children and nearly 11.8 million adults with asthma live in counties that received an F for at least one pollutant. More than 638,000 children and some 3.1 million adults with asthma live in counties failing all three measures.
- Chronic Obstructive Pulmonary Disease (COPD)—Some 6.8 million people with COPD live in counties that received an F for at least one pollutant. Close to 1.7 million people with COPD live in counties failing all three measures.
- Lung Cancer—Nearly 72,000 people diagnosed with lung cancer as of 2021 live in counties that received an F for at least one pollutant, and about 17,500 people ever diagnosed with lung cancer live in counties failing all three measures.
- Cardiovascular Disease—Close to 9.7 million people with cardiovascular disease live in counties that received an F for at least one pollutant. Nearly 2.5 million 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 1.7 million pregnancies were recorded in 2023 in counties that received at least one failing grade for air pollution. Of those, close to 453,000 were in counties that received failing grades for all three measures.
- People experiencing poverty—Nineteen million people with incomes meeting the federal poverty definition live in counties that received an F for at least one pollutant. Close to 5.7 million people in poverty live in counties failing all three measures.
- People of color—About 78.3 million people of color live in counties that received at least one failing grade for ozone and/or particle pollution. Over 26.0 million people of color live in counties that received failing grades on all three measures, including some 15.2 million Hispanics.