The American Lung Association released its 27th annual national air quality report on April 22, 2026, finding that 33.5 million children in the United States live in areas that received a failing grade for at least one measure of air pollution. The report determined that 44% of the U.S. population, including 33 million people younger than 18, reside in areas with unhealthy levels of pollution.

The report analyzed quality-assured data collected between 2022 and 2024. It found that 7 million children, representing 10% of all children in the U.S., live in communities that failed all three measures of air pollution. The 33.5 million figure represents 46% of those under 18.

Between 2022 and 2024, 38% of the U.S. population, approximately 129.1 million people, were exposed to ozone levels that put their health at risk. That figure is the highest recorded in the report in six years and represents a 3.9 million increase from the previous year. Nearly 4 million more people across the U.S. were breathing unhealthy levels of smog between 2022 and 2024 than between 2021 and 2023.

According to the report, more than 61 million people lived in counties that earned "F" grades for unhealthy short-term spikes in soot pollution, and 75 million people lived in counties with "F" grades for soot pollution year-round. The regions most affected by high ozone levels include southwestern states from California to Texas and much of the Midwest.

The report found that people of color make up 42.1% of the U.S. population but represent 54.2% of those living in counties with at least one failing air pollution grade. A person of color is 2.42 times more likely than a white person to live in a community that fails all three pollution measures.

"Children's lungs are still developing. For their body size, they're breathing more air. Air pollution exposure in children can contribute to long-term developmental harm to their lungs, new cases of asthma, increased risks of respiratory illness and other health considerations later in life," said Will Barrett, Assistant Vice-President for Nationwide Clean Air Policy at the American Lung Association.

Kevin Stewart, Director of Environmental Health at the Association, said: "We recognize that there's a connection between air pollution and exposure in children and chronic diseases. The problems aren't necessarily immediate, in terms of just sending a child with asthma to the hospital. It also can affect the induction of asthma in children who ordinarily wouldn't have gotten it, or reduce lung function over their lifetime because they've been exposed as children."

Bakersfield, California continued to rank highest on the association's list of cities with the worst particle pollution year-round, and ranked third-highest for short-term particle pollution and ozone pollution. The five cities with the highest combined rankings across the three categories were Bakersfield-Delano, California; Brownsville-Harlingen-Raymondville, Texas; Eugene-Springfield, Oregon; Fresno-Hanford-Corcoran, California; and San Diego-Chula Vista-Carlsbad, California, tied with Visalia, California.