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Air and Water Quality
Air pollution has recently increased after reaching a 20-year low in 2019-2021.
Air Pollution
Air pollution was responsible for 6.7 million untimely deaths worldwide in 2019. Large particulate matter can cause eye, nose and throat irritation or discomfort when inhaled, while small, fine pollutants can penetrate deep into lung tissue and enter the bloodstream. Air pollution also affects the environment, as particles are carried from one area to another, increasing acidification in lakes and streams as well as changing nutrient patterns in soil.
Changes over time. Nationally, the average exposure of the general public to particulate matter of 2.5 microns or less, measured in micrograms per cubic meter, decreased 35% from 13.2 to 8.6 between 2000-2002 and 2021-2023. However, air pollution has increased 4% from 8.3 to 8.6 micrograms per cubic meter between 2018-2020 and 2021-2023 and is the same level as in 2014-2016.
Between 2000-2002 and 2021-2023, air pollution decreased the same as or more than the national change in 26 states, led by: 52% in Alabama (15.6 to 7.5 micrograms of fine particles per cubic meter), 51% in both Maryland (13.9 to 6.8) and New Hampshire (9.9 to 4.9), and 50% in Maine (10.5 to 5.2).
Disparities. Air pollution varied by geography in 2021-2023 and was 3.0 times higher in California (12.7 micrograms per cubic meter) than Hawaii (4.3).
Climate and Health
Heat and worker health is a new measure in the Annual Report that tracks heat-related illnesses among U.S. workers.
Heat and Worker Health
Exposure to extreme heat or working in hot environments can result in heat-related illnesses such as heat stroke, heat exhaustion, heat cramps and heat rash. Of these illnesses, heat stroke is the most serious and can result in death. In the U.S., heat is the leading cause of weather-related deaths.
Changes over time. Of the 28 states with data, the rate of nonfatal heat-related illness cases causing days away from work per 10,000 full-time workers increased in four states and decreased in 12 states by 10% or more between 2019 and 2020. The increases were 200% in Minnesota (0.1 to 0.3 cases per 10,000 full-time workers), 167% in Tennessee (0.6 to 1.6), 100% in Kentucky (0.1 to 0.2) and 60% in Arizona (0.5 to 0.8). The largest decreases were: 86% in South Carolina (0.7 to 0.1), 75% in Louisiana (0.4 to 0.1), and 67% in Arkansas (1.2 to 0.4), Indiana (0.3 to 0.1) and Maryland (0.6 to 0.2).
Disparities. Heat and worker health varied by geography in 2020. The prevalence was 16.0 times higher in Tennessee (1.6 cases per 10,000 full-time workers) than in Illinois, Indiana, Louisiana, Massachusetts, Michigan, New Jersey, New York, Ohio, Pennsylvania, South Carolina, Washington and Wisconsin (all 0.1).
Housing and Transit
Over the past decade, severe housing problems have decreased, yet geographic and racial/ethnic disparities persist.
Severe Housing Problems
Housing influences health and well-being. Poor quality of housing can cause disease and injury and affect childhood development. Other housing-related factors, such as neighborhood environment and overcrowding, can lead to mental and physical health problems.
Changes over time. Nationally, the percentage of occupied housing units with at least one of the following problems — lack of complete kitchen facilities, lack of plumbing facilities, overcrowding or severely costburdened occupants — decreased 11% from 18.8% to 16.8% of households between 2007-2011 and 2017-2021. During this time, severe housing problems decreased the same as or more than the national change in 23 states, led by: 22% in Michigan (17.1% to 13.4%), and 18% in Maine (15.4% to 12.6%), Rhode Island (19.9% to 16.3%) and Wisconsin (15.2% to 12.4%).
Between 2007-2011 and 2017-2021, severe housing problems decreased 20% among Hispanic households (34.0% to 27.3%), 12% among Asian/Pacific Islander (25.1% to 22.0%), Black (27.4% to 24.1%) and white (14.5% to 12.8%) households, and 8% among American Indian/Alaska Native households (25.2% to 23.3%).
Disparities. Severe housing problems varied by geography and race/ethnicity in 2017-2021. The prevalence was:
- 2.1 times higher among Hispanic (27.3%) than white (12.8%) households.