Poor Air Quality as a Climate Health Hazard
This summary is part of the NAM’s “Communicating About Climate Change and Health” project. The project aims to support health providers and other communicators in sharing actionable information with patients and the public.
Health Impacts of Poor Air Quality
Climate change and the combustion of fossil fuels each contribute to reduction in air quality and reinforce one another’s effects. Combustion releases pollutants that directly degrade air quality, while climate change amplifies pollution by increasing ozone formation, intensifying wildfires, and altering weather patterns that trap pollutants near the ground.
Air pollution, including ground-level ozone, particulates, and aeroallergens, is associated with respiratory and cardiovascular diseases, allergies, and asthma. Fossil fuel combustion is a major contributor to pollution from particulates and is a leading driver of health harms. It is linked to asthma, respiratory diseases, heart disease, certain cancers, adverse birth outcomes, cognitive impairments, and premature death.
For people with preexisting medical conditions, such as hypertension, diabetes, or chronic obstructive pulmonary disorder, poor air quality can intensify these conditions. Children are especially vulnerable to air pollution, which can act as a trigger for exacerbations in those with asthma and increase risks for other respiratory conditions such as wheezing, bronchitis, and pneumonia. Children exposed to poor air quality may experience altered immune function, cardiovascular effects, and neurodevelopmental impacts. Prenatal exposure to air pollution has been associated with preterm birth, low birth weight and stillbirth.
In the United States, 350,000 premature deaths in 2018 were attributed to fossil-fuel-related pollution, with the highest number of deaths per capita in Pennsylvania, Ohio, and West Virginia. Air-pollution-related mortality attributable directly to climate change is likely to increase because wildfire smoke is undermining clean air quality gains achieved through U.S. environmental policies.
Like many other climate health hazards, air pollution and its associated health risks are disproportionately concentrated. Communities of color, low-wealth communities, and historically redlined neighborhoods are particularly affected. For example, Black and Hispanic Americans are exposed to 56 and 63 percent more particulate matter pollution, respectively, than they produce.
Case Example
Cancer Alley, Louisiana
"Cancer Alley" refers to an 85-mile stretch along the Mississippi River between Baton Rouge and New Orleans, Louisiana, is infamously characterized by an unusually high concentration of chemical plants and refineries. This region has long been exposed to elevated levels of air pollution, contributing significantly to health burdens among its residents.
Studies have indicated a higher incidence of respiratory diseases, cancers, and other health harms linked to continuous exposure to pollutants such as benzene and formaldehyde -- known carcinogens that are produced through fossil fuel combustion. A 2021 study from Tulane University found that high levels of toxic air pollution are estimated to cause 85 cancer cases every year in Louisiana.
In addition to elevated cancer rates, residents of "Cancer Alley" report rates of low birthweight as high as 27 percent, double the state average, and rates of preterm birth as high as 25 percent, also nearly double the state average. Many residents also report severe respiratory ailments including chronic asthma and bronchitis, childhood asthma, and persistent sinus infections. Predominantly affecting low-income and African American communities, the example of "Cancer Alley" also highlights severe inequities in health outcomes correlated with industrial pollution.
Steps to Protect Your Health
You can stay aware of the air quality index for your area using tools that aggregate real-time data, such as airnow.gov or PurpleAir, which provides local real-time maps at the community level to inform the public. With the correct information, you can take steps to protect yourself (e.g., reducing or avoiding outdoor activities). This is especially important for those living with asthma, COPD, or other chronic respiratory diseases. When the air quality is poor, stay inside as much as possible and keep the windows to your house and car closed.
Wearing an N-95 mask on poor air quality days can reduce your exposure to particulate matter. Using portable air cleaners or high efficiency filters (e.g., HEPA) can keep the air in your home clean and reduce indoor exposure to particulates. If you have a gas stove, you can ensure that your cooking area is well ventilated to minimize exposure to hazardous emissions or consider using an electric induction stove instead.
Mitigation Strategies
A key strategy to reducing air pollution and exposure to poor air quality is reducing reliance on and use of fossil fuels, and, where possible, transitioning to clean sources of energy. At the individual level, this can look like reducing vehicle use and/or switching to electric or hybrid vehicles, and walking, biking, or using public transportation. Many cities are already implementing strategies to incentivize adoption of cleaner transportation to reduce emissions and improve air quality, whether through switching city vehicles from diesel to electric, creating low emission zones, or divesting pension funds from fossil fuels.
References and Related Resources
- Preparing for the Regional Health Impacts of Climate Change in the United States (CDC, 2024)
- Climate Change Impacts on Air Quality (EPA, 2025)
- Power Plants and Neighboring Communities (EPA, 2025)
- Pollution from Fossil-Fuel Combustion is the Leading Environmental Threat to Global Pediatric Health and Equity: Solutions Exist (Perera, 2017)
- Policy Brief for the United States of America (Lancet Countdown, 2023)
- Climate Change, Fossil-Fuel Pollution, and Children’s Health (Perera and Nadeau, 2022)
- Global mortality from outdoor fine particle pollution generated by fossil fuel combustion: Results from GEOS-Chem (Vohra et al., 2021)
- The contribution of wildfire to PM2.5 trends in the USA (Burke et al., 2023)
- Inequity in consumption of goods and services adds to racial–ethnic disparities in air pollution exposure (Tessum et al., 2019)
- “We’re Dying Here”: The Fight for Life in a Louisiana Fossil Fuel Sacrifice Zone (Human Rights Watch, 2023)
- Air pollution is linked to higher cancer rates among black or impoverished communities in Louisiana (Terrell and St. Julien, 2022)
- Fossil-fuel and combustion-related air pollution and hypertension in the Sister Study (Xu et al., 2023)
- Cities100 2019 (C40 Knowledge, 2019)
- Fossil-Fuel Pollution and Climate Change — A New NEJM Group Series (Solomon et al., 2022)
- Fossil fuels are harming our brains: identifying key messages about the health effects of air pollution from fossil fuels (Kotcher et al., 2019)
DISCLAIMER: The information on this webpage is for general informational purposes only and should be not considered a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical condition.
This webpage summarizes available research on the health impacts of poor air quality and mitigation strategies. The content was reviewed for accuracy by members of the expert committee on Communicating About Climate Change and Health. The summary is intended to help inform and stimulate discussion. It is not a report of the National Academy of Medicine or the National Academies of Sciences, Engineering, and Medicine.
Last updated April 10, 2025.
