There’s no sugarcoating the 2026 American Lung Association (ALA) “State of the Air” report. The focus of this year’s annual trusted air quality report card, now in its 27th year, is kids in the United States. The report finds that 33.5 million children live in areas with poor air quality. That’s 46% of people under 18 years old.
“Nearly half of the kids in the U.S. are breathing air that’s unhealthy at unhealthy levels. Lung health is one of the first things you think of when you think of air pollution, but it also has neurological and cognitive consequences. And long term, we’ve even seen fertility issues. There’s just so many negative consequences of this exposure,” says Traci Gonzales, a pediatric nurse practitioner with Texas Children’s Hospital in Houston and an ALA national spokesperson.
Photo courtesy of the American Lung Association.
The “State of the Air” report looks at the latest air quality data available, which is from 2022 to 2024. It grades counties’ air quality in terms of unhealthy levels of smog (or ground-level ozone air pollution) and year-round and short-term spikes in soot (particle pollution) over a three-year period. This year’s report finds nearly half of the kids in the U.S. live in places that received a failing grade for at least one measure of air pollution. And more than 7 million children (10% of all kids) live in a community with failing grades for all three measures.
The report also shows that a person of color in the U.S. is more than twice as likely as a white individual to live in a community with a failing grade on all three pollution measures. And for Hispanic individuals, that figure jumps to more than three times as likely.
This bleak news can understandably feel devastating to parents and caregivers. Still, as a pediatric nurse practitioner, Traci appreciates the data. “It’s incredibly helpful. I like to show families concrete data. This adds extra weight to what I’m saying,” she says, adding that being able to send families to Lung.org for educational resources and actionable steps to take is also useful. “That way they can protect their kids to the best of their ability, to limit exposure. I can treat symptoms, but healthy air can prevent the symptoms, and that’s always the goal.”
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This is especially important because, as Traci puts it, children are not small adults. “They’re physiologically completely different, and that physiology changes as they grow, every year until they reach adulthood. So air pollution affects them much differently than it affects adults. Their young lungs are still developing. Their brains are still developing. They breathe more air per body size than the adults. So the effects are going to be greater,” she says.
According to ALA, air pollution exposure in childhood can cause long-term harm, including reduced lung growth, new asthma cases, increased risk of respiratory diseases, and impaired cognitive functioning later in life. Both ozone and particle pollution can cause premature death and other serious health effects, such as asthma attacks, heart attacks and strokes, and preterm births. Particle pollution can also cause lung cancer. This demonstrates why practitioners and caregivers—together—need to be on the forefront of improving air quality—outdoors and in.
This is also why Traci spends much of her time working with parents on assessing if kids can play outside or not. “It’s a huge deal,” she says. “If the air quality is too bad, we don’t want you out there, unfortunately. It plays a huge role in care.” She teaches families to check weather apps for air quality and pollen counts before they go outside for the day. “It’s not the first thing you think of, right? You’re just like, ‘Oh, send the kids outside. It’s good to go outside.’ And it is—as long as the air quality is good,” she says.
In a press release announcing the 2026 report findings, Harold Wimmer, ALA president and CEO, addresses the unusual conundrum the U.S. is currently in. Recent progress on clean air is at risk due to extreme heat and wildfires, fueled by climate change, and also, there are policy changes making the problem worse. “Clean air is not something we can take for granted. It takes work. For decades, people in the U.S. have breathed cleaner air thanks to the Clean Air Act… Now is the time to strengthen air pollution standards, but the EPA is doing the opposite. In the last year, EPA has weakened enforcement and rolled back rules that would have protected kids from power plant and vehicle pollution. Children need clean air to grow and play, and communities need clean air to thrive. Leaders at every level must act to improve and protect America’s air quality,” he says.
While it may feel like individuals can’t be part of the solution to push EPA to value the health of kids in the U.S., all-hands-on-deck advocacy can truly help. Historically, EPA has played an essential role in protecting people’s health from air pollution. We can all join the fight to insist EPA not devalue kids’ health. “Sometimes as an individual you might feel, ‘Yeah, the air quality is bad, but what can I do?’ ALA is not one person. They’re a great group to get behind, and they have a big voice in high up places to fight for air quality. That’s really important for families.” If we advocate together for healthier air and win, we will see better outcomes in our kids. Traci says, “We’ll see less of some of the things that we’re seeing at this time. Overall, they’ll be healthier.”
A worthy goal.
Tell Congress: Hold Zeldin Accountable for Corrupting EPA’s Mission