The 2026 “State of the Air” report reveals that 82% of Californians live in areas with failing air quality grades for ozone or particle pollution.

RT’s Three Key Takeaways:

Pediatric Respiratory Risks: Nearly half of children in the US, including 7 million in California, are exposed to unhealthy levels of air pollution that can cause long-term harm to developing lungs.

Regional Pollution Rankings: Los Angeles-Long Beach remains the most ozone-polluted city in the nation, while Bakersfield CA ranks highest for annual particle pollution despite showing some improvement.

Chronic Health Implications: Exposure to ozone and particle pollution is linked to premature death, new asthma cases, and an increased risk of respiratory diseases, heart attacks, and strokes.

The American Lung Association (ALA) released its 27th annual “State of the Air” report, finding that nearly half of children in the US breathe unhealthy levels of air pollution. In California, this includes 7 million children, with more than eight in 10 residents living in counties affected by unhealthy air.

The report analyzed air quality data from 2022 to 2024, grading counties on ground-level ozone pollution, also known as smog, and particle pollution, also known as soot. Los Angeles-Long Beach was once again ranked as the most ozone-polluted city in the nation. Bakersfield ranked as the most polluted for annual particle pollution, even as the 2026 report showed ongoing improvement for the area.

Ground-level ozone pollution, also known as smog, is a powerful respiratory irritant whose effects have been likened to a sunburn of the lungs. Inhaling ozone can cause shortness of breath, trigger coughing and asthma attacks, and can cause premature death.

Though progress has been made over the years to clean up ozone, that progress is fragile, and more communities are seeing their worst ozone levels in years. The number of people living in counties with unhealthy ozone pollution increased compared to last year’s report. More than 129 million people (38% of the nation’s population) lived in counties earning F grades for ozone, which is nearly 4 million more than in last year’s report. Extreme heat, smoke and other factors during the report period contributed to the formation of ozone from precursor pollutants, resulting in higher levels for many parts of the country, most notably in Central states from Minnesota to Texas, and in a swath from California to Texas.

Top 5 Cities Most Polluted by Ozone Pollution:

Los Angeles-Long Beach, CA

Visalia, CA

Bakersfield-Delano, CA

Phoenix-Mesa, AZ

Fresno-Hanford-Corcoran, CA

“Clean air is essential to the health and wellbeing of families across California. Children deserve to breathe air that won’t make them sick,” said Will Barrett, assistant vice president, nationwide policy, clean air for the American Lung Association, in a news release. “Despite decades of progress, too many people throughout California are living with unhealthy levels of air pollution, and the risk to clean air progress is only growing. Air pollution in California is causing kids to have asthma attacks, contributing to chronic health conditions, and making people who work outdoors sick.”

Impact on Pediatric Lung Health

Infants, children, and teens are more susceptible to the health impacts of air pollution because their lungs are still developing. According to the report, children breathe more air for their body size than adults and experience frequent exposure to outdoor air. Exposure during childhood can lead to reduced lung growth, the development of new asthma cases, and an increased risk of respiratory diseases.

Nationally, 33.5 million children, or 46% of those under 18 years old, live in areas that received a failing grade for at least one measure of air pollution. In total, 152 million people in the US live in a county with a failing grade for at least one pollutant, and 32.9 million live in counties with failing grades for ozone, short-term particle spikes, and annual particle levels.

Policy and Environmental Oversight

The ALA expressed concern regarding the current trajectory of the Environmental Protection Agency (EPA). The report noted that the EPA has retreated from its public health foundation by rolling back clean air protections and eliminating health-related information from its economic analyses. This change means the financial and healthcare costs of pollution to families and communities may not be fully accounted for as policies are altered.

“‘State of the Air’ shows that cleaning the air in California has been a hard-fought effort for decades, and we can’t let that progress stall,” said Barrett, in a news release.

The ALA is calling for policymakers to defend lung health through budget investments in clean transportation and rules to address diesel hotspots, such as warehouses. The organization also urged the federal government to prioritize the health of children when evaluating air quality protections.