The Health Divide: Nearly half the country breathes polluted air, but Black Americans are more likely to die from it

Deanna Reed-Foster has battled asthma throughout her life. Her condition was so severe that her family relocated from Chicago to Glendale, California, three years ago to help her find relief.

Reed-Foster, 54, an actress, described living with asthma this way:

“When you work out, you get short of breath and must pause to catch your breath. With asthma, you pause, but you are unable to catch your breath,” she said.  

Reed-Foster, who is African American, uses an app on her phone to check the air quality before going to work, stepping outside, or planning her day. When the air quality is in the yellow range, she exercises caution. If it reaches the red level, she stays indoors. 

Nearly half of the United States population now lives in an area where they breathe polluted air. This year’s “State of the Air” report from the American Lung Association (ALA) reveals that, despite relentless efforts over the decades to cleanse the air we breathe, an astonishing 46% of Americans — around 156.1 million people — reside in areas with unhealthy ozone levels and particulate pollution.  

This marks a staggering increase of nearly 25 million individuals exposed to hazardous air compared to the previous year's findings, setting a record for the "State of the Air" reports in the past decade.

Such air quality statistics are particularly alarming for African Americans, given that 4.2 million Black Americans suffer from asthma, the highest prevalence among ethnic groups. Blacks are also five times more likely to seek emergency care due to asthma and three times more likely to experience dire consequences. The outcomes for Black women and children are even worse.

The health burden of air pollution unevenly falls on people of color, the ALA report said, adding that Hispanics are nearly three times as likely as white people to live in areas with unhealthy air.  

“The number of people living in places with unhealthy air just seems to keep getting bigger,” Katherine Pruitt, the lead author and national senior director for policy at the American Lung Association, told USA Today. 

Policy rollbacks under Trump place more people at risk 

The latest air quality report arrives as the Trump administration intends to cut air pollution policies and eliminate two federal offices charged with regulating climate and air pollution.

The Environmental Protection Agency said the Trump rollbacks would reverse regulations encouraging power plants and car manufacturers to adopt cleaner energy sources. It will also undo rules on soot, mercury, and coal ash pollution, which could significantly harm public health in the U.S. Meanwhile, the EPA is eliminating the Office of Atmospheric Protection and Office of Air Quality Planning and Standards.

An analysis by The Guardian revealed that the clean air and water regulations targeted by Trump’s EPA were projected to save nearly 200,000 lives in the coming years.

While more than 156 million people in the U.S. now live in places with failing grades for unhealthy levels of ozone and particle pollution, the groups who are especially vulnerable to illness and death from their exposure levels are African Americans with underlying conditions like asthma and diabetes.  

Contributing factors include residents’ proximity to major roadways, limited access to fresh food options, and a lack of political power and decreased advocacy in these communities.

For many African Americans, controlling their asthma can be a challenge, according to the NIH brief, “Asthma in the Black Community.”

Systemic barriers in accessing health care make it harder for many African Americans to manage their asthma. Also, African Americans often live in densely populated areas with higher levels of pollution. Additionally, they are more likely to inhabit older homes that harbor rodents, insects, or mold — all factors that can trigger asthma attacks.

Black people are 40% more likely to have asthma than white individuals, and there is a gender gap, too: Black women are 84% more likely to have asthma compared to Black men. Moreover, Black children are eight times more likely to die from asthma than white children, according to the NIH brief.

Reed-Foster started wearing masks years ago to help manage her asthma, long before COVID-19 made mask-wearing routine. Her family decided to move to California after her physicians recommended that a warmer climate would help her better control her asthma symptoms.

“When we lived in Chicago, I would have to be rushed to the emergency room every October and November because of my asthma symptoms,” Reed-Foster said. 

Black Americans with asthma more likely to die from air pollution

Reed-Foster urged the media to investigate the reasons why asthma rates are higher among Black and Hispanic communities.  

She experienced issues with doctors who downplayed her symptoms.  

“I had doctors discharge me from the hospital, telling me I was fine when I could feel it in my lungs,” Reed-Foster said.

Finding affordable asthma medications is also a problem for her.

While Reed-Foster’s family pays $500 a month for her insurance under COBRA, her out-of-pocket costs for her asthma medication were as high as $275 a month. It’s now down to $200 every three months — still a considerable outlay.  

Reed-Foster stated that the warmer temperatures in California have made her asthma symptoms less frequent, but the California wildfires have caused her some serious issues.

Health journalists can play a crucial role in tracking air quality in their communities. But even more importantly at this particular moment, we can help inform the public about how the Trump administration's policy rollbacks would affect vulnerable populations.

It is widely known that air pollution is harmful to health. But not everyone fully understands how shifting federal policies at the EPA and elsewhere could worsen air quality and the severity of chronic health conditions in their communities. Stories like Reed-Foster’s help readers and viewers make those connections. These are impactful stories that need to be told, especially now.

Such awareness helps people have informed opinions, and makes them more likely to speak out on rollbacks of clean air protections. As the data suggests, such knowledge can empower communities and, over time, save lives.