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Midwest cities still have air quality problems. Here’s what you need to know

Some of the Midwest's coal-burning power plants emit the highest rates of pollution in the country.
Crysta Henthorne
Some of the Midwest's coal-burning power plants emit the highest rates of pollution in the country.

The American Lung Association's latest “State of the Air” report card shows cities in Iowa, Kansas, Missouri and Nebraska have cleaner air than they used to. But soot from wildfires continues to pose a risk.

Stricter federal rules for major ozone emitters have led to a reduction in dangerous ozone levels around the country. The American Lung Association says the trend has continued since the Clean Air Act went into effect in 1963. It’s been amended several times since.

“The EPA has put strict limits on the industrial processes and the power plants,” said Angela Tin, director of clean air initiatives for the ALA. “And so what we're left with is the mobile transportation sources. As time has gone by in the past 25 to 30 years, everything is becoming cleaner. The cars are cleaner, the trucks are cleaner, the fuel is cleaner.”

But the organization's latest State of the Air report card shows that particle pollution continues to plague many regions, including the Midwest. Tin said soot drifting into the region from wildfires to the west is largely to blame for the problem.

Angela Tin, American Lung Association director of clean air initiatives
Stefan Quinn Kirkpatrick
American Lung Association
Angela Tin, American Lung Association director of clean air initiatives

“Ozone you can kind of blame it on the sun and the heat,” she said. “But on particulate matter a lot of it is the fires, and across every one of these (air quality) reports we see an impact from the wildfires.”

Who's breathing it?

The ALA says 120 million, or more than one in three, people in the U.S. live in counties that have unhealthy levels of ozone or particle pollution. Its report card covers 2019 to 2021 and is based on data from the Environmental Protection Agency (EPA).

The data compiled by the ALA also shows disparities in who is affected by air pollution. Of the nearly 120 million people who live in areas with unhealthy air quality, a disproportionate number – more than 64 million (54%) – are people of color.

In fact, said the ALA, people of color were 64% more likely than white people to live in a county with a failing grade for either ozone or particle pollution, and 3.7 times as likely to live in a county with failing grades for both.

Ozone can damage the tissues of the respiratory tract, causing inflammation and irritation and worsening of asthma symptoms. Particle pollution can also affect lung function and worsen asthma and heart disease. It is also linked to eye, nose, throat and lung irritation.

“Even one poor air quality day is one too many for our residents at highest risk, such as children, older adults, individuals who are pregnant, and those living with chronic disease,” said Kristina Hamilton, advocacy director for the American Lung Association.


The Lincoln-Beatrice metropolitan area appears on the cleanest cities list in the 2023 “State of the Air” report – with zero unhealthy ozone pollution days and zero unhealthy particle pollution days. This is the same as in the 2022 report.

“Here in Lincoln and across the nation, we are seeing ozone pollution improving, thanks in big part to the success of the Clean Air Act. But there is more work to do,” said Sara Prem, advocacy director for the Lung Association.

Des Moines

Compared to the 2022 report, Des Moines experienced fewer unhealthy days of high ozone. It’s also listed among the cleanest cities for ozone.

But Des Moines’s particle pollution got worse. The ALA said coal plants in Iowa are a major producer of particle pollution, and western wildfires also added to local particle burdens.

“Despite Iowa’s leadership in clean energy, there needs to be a commitment to transition away from fossil fuels so that Iowans have cleaner air to breathe,” Hamilton said.

Kansas City, Kansas

The air Kansas City, Kansas, residents breathe is getting better – at least by one measure. The ALA national report card for 20-19 through 20-21 shows the city had fewer unhealthy days of high ozone than in its previous report card.

Kansas City’s particle pollution got worse in this year’s report.

Kansas City, Missouri

The air quality report card says the region dropped to about two unhealthy days of high ozone pollution on average between 20-19 and 20-21. That’s its lowest level ever since the association began measuring the metro area 25 years ago.

St. Louis

Compared to the previous report card, St. Louis experienced fewer unhealthy days of high ozone in this year’s report. “State of the Air” ranked St. Louis the 35th most polluted city for ozone – an improvement over its ranking of 37th in last year’s rankings.

East and West

The “State of the Air” report shows differences in air quality between eastern and western states. More than 18 million residents in Western states live in counties with failing grades for ozone and particle pollution. The worst 25 counties for short-term particle pollution were all located in the Western U.S.

Doing something

While people in the Midwest may not be able to control soot coming from points west, Tin says they can continue to bring down ozone levels by changing habits.

“And one of the major things is to use alternate forms of transportation,” she said. “Drive less. Commute together, walk, take bikes. Use alternative fuels. It's up to us to make these decisions and to make the improvements because we are the ones, you know, that are being impacted.

The Midwest Newsroom is an in-depth and investigative journalism collaboration including KCUR, St. Louis Public RadioIowa Public RadioNebraska Public Media and NPR.

Holly Edgell is the managing editor of the Midwest Newsroom, a public radio collaboration among NPR member stations in Missouri, Kansas, Iowa and Nebraska. Based in St. Louis, she has more than 25 years experience as a journalist and journalism education. You can contact Holly at hollyedgell@kcur.org.
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