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One night in November a few years ago, I got home from work and thought, huh, someone must have a big bonfire going! The air was thick with the smell of smoke. At first I was charmed by it (there’s nothing like the smell of a fire in autumn), but as the hours wore on, I started wheezing. By the time I tried to go to sleep, I was fully freaking out—because I could barely breathe.

The smoke was not from a backyard bonfire, but from the Great Smokey Mountain wildfires of 2016. The fires killed at least 14 people and were one of the largest natural disasters in the history of Tennessee. The fires were also 35 miles from Knoxville, where I huffed and puffed into a paper bag that night, underscoring how far-reaching the impacts of air pollution can be.

Air quality in the United States used to be much worse before the Clean Air Act of 1970 and subsequent Environmental Protection Agency (EPA) regulations. Those federal policies dramatically reduced fine particulate matter, PM2.5, which is produced by power plants, car exhaust, and wildfires. Those policies also likely saved thousands of lives. Studies have found that air pollution can be as harmful to lungs as smoking and can cause lasting and accumulating lung damage with long-term exposure. According to the World Health Organization, air pollution causes one third of deaths from stroke, lung cancer, and heart disease.¹

Despite overall air quality improvements over the last few decades, more than 4 in 10 Americans still live in places where air quality threatens health. The Trump administration has also eliminated environmental regulations, including 10 air quality rules that have already been reversed and 13 more on track to end.² Just as air quality improved during the years of Obama’s strong regulations,³ we can expect air quality—and our lungs—to deteriorate under the current administration’s weaker guidelines.

Air pollution is particularly dangerous for children, older adults, pregnant women, and people with chronic lung and heart diseases. It especially impacts people of color and people with low incomes, because their communities are more likely to be located near highways and fossil fuel power plants (a design pattern sometimes called pollution inequity or environmental racism). Recent studies have found that people of color live with 66% more air pollution, and that there is a racial gap between who causes air pollution and who breathes it.

Luckily, there are multiple strategies for improving air quality. First, we know that federal regulations work. As community health advocates and professionals, we can call and write to our local and state representatives to ask that they support legislation that restores air quality protections. We can choose to support candidates, organizations, and companies that make it clear that they value clean air and public health, and hold accountable those which don’t.

In our own communities, we can work toward changes that improve local air quality, with the greatest potential for impact coming from decisions made in planning, transportation, and parks departments. Effective strategies include, among many others:

• Expanding public transportation options and service routes to reduce driving and vehicle emissions.
• Making it easier and safer to bike and walk by installing bike lanes, bike parking, and better sidewalks and crossing areas.
• Ending free and subsidized parking.
• Prohibiting highway expansions, focusing instead on road diets.
• Transforming key streets into pedestrian-only zones.
• Changing zoning codes to create multi-use, dense places where it’s possible to live daily life without a car.
• Updating land-use decision-making processes to consider air pollution-related health impacts and require minimum distances between pollution sources and places where residences, schools, and hospitals are built.
• Increasing local energy efficiency standards for buildings so that they put less demand on fossil-fuel power stations.
• Creating tax incentives for energy generation from solar, wind, and hydro power.
• Preserving and increasing parks, greenspaces, and “tredges” (trees at hedge-height) to capture existing fine particles from the air.

Air quality became personal for me after the 2016 wildfires. I went to a doctor about the wheezing I had experienced and was promptly diagnosed with asthma. Since then, I’ve become familiar with what triggers my asthma attacks: camp fires, car exhaust, and simply being outside on days when the air quality index (AQI) measures in the 100s. Today’s local AQI forecast is 101. Wish me luck.

Better yet, join Healthy Places by Design in working toward a future when all communities can breathe easy, and equitably, in clean air.