County Health Rankings Model

Air and Water Quality

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Use County Health Rankings’ model of health to explore the measures that influence how long and how well we live.

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Clean air and safe water are prerequisites for health. Poor air or water quality can be particularly detrimental to vulnerable populations such as the very young, the elderly, and those with chronic health conditions.

Why Are Air and Water Quality Important to Health?

Clean air and water support healthy brain and body function, growth, and development. Air pollutants such as fine particulate matter, ground-level ozone, sulfur oxides, nitrogen oxides, carbon monoxide, and greenhouse gases can harm our health and the environment [1]. Excess nitrogen and phosphorus run-off, medicines, chemicals, lead, and pesticides in water also pose threats to well-being and quality of life [2].

In 2016, 43 million people—more than 1 in 8 Americans—had been diagnosed with asthma [3]. Air pollution is associated with increased asthma rates and can aggravate asthma, emphysema, chronic bronchitis, and other lung diseases, damage airways and lungs, and increase the risk of premature death from heart or lung disease. Using 2009 data, the CDC’s Tracking Network calculates that a 10% reduction in fine particulate matter could prevent over 13,000 deaths per year in the US [4]. 

While drinking water safety is improving, a 2012 study estimates that contaminants in drinking water sicken up to 1.1 million people per year [5]. Improper medicine disposal, chemical, pesticide, and microbiological contaminants in water can lead to poisoning, gastro-intestinal illnesses, eye infections, increased cancer risk, and many other health problems [2]. 

Poor surface water quality can also make lakes unsafe for swimming and wild fish unsafe for consumption. Nitrogen pollution and harmful algae blooms create toxins in water, which can lead to rashes, stomach or liver illness, respiratory problems, and neurological effects when people ingest or come into contact with polluted water. Water pollution also threatens wildlife habitats [2].

Communities can adopt and implement various strategies to improve and protect the quality of their air and water, supporting healthy people and environments.


[1] Environmental Protection Agency. Learn about air. December 4, 2018. Accessed March 14, 2019.  
[2] Environmental Protection Agency. Learn about water. December 4, 2018. Accessed March 14, 2019.
[3] Centers for Disease Control and Prevention. Asthma: 2016 National Health Interview Survey. May 18, 2018. Accessed March 14, 2019.
[4] Centers for Disease Control and Prevention. Outdoor Air: Health Impacts of Fine Particles in Air. August 2, 2018. Accessed March 14, 2019.
[5] Lambertini E, Borchardt MA, Kieke BA, Spence SK, Loge FJ. Risk of Viral Acute Gastrointestinal Illness from Nondisinfected Drinking Water Distribution Systems. Environmental Science & Technology. 2012; 46(17):9299–9307.


Our Rankings show how healthy a community is as well as indicators for future health. This provides a starting point for action on improving health for all. Dig deeper into the measures below to learn more about our approaches to measuring health.

Indicator of the presence of health-related drinking water violations. 'Yes' indicates the presence of a violation, 'No' indicates no violation.