Air and Water Quality

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. Last reviewed December 4, 2018. Accessed March 14, 2019.  
[2] Environmental Protection Agency. Learn about water. Last reviewed December 4, 2018. Accessed March 14, 2019.
[3] Centers for Disease Control and Prevention. Asthma: 2016 National Health Interview Survey. Last reviewed May 18, 2018. Accessed March 14, 2019.
[4] Centers for Disease Control and Prevention. Outdoor Air: Health Impacts of Fine Particles in Air. Last reviewed August 2, 2018. Accessed March 14, 2019.
[5] Lambertini E, et al. Risk of Viral Acute Gastrointestinal Illness from Nondisinfected Drinking Water Distribution Systems. Environ. Sci. Technol. 2012; 46 (17):9299–9307.

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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.

When it comes to developing and implementing solutions to problems that affect communities, evidence matters. The strategies below give some ideas of ways communities can harness evidence to make a difference locally. You can learn more about these and other strategies in What Works for Health, which summarizes and rates evidence for policies, programs, and systems changes.

Encourage methods of soil cultivation that keep at least one-third of cultivated soil covered with the previous year’s crop residue (e.g., mulch till, ridge till, strip till, or no-till)
Support site-specific plans for crop production that match nutrient applications to crop needs, typically with agricultural best management practices
Use pervious concrete, porous asphalt, permeable interlocking pavers, open-jointed blocks or cells, or other permeable pavement in individual or commercial development efforts; also called porous or pervious pavement
Use ready-made or home constructed barrel systems to collect and store rainwater from rooftops that would otherwise flow to storm drains and streams

The County Health Rankings provide a snapshot of a community’s health and a starting point for investigating and discussing ways to improve health. Select a state below to see what’s happening locally.