S TAT E TA B L E S
State Table Notes
A full explanation of the sources of data and methodology is in Methodology.
Notes for all state data tables
1. Total Population is based on 2016 U.S. Census and represents the at-
risk populations in counties with ozone or PM2.5 pollution monitors; it
does not represent the entire state’s sensitive populations.
2. Those 18 & under and 65 & over are vulnerable to ozone and PM2.5.
Do not use them as population denominators for disease estimates—
that will lead to incorrect estimates.
3. Pediatric asthma estimates are for those under 18 years of age and
represent the estimated number of people who had asthma in 2016
based on the state rates when available or national rates when not
(Behavioral Risk Factor Surveillance System, or BRFSS), applied to
county population estimates (U.S. Census).
4. Adult asthma estimates are for those 18 years and older and represent
the estimated number of people who had asthma during 2016 based
on state rates (BRFSS) applied to county population estimates (U.S.
Census).
5. COPD estimates are for adults 18 and over who had ever been
diagnosed with chronic obstructive pulmonary disease, which includes
chronic bronchitis and emphysema, based on state rates (BRFSS)
ED
applied to county population estimates (U.S. Census).
GO
R
6. Lung cancer estimates are for all ages and represent the estimated
A
B
number of people diagnosed with lung cancer in 2014 based on state
EM
rates (StateCancerProfiles.gov) applied to county population estimates
(U.S. Census).
7. Cardiovascular disease estimates are for adults 18 and over who have
been diagnosed within their lifetime, based on state rates (BRFSS)
applied to county population estimates (U.S. Census). CV disease
includes coronary heart disease, stroke and heart attack.
8. Diabetes estimates are for adults 18 and over who have been
diagnosed within their lifetime based on state rates (BRFSS) applied to
county population estimates (U.S. Census).
9. Poverty estimates include all ages and come from the U.S. Census
Bureau’s Small Area Income and Poverty Estimates program. The
estimates are derived from a model using estimates of income or
poverty from the Annual Social and Economic Supplement and the
Current Population Survey, 2016.
10. Adding across rows does not produce valid estimates. Adding the at-
risk categories (asthma, COPD, poverty, etc.) will double-count people
who fall into more than one category.
LUNG.org AMERICAN LUNG ASSOCIATION STATE OF THE AIR 2018
Notes for all state grades tables.
1. Not all counties have monitors for either ozone or particle pollution.
If a county does not have a monitor, that county’s name is not on the
list in these tables. The decision about monitors in the county is made
by the state and the U.S. Environmental Protection Agency, not by the
American Lung Association.
2. INC (Incomplete) indicates that monitoring is underway for that
pollutant in that county, but that the data are incomplete for all
three years. For particle pollution, some states collected data, but
experienced laboratory quality issues that meant the data could not be
used for assessing pollution levels.
3. DNC (Data Not Collected) indicates that data on that particular
pollutant is not collected in that county.
4. The Weighted Average (Wgt. Avg) was derived by adding the three
years of individual level data (2014-2016), multiplying the sums of
each level by the assigned standard weights (i.e. 1=orange, 1.5=red,
2.0=purple and 2.5=maroon) and calculating the average. Grades are
assigned based on the weighted averages as follows: A=0.0, B=0.3-0.9,
C=1.0-2.0, D=2.1-3.2, F=3.3+.
5. The Design Value is the calculated concentration of a pollutant based
on the form of the National Ambient Air Quality Standard and is used
by EPA to determine whether the air quality in a county meets the
standard. The numbers refer to micrograms per cubic meter, or µg/
m3. Design values for the annual PM2.5 concentrations by county
for the period 2014-2016 are as posted on July 26, 2017 at EPA’s
website at https://www.epa.gov/sites/production/files/2017-07/
pm25_designvalues_20142016_final_07_14_17.xlsx. The 2014-2016
design values were compared to the 2012 National Ambient Air Quality
Standard for Annual PM2.5, particularly to the EPA’s assessment of data
quality required, as discussed on EPA’s website at https://www.epa.
gov/pm-pollution/2012-national-ambient-air-quality-standards-naaqs-
particulate-matter-pm. Many design values are missing because state
data did not meet quality requirements.
6. The annual average National Ambient Air Quality Standard for PM2.5 is
12 µg/m3 as of December 14, 2012. Counties with design values of 12
or lower received a grade of “Pass.” Counties with design values of 12.1
or higher received a grade of “Fail.”
 S TAT E TA B L E S

NORTH CAROLINA
American Lung Association in North Carolina
www.lung.org/northcarolina
AT-RISK GROUPS
Lung Diseases
Total 65 & Pediatric Adult Lung Cardiovascular
County Population Under 18 Over Asthma Asthma COPD Cancer Disease Diabetes Poverty
Alamance 159,688 36,032 26,633 4,141 10,060 9,379 109 12,471 14,285 25,014
Alexander 37,428 7,659 7,491 880 2,412 2,382 26 3,264 3,699 5,401
Avery 17,516 2,704 3,754 311 1,197 1,161 12 1,587 1,788 2,985
Buncombe 256,088 48,518 48,984 5,575 16,818 15,988 176 21,576 24,467 33,631
Caldwell 81,449 16,936 15,132 1,946 5,249 5,134 56 6,967 7,969 13,697
Carteret 68,890 12,496 16,045 1,436 4,555 4,743 47 6,663 7,493 8,321
Caswell 22,910 4,339 4,775 499 1,506 1,518 16 2,094 2,377 4,265
Catawba 156,459 35,407 26,582 4,069 9,858 9,363 108 12,530 14,378 19,537
Chatham 72,243 14,322 18,541 1,646 4,647 5,003 49 7,175 7,961 8,384
Cumberland 327,127 83,099 37,950 9,549 19,916 16,268 225 20,155 23,436 59,570

ED
Davidson 164,926 37,023 29,066 4,255 10,413 10,054 113 13,556 15,535 25,150

RGO
Davie 42,013 9,067 8,393 1,042 2,675 2,698 29 3,718 4,228 4,820

BA
Duplin 58,969 14,449 10,003 1,660 3,619 3,432 41 4,603 5,259 12,418

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Durham 306,212 66,016 36,554 7,586 19,635 16,118 210 19,961 23,309 47,269
Edgecombe 53,318 12,319 9,690 1,416 3,329 3,222 36 4,366 4,974 12,514
Forsyth 371,511 87,331 55,989 10,036 23,173 21,012 254 27,485 31,701 62,994
Franklin 64,705 14,452 10,508 1,661 4,101 3,860 45 5,128 5,916 9,624
Gaston 216,965 49,729 33,729 5,715 13,645 12,578 149 16,562 19,113 33,562
Graham 8,558 1,817 1,968 209 543 563 6 792 885 1,675
Granville 59,031 12,244 9,697 1,407 3,821 3,602 41 4,782 5,527 8,403
Guilford 521,330 117,601 74,947 13,514 32,944 29,166 357 37,677 43,583 92,205
Haywood 60,682 11,081 14,792 1,273 3,992 4,182 42 5,916 6,605 9,545
Jackson 42,241 7,271 7,716 836 2,829 2,554 29 3,379 3,822 8,051
Johnston 191,450 49,722 24,670 5,714 11,613 10,330 132 13,278 15,519 25,065
Lee 59,616 14,630 9,507 1,681 3,663 3,401 41 4,509 5,176 9,869
Lenoir 57,307 12,961 10,794 1,489 3,599 3,527 39 4,808 5,468 11,637
Lincoln 81,168 17,566 13,591 2,019 5,195 4,973 56 6,648 7,677 10,179
McDowell 45,075 9,241 8,711 1,062 2,909 2,852 31 3,887 4,422 8,050
Macon 34,376 6,510 9,383 748 2,228 2,433 24 3,521 3,883 5,585
Martin 23,172 4,740 5,105 545 1,491 1,540 16 2,153 2,428 5,175
Mecklenburg 1,054,835 255,098 111,435 29,315 65,580 53,419 723 65,471 77,189 127,889
Mitchell 15,126 2,778 3,714 319 994 1,049 10 1,488 1,662 2,444
Montgomery 27,418 6,242 5,312 717 1,716 1,690 19 2,314 2,621 5,655
New Hanover 223,483 42,418 37,372 4,874 14,706 13,224 153 17,348 19,818 37,472
Person 39,284 8,439 7,247 970 2,509 2,454 27 3,331 3,809 5,962
Pitt 177,220 38,791 21,162 4,458 11,298 9,157 121 11,297 13,141 36,594

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NORTH CAROLINA (cont.)

American Lung Association in North Carolina
www.lung.org/northcarolina
AT-RISK GROUPS
Lung Diseases
Total 65 & Pediatric Adult Lung Cardiovascular
County Population Under 18 Over Asthma Asthma COPD Cancer Disease Diabetes Poverty
Robeson 133,235 34,119 18,699 3,921 8,086 7,199 91 9,330 10,782 35,835
Rockingham 91,393 18,938 17,602 2,176 5,889 5,834 63 7,968 9,091 16,352
Rowan 139,933 31,331 23,850 3,600 8,836 8,335 96 11,136 12,755 22,283
Swain 14,346 3,228 2,791 371 899 875 10 1,195 1,349 2,357
Union 226,606 62,685 27,126 7,203 13,468 11,983 156 15,332 18,043 20,266
Wake 1,046,791 256,755 111,506 29,505 64,871 53,761 719 66,352 78,411 94,001
Watauga 53,922 7,039 8,016 809 3,806 3,095 37 3,866 4,427 11,717
Wayne 124,150 29,618 19,028 3,404 7,699 6,985 85 9,159 10,531 24,889
Yancey 17,678 3,337 4,350 383 1,153 1,216 12 1,726 1,924 3,350
Totals 7,047,843 1,618,098 1,009,910 185,945 443,142 393,311 4,839 508,524 588,436 1,031,661

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NORTH CAROLINA
American Lung Association in North Carolina
www.lung.org/northcarolina
HIGH OZONE DAYS 2014–2016 HIGH PARTICLE POLLUTION DAYS 2014–2016
24-Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg. Grade Orange Red Purple Avg. Grade Value Fail
Alamance DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Alexander 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC
Avery 3 0 0 1.0 C DNC DNC DNC DNC DNC DNC DNC
Buncombe 1 0 0 0.3 B 3 4 0 3.0 D 7.8 PASS
Caldwell 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC
Carteret 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC
Caswell 0 0 0 0.0 A 0 0 0 0.0 A INC INC
Catawba DNC DNC DNC DNC DNC 1 2 0 1.3 C 8.9 PASS
Chatham INC INC INC INC INC INC INC INC INC INC INC INC
Cumberland 0 0 0 0.0 A 0 0 0 0.0 A 8.4 PASS

OED
Davidson DNC DNC DNC DNC DNC 0 0 0 0.0 A 9.0 PASS

ARG
Davie INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC

EMB
Duplin DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Durham 0 0 0 0.0 A 1 0 0 0.3 B 8.7 PASS
Edgecombe 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC
Forsyth 6 0 0 2.0 C 0 0 0 0.0 A 8.2 PASS
Franklin INC INC INC INC INC DNC DNC DNC DNC DNC DNC DNC
Gaston DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Graham 2 0 0 0.7 B DNC DNC DNC DNC DNC DNC DNC
Granville 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC
Guilford 4 0 0 1.3 C 1 0 0 0.3 B 8.3 PASS
Haywood 4 0 0 1.3 C INC INC INC INC INC INC INC
Jackson 4 0 0 1.3 C 3 2 0 2.0 C 8.0 PASS
Johnston 0 0 0 0.0 A 1 0 0 0.3 B 7.4 PASS
Lee 0 0 0 0.0 A INC INC INC INC INC INC INC
Lenoir 0 0 0 0.0 A DNC DNC DNC DNC DNC DNC DNC
Lincoln 4 1 0 1.8 C DNC DNC DNC DNC DNC DNC DNC
McDowell DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Macon 1 0 0 0.3 B DNC DNC DNC DNC DNC DNC DNC
Martin 0 0 0 0.0 A INC INC INC INC INC INC INC
Mecklenburg 17 0 0 5.7 F 0 0 0 0.0 A 9.0 PASS
Mitchell DNC DNC DNC DNC DNC 1 3 0 1.8 C 7.8 PASS
Montgomery 0 0 0 0.0 A 0 0 0 0.0 A 7.2 PASS
New Hanover 0 0 0 0.0 A 0 0 0 0.0 A 5.9 PASS
Person 1 0 0 0.3 B DNC DNC DNC DNC DNC DNC DNC
Pitt 0 0 0 0.0 A 0 0 0 0.0 A 7.2 PASS

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NORTH CAROLINA (cont.)

American Lung Association in North Carolina
www.lung.org/northcarolina
HIGH OZONE DAYS 2014–2016 HIGH PARTICLE POLLUTION DAYS 2014–2016
24-Hour Annual
Wgt. Wgt. Design Pass/
County Orange Red Purple Avg. Grade Orange Red Purple Avg. Grade Value Fail
Robeson DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Rockingham 3 0 0 1.0 C DNC DNC DNC DNC DNC DNC DNC
Rowan 1 0 0 0.3 B INC INC INC INC INC INC INC
Swain 0 0 0 0.0 A 8 4 0 4.7 F 8.1 PASS
Union 6 0 0 2.0 C DNC DNC DNC DNC DNC DNC DNC
Wake 2 0 0 0.7 B 3 0 0 1.0 C 9.9 PASS
Watauga DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Wayne DNC DNC DNC DNC DNC INC INC INC INC INC INC INC
Yancey 3 0 0 1.0 C DNC DNC DNC DNC DNC DNC DNC

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 2018
We will breathe easier when the air in every
American community is clean and healthy.

We will breathe easier when people are free from the addictive
grip of tobacco and the debilitating effects of lung disease.

We will breathe easier when the air in our public spaces and
workplaces is clear of secondhand smoke.

We will breathe easier when children no longer

battle airborne poisons or fear an asthma attack.

Until then, we are fighting for air.

About the American Lung Association

The American Lung Association is the leading organization working to save lives by
improving lung health and preventing lung disease, through research, education and
advocacy. The work of the American Lung Association is focused on four strategic
imperatives: to defeat lung cancer; to improve the air we breathe; to reduce the burden
of lung disease on individuals and their families; and to eliminate tobacco use and tobacco-
related diseases. For more information about the American Lung Association, a holder of
the Better Business Bureau Wise Giving Guide Seal, or to support the work it does, call
1-800-LUNGUSA (1-800-586-4872) or visit: www.Lung.org.