The Los Angeles-Long Beach metropolitan area again ranked as the most ozone-polluted region in the nation, joining six other California areas on the list of the 10 worst cities for ozone in the United States, according to an American Lung Association report released Wednesday.

Los Angeles has topped the ozone-pollution list for 21 of the 22 years the Lung Association has produced the “State of the Air” report. The San Diego-Chula Vista-Carlsbad region ranked seventh on this year’s list.

Los Angeles-Long Beach ranked sixth on the list of cities with the worst short-term particle pollution, and fourth for year-round particle pollution.

As a result, the report ranked Los Angeles County as the third most-polluted place to live in the country.

“California’s leading clean air policies have driven significant improvements, but more must be done to ensure that all communities experience the benefits of healthy air,” said Will Barrett, director of clean air advocacy for the American Lung Association in California. “California must seize current opportunities through the state budget, legislative and agency actions to invest in healthier travel and zero-emission transportation options and infrastructure that leave no community behind.”

According to the report, ozone and particle pollution threatens the health of more than 38 million people in California. Nationwide, more than four in 10 people live with polluted air. People of color are 61% more likely to live in a county with unhealthy air than white people, and three times more likely to live in a county that failed in all three pollution categories.

“While nearly all Californians are impacted by unhealthy air, we know that low-income communities and communities of color too often face disparities in exposures and negative health outcomes,” said Dr. Afif El-Hasan, asthma physician with Kaiser Permanente Southern California and a member of the Lung Association board. “Greater attention and priority must be placed on environmental justice, equitable policies and priority investments that target clean-up where it is needed most.”

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