Economic Infrastructure Commentary Series
Originally drafted 2021 by Phillip Lincoln & Isabella Sabri. Updated by the Drake Institute Editorial Team, August 2025.
Commentary
In 2021, the Drake Institute’s fellows examined how air pollution and respiratory illness intersected to create one of the most pressing women’s health challenges of our time. They noted that more than 12 million women in the United States were living with asthma, compared to about 6.6 million men, and that women of color—particularly Black and Hispanic women—faced higher rates of hospitalization and emergency room visits for respiratory conditions. At the time, asthma and chronic obstructive pulmonary disease (COPD) ranked among the most costly medical conditions in the country, and the gender disparities were already clear. The conclusion was unavoidable: air pollution was not only an environmental crisis, but also a women’s health and economic equity issue.
The 2021 analysis pointed to the science underlying these disparities. Ground-level ozone, formed when hydrocarbons like methane mix with nitrogen oxides and sunlight, exacerbates asthma and decreases lung function. Greenhouse gases—carbon dioxide, methane, nitrous oxide—not only trap heat but also intensify pollen seasons and raise the risk of ground-level ozone and airborne dust. Together, these pollutants worsen respiratory illnesses and contribute to costly cycles of missed school, missed work, and higher healthcare expenditures. Policies like California’s Global Warming Solutions Act and early legislative efforts in states like New York and Pennsylvania were highlighted as examples of how targeted policy could reduce emissions and protect women’s respiratory health.
Four years later, the picture has become even more urgent. The wildfire seasons of 2023 and 2024 demonstrated how climate change is reshaping air quality across the country. Smoke from Canadian wildfires blanketed U.S. cities, leading to a documented 17 percent increase in asthma-related emergency room visits on smoky days. Families far from fire zones found themselves facing hazardous air, and rural communities—often with fewer medical resources—saw the greatest strain. Meanwhile, the Centers for Disease Control and Prevention estimate that asthma now costs the U.S. economy more than $80 billion annually in healthcare expenses and lost productivity, with women in low-income households bearing a disproportionate share of the burden due to higher prevalence and lower access to paid leave.
Policy has responded, albeit unevenly. In 2024, the Environmental Protection Agency finalized a stronger standard for fine particulate matter (PM₂.₅), lowering the annual limit to 9 micrograms per cubic meter. The agency also issued comprehensive rules on methane emissions from oil and gas operations, ending routine flaring and requiring leak monitoring and repair—steps that will help both climate and respiratory outcomes. Yet while these regulatory moves matter, they are not enough on their own. Women in frontline jobs, mothers balancing caregiving, and women with disabilities remain disproportionately affected by the daily health costs of polluted air.
At the Drake Institute, we recognize that health is economic infrastructure. Communities cannot thrive if respiratory illness keeps women out of classrooms, workplaces, and leadership roles. Protecting women’s respiratory health requires investment in clean transportation, renewable energy, and building standards, but also in practical measures that safeguard women today: clean air shelters in rural counties, access to portable HEPA filters and N95 masks during wildfire smoke events, and expanded Medicaid coverage for asthma and COPD management. Equally important is addressing inequities in monitoring and data access, so that women in low-income and rural communities have the same real-time information that wealthier areas take for granted.
The evidence is clear. Air pollution is not only a public health problem—it is a failure of economic infrastructure. Every emergency room visit from an asthma attack, every missed day of work or school, every mother forced to choose between caregiving and her own health is a reminder that the costs of inaction are both human and economic. Investing in clean air is investing in women’s ability to work, care, and lead. It is, at its core, an investment in the economic future of us all.
Archival Reference
This commentary draws on Air Pollution Policy and Women’s Respiratory Health (Lincoln & Sabri, 2021). The original version is archived by the Drake Institute.