The American Lung Association report finds that climate events are causing more people in the U.S. to breathe toxic air even as other pollution falls.

Despite improvements in air quality in past decades, 156 million Americans still breathe in too much soot or ozone, says the annual State of the Air report from the American Lung Association.

Almost half of everyone who lives in the United States breathes unhealthy levels of air pollution, according to the American Lung Association’s annual State of the Air report.