The EPA says North Dakota has the most unhealthy air in the US. From KXNews, EPA: ND Has Most Unhealthy Air in US
The unhealthy air is caused by smoke from forest fires in Canada. One of the comments included the “flaring of gas toxic CO2’s” among other air problems. Sure says the propaganda is working. I couldn’t find any reports of higher rates of pulmonary problems with this unhealthy air or even the past history. ND is 21st in asthma and about 35th in COPD. Not much happening immediately or historically.