A large swath of the midwest remains on a health alert Thursday (June 29) over poor air quality in the region from the Canadian wildfires.

The Michigan Department of Environment extended its air quality warning as weather forecasters predicted that low-level winds would change direction and likely cause more smoke and dangerous particulates to spread across much of the state, the Detroit Free Press reported.

Meanwhile, the Northeast Ohio Areawide Coordinating Agency extended its air quality advisory for multiple counties, Cleveland.com reported. The air quality index was 166 for the Cleveland-Akron-Lorain region at 4 a.m. on Thursday, which was an improvement from the previous day but still unhealthy.

"The poor air quality can make it harder to breathe, trigger an asthma or emphysema attack, or allergies. Difficulty breathing can also cause increased strain for patients with cardiovascular disease,” said Dr. Jaime Hope, medical director of Emergency Medicine at Beaumont Outpatient Campus in Livonia, the Free Press reported.

All communities do not experience the consequences of poor air quality equally.

Under normal conditions, residents of low-income areas and communities of color are exposed disproportionately to higher levels of dangerous fine particulate air pollution than other groups, according to research released in 2022 from Harvard T.H. Chan School of Public Health.The study, published in the journal Nature, was not the first to show that poor, Black, Latino and Asian Americans are at higher risk of premature death from exposure to PM2.5 air pollution.

In 2021, research published in the journal Science Advances showed that communities of color are exposed to more pollution from nearly every source compared to white communities. Black Americans were particularly exposed to every source of air pollution, including industrial, vehicular, agricultural, and construction, to name just a few.

The Canadian wildfires, which started about six weeks ago, caused the air quality index in New York City to peak June 7 at 405 out of 500, which is considered hazardous, according to the New York Post.

In the aftermath, the highest numbers of asthma-related emergency room visits were from ZIP codes with low-income residents from predominantly Black and Hispanic communities, Gothamist reports, citing Census and local health department data.