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New research highlights disparities in fine particulate matter (PM2.5) trends between American Indian (AI) and non-AI populated U.S. counties. PM2.5 is one of several air pollutants regulated by the U.S. EPA. Downward trends in PM2.5 concentrations were steeper among the non-AI populated compared to AI-populated counties. With most U.S. air pollution research conducted in urban settings, this is the first study to detail the extent of particulate air pollution levels and its potential health consequences among rural AI communities.