Residents of the Twin Cities metro area are not the only ones whose health is affected by air quality.

A new analysis by the Minnesota Department of Health found in 2013 that as many as 10% of deaths and 5% of hospital visits statewide were due in part to air pollution.

That means polluted air played a role in up to 4,000 deaths, 800 visits to the emergency room and 500 hospital stays statewide.

The “Life and Breath” report looked at the two main types of air pollution: fine particles and ground-level ozone. The 2013 data is the latest available.

The study expands on a 2015 analysis that focused on the Twin Cities metro. State health officials broadened their look to include health and pollution data from across the entire state.

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The report notes that Minnesota’s air quality meets federal standards, but even low levels of pollution can have an adverse impact on health including serious illnesses and early death.

“Good health and a safe and clean environment are fundamental needs for all Minnesotans,” said Jan Malcolm, health commissioner. “This report clearly demonstrates that air quality and health are closely linked.”

The report emphasized Minnesotans who are older, those who have heart and lung problems and children with uncontrolled asthma are the most likely to be hurt by breathing polluted air. It added that greater Minnesota has a higher proportion of older Minnesotans who are uninsured than the metro.

Breathing polluted air can cause shortness of breath, wheezing, coughing and chest pain, health officials said. It can worsen medical conditions like asthma, heart disease and emphysema.

Southern Minnesota has the most polluted air, the study concluded. The southwest part of the state has the highest levels of ozone, and the metro and southeast had the most fine particulates.

Reducing those pollutants by 10% could lead to 500 fewer deaths and 200 fewer hospital visits, the report found.

Reducing pollution is not the only way to save lives and keep people out of the hospital. Health officials say addressing disparities in health care is also important.