PM2.5 produced by freight trucks has adverse impacts on human health. However, it is unknown to what extent freight trucking affects communities of color and the total public health burden arising from the sector. Based on spatially resolved US federal government data, we explore the geographic distribution of freight trucking emissions and demonstrate that Black and Hispanic populations are more likely to be exposed to elevated emissions from freight trucks. Our results indicate that freight trucks contribute ~10% of NOx and ~12% of CO2 emissions from all sources in the continental US. The annual costs to human health and the environment due to NOx, PM2.5, SO2, and CO2 from freight trucking in the US are estimated respectively to be $11B, $5.5B, $110M, and $30B. Overall, the sector is responsible for nearly two-fifths (~$47B out of $120B) of all transportation-related public health damages.