Worst Cities for Asthma

  • Springfield, Massachusetts, USA
    Worst Places to Live With Asthma
    Various factors contribute to a poor environment for people with asthma. The Allergy and Asthma Foundation of America (AAFA) used eight of them when they looked at the most populated cities in the United States, ranking the worst ones for asthma sufferers in 2019. They assessed the prevalence of asthma, number of asthma-related emergency department visits and deaths, asthma medicine use, poverty, lack of health insurance, lax tobacco regulations, and access to asthma specialists. Measured by those factors, here are the AAFA’s 10 worst cities for people with asthma.
  • Milwaukee Skyline And Shoreline Aerial
    #10. Milwaukee, WI
    Milwaukee ranks number 10 on the AAFA’s worst cities for asthma list due in part to the number of asthma-related emergency room visits, and also for its high incidence of poverty, which includes nearly 20% of the population. People who live at or below the poverty line tend to develop asthma more often because of poor living conditions, housing that may be located near congested, polluting roadways, and the inability to pay for insurance or medical treatment.
  • Omaha, Nebraska, City View
    #9. Omaha, NE
    Omaha is the farthest west of any of the AAFA’s worst cities for asthma. It has a high number ER asthma-related visits and a high death rate from asthma. Among low-income black and Hispanic residents, the incidence of asthma is disproportionately high. Omaha ranks third in the use of long-term asthma controllers, which are medicines taken daily over an extended period of time. If you’re an asthma sufferer, work with your doctor to find the most effective medicine for you and take it as directed to help control your asthma.
  • Boston, Massachusetts skyline
    #8. Boston, MA
    Boston had the third highest numbers of asthma-related deaths in major U.S. cities in 2019 and a high prevalence of people with asthma. The city also has a high seasonal pollen count which can trigger asthma attacks in some people. If you have allergic asthma, keep track of the vegetation that seems to affect you the most and try to stay indoors during spikes in pollen count. Make sure you have sufficient long and short-term asthma prescription medicines on hand in case your asthma flares up
  • Louisville, Kentucky skyline with pedestrian walkway in front
    #7. Louisville, KY
    Louisville consistently ranks as one of the worst cities for seasonal allergies, which makes it tough going for people with allergic asthma. The bluegrass that gives the state its nickname and feeds so many thoroughbred horses gives off more pollen than any other kind of grass. Because Louisville lies in the bowl-shaped Ohio Valley, and often has high humidity that keeps particulates earthbound, Louisville ranks among the smoggiest cities in the country. The poor air quality is hard on people with asthma, so stay inside as much as possible during air quality alerts.
    #6. Allentown, PA
    Allentown gets a bad grade when it comes to ozone pollution—experts give it a “D.” Ozone is the main ingredient in smog, which can set off asthma attacks. Not surprisingly, Allentown has a high number of people with asthma as well as a high rate of asthma-related ER visits. Unfortunately, there were fewer than twelve asthma specialists in the area in 2019. Allentown also has lax smoking regulations and secondhand tobacco smoke is a common trigger for asthma flares. Look for smoke-free zones when you have asthma and try to keep your distance from smokers.
  • Cleveland, Ohio, USA
    #5. Cleveland, OH
    Among the cities studied by the AAFA, Cleveland had the sixth highest use of quick-relief asthma medicine, or “rescue drugs,” which people with asthma take when they are having an attack. These medications help relax and open your airways. Cleveland has poor air quality and a poverty rate of more than 10%, which contribute to the high number of asthma-related ER visits that, on average, cost more than $1500 apiece. Use asthma medicines correctly and follow up with your doctor to lower the chance of a serious flare that could land you in the ER.
  • The Schuylkill River Meanders Flowing thru Downtown Philadelphia PA
    #4. Philadelphia, PA
    Philadelphia is one of the poorest major cities in the U.S. Poverty often leads to higher rates of asthma, due in part to the lack of healthcare. In addition to the health risks of low-income living, Philadelphia has high ozone levels and air particle pollution. The combination of factors leads to a large number of asthma-related ER visits and fatalities. One survey found that asthma was one of the top 20 reasons for ER visits in the U.S., accounting for 1.7 million visits yearly.
  • Greensboro, North Carolina, USA
    #3. Greensboro, NC
    Greensboro is close to North Carolina’s Research Triangle, which is known for medical research and technology, but this city has the tenth worst access to asthma specialists in the country. It also has a high number of people without health insurance, which means fewer trips to the doctor’s office and more asthma-related ER visits instead. Asthma treatment can be expensive and people without insurance may not be able to pay for medicines and healthcare, which can lead to dangerous, uncontrolled asthma.
  • Dayton, Ohio skyline with vivid color
    #2. Dayton, OH
    When it comes to asthma medicine, Dayton ranks third among U.S. cities in the AAFA report in the use of both quick relief and long-term controller medications. Dayton forms part of the Ohio “asthma-belt,” where the disease is very common. It holds another negative distinction: Dayton has the highest rate of ER visits due to asthma in the country. Dayton has a poverty rate of nearly 1 in 3 residents, a measure often associated with a high number of people with asthma.
  • Springfield, Massachusetts, USA
    #1. Springfield, MA
    Springfield lies in a valley where high levels of carbon dioxide collect and pollute the air. It also has a high pollen count—it’s tied with three nearby cities for the highest count in the area. About 60 to 80% of kids with asthma and about half of adults have allergic asthma as part of their condition. The pollen and pollutant factors, along with recording the second highest number of asthma-related ER visits among cities in the report, lands Springfield at the unenviable number 1 position for worst cities for asthma sufferers in the AAFA report.
Worst Cities for Asthma | Worst Places to Live With Asthma

About The Author

Nancy LeBrun is an Emmy- and Peabody award-winning writer and producer who has been writing about health and wellness for more than five years. She is a member of the Association of Health Care Journalists and the American Society of Journalists and Authors.
  1. State of the Air. American Lung Association. https://www.lung.org/research/sota/city-rankings/states/pennsylvania/lehigh
  2. Asthma Capitals: 2019. Asthma and Allergy Foundation of America. https://www.aafa.org/asthma-capitals/
  3. Louisville once again ranked one of the worst cities for seasonal allergies. WAVE3 News https://www.wave3.com/2019/04/24/misery-loves-company-you-may-be-feeling-miserable-due-allergies/
  4. Ground-level Ozone Pollution. United States Environmental Protection Agency. https://www.epa.gov/ground-level-ozone-pollution/ground-level-ozone-basics
  5. Asthma. MedlinePlus, U.S. National Library of Medicine. https://medlineplus.gov/ency/patientinstructions/000008.htm
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Last Review Date: 2020 Jun 10
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