The 10 Worst Cities for Asthma in 2023

The worst cities for asthma may lack access to effective medical care and have high pollution levels. These factors can lead to the development of asthma or worsening of symptoms. Each year, the Allergy and Asthma Foundation of America (AAFA) studies the 100 largest U.S. cities to examine how challenging it is for people with asthma to live in each one. To do this, the AAFA measures factors such as:

• the number of asthma cases
• the number of asthma-related deaths
• the number of visits to emergency rooms
• pollution levels
• poverty levels
• access to health insurance and asthma specialists
• medication use
• exposure to smoke and other irritants

This article discusses the most challenging cities to live with asthma in 2023, according to the AAFA’s report.

According to the AAFA, Rochester is now the 10th most challenging place to live with asthma, as shown by its high rates of asthma cases.

Rochester may also have a high rate of quick-relief or rescue medication use. While quick-relief medication can be a key part of asthma treatment, frequent use may suggest that overall asthma treatment and management isn’t effective.

That said, Rochester currently has an average number of emergency room visits and asthma-related deaths. Trips to the emergency room can also indicate that asthma is not effectively being managed with treatment.

Read more about treatment options for asthma.

Fresno, which comes in ninth place this year, has a high rate of asthma cases and asthma-related deaths, with average rates of emergency room visits.

These ratings may be related to the air quality in Fresno. The American Lung Association (ALA) suggests that the Fresno, Madera, and Hanford area is the second-worst out of 223 metropolitan areas for 24-hour particle pollution. Particle pollution refers to solid or liquid debris in the air, such as from dirt, dust, and chemicals.

Fresno also ranks worse than average for the number of days with high levels of harmful ozone chemicals.

Plus, the AAFA suggests that Fresno may have a low ratio of asthma specialists to people with asthma. This means people with asthma may find it more challenging to receive specialized care that could help improve their condition.

Learn more about asthma outlook and its effect on life expectancy.

The AAFA ranks Philadelphia as the eighth worst asthma city of 2023 due to its high number of asthma cases and asthma-related deaths. This is one place higher than its 2022 ranking of ninth place.

Philadelphia’s high poverty rate may affect this ranking. In fact, it may be one of the more under-resourced major cities in the United States. The Centers for Disease Control and Prevention (CDC) Trusted Source Centers for Disease Control and Prevention (CDC) Governmental authority Go to source suggests that people living below the poverty line tend to develop asthma more often.

Also, while levels may have improved from last year, Philadelphia still has high ozone and particle pollution levels.

According to the AAFA, Richmond has the second-highest rating for deaths from asthma in all of the cities studied. This, along with its high number of emergency room visits, means that Richmond places seventh for the worst cities for asthma in 2023.

Poughkeepsie places sixth out of the 100 cities the AAFA examined, due to its high rates of asthma cases.

One factor that may contribute to these challenges is that Poughkeepsie is the metropolitan area with the lowest proportion of asthma specialists among the cities included in the report, according to the AAFA.

However, Poughkeepsie may have an average number of asthma-related deaths and a smaller-than-average number of emergency room visits.

Detroit is the fifth most challenging place to live with asthma in 2023. This is lower than its ranking in 2022, when the AAFA named Detroit the most challenging place to live with asthma.

Currently, Detroit has high rates of asthma-related deaths. It also has the second-highest rate of asthma cases out of all the cities included.

Factors that may contribute to Detroit’s ranking include its high poverty rates and low air quality.

This year, Cleveland is named the fourth most challenging place to live with asthma.

Factors contributing to Cleveland’s ranking include high levels of asthma cases, asthma-related deaths, and visits to the emergency room.

A higher-than-average poverty rate and a high level of ozone pollution may also make it more challenging to live with asthma in the city and contribute to worse outcomes for asthma care.

Charleston has higher-than-average rates of asthma cases and emergency room visits, according to the AAFA. These contribute to its third place spot.

The South Carolina Department of Health and Environmental Control suggests that more children are admitted to the hospital due to asthma in the spring and fall. It also suggests this may be due to seasonal triggers, such as high rates of respiratory infections after returning to school and the effects of pollen and mold during these times.

Learn more about pollen, mold, and allergic asthma.

Lakeland comes in second place, due to its high levels of asthma cases and asthma-related visits to the emergency room. Similar to Rochester, the city also has a high rate of quick-relief medication use.

In 2022, the AAFA also suggested that Lakeland had a low rate of asthma specialists per person with asthma.

Plus, a large number of people in Lakeland may not have health insurance. This can make daily asthma management unaffordable for some people and may contribute to the high use of emergency treatment.

Allentown was named the most challenging place to live with asthma in 2023. The city was also first on the AAFA list in 2021 and third in 2022.

Like other cities, Allentown’s high ranking is due to its high rates of asthma cases and emergency room visits. In fact, Allentown has the highest score for emergency room visits of all the cities analyzed by the AAFA this year. However, it currently has an average number of asthma-related deaths.

Factors contributing to this may include relatively few smoking laws and the effects of pollen.

Learn more about secondhand smoke and how to protect yourself.

While asthma rates may be higher in certain cities, not everyone living in them will develop asthma.

Other factors can contribute to whether you develop asthma and how it affects you. These factors can include:

• age
• race
• socioeconomic status

The above factors can contribute to developing asthma due to inequities in healthcare. Also, factors that affect one person may not affect another in the same way.

If you have concerns about asthma, contact a doctor for personalized advice.

Read more about the causes and risk factors of asthma.

According to an AAFA study of 100 cities in the United States in 2023, the most challenging place to live with asthma may be Allentown, Pennsylvania. Lakeland, Florida, and Charleston, South Carolina, closely follow.

This ranking is based on factors such as the number of asthma cases in the city, emergency room visits, and asthma-related deaths.

The worst cities for asthma may have environmental factors, such as pollution, and impaired access to medical care. This can contribute to the development of asthma and make it more challenging to receive effective treatment.

Contact a doctor if you have questions or concerns about asthma and your health.