The 10 Worst Cities for Asthma in 2022

Medically Reviewed By Thomas Johnson, PA-C
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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 worsen symptoms. The Allergy and Asthma Foundation of America (AAFA) studied 100 cities to examine how challenging it is for people with asthma to live there. To do this, they measured factors such as the levels of:

  • asthma cases
  • asthma-related deaths and trips to emergency rooms
  • pollution
  • poverty
  • access to health insurance and asthma specialists
  • medication use
  • exposure to smoke

This article discusses the most challenging cities to live with asthma, according to research.

10. Baltimore, Maryland

A person stands outside an urban area with a glass bubble over their head.
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According to the AAFA, Baltimore is now the 10th most challenging place to live with asthma due to its high rates of asthma cases. Baltimore may also have a higher rate of people passing away due to asthma-related factors.

Another factor that may contribute to the development of asthma in Baltimore is its high poverty rate. The Centers for Disease Control and Prevention (CDC) suggest that people living below the poverty line tend to develop asthma more often. This may be because of factors such as:

  • lower quality housing conditions, such as due to mold exposure
  • higher rates of malnutrition
  • exposure to high pollution areas, such as congested roadways or industrial work
  • lower ability to pay for insurance or medical treatment

9. Philadelphia, Pennsylvania

Philadelphia is another city with a high rate of asthma and asthma-related deaths. Similarly to Baltimore, this may be due to its high poverty rate, as Philadelphia is one of the under-resourced major cities in the United States.

In addition, Philadelphia has high ozone levels and air particle pollution from pollen in the spring. This can worsen asthma symptoms and may cause more people to need medical care.

Learn more about pollen and allergic asthma.

8. Poughkeepsie, New York

The AAFA ranks Poughkeepsie as the eighth asthma capital of 2022. This is due to its high rates of asthma. In fact, it has the highest rate of asthma cases of all 100 cities that researchers studied in the report.

This may be due to factors such as high pollen levels in the spring. Additionally, Poughkeepsie has a low ratio of asthma specialists to people with the condition. This means it may be harder for those with asthma to receive specialized care and improve their condition.

Poughkeepsie also doesn’t record information about its air quality, making it difficult to track pollution and take steps to reduce exposure.

7. Harrisburg, Pennsylvania

According to the AAFA, Harrisburg has the seventh-highest rate of asthma cases of the 100 cities studied.

Harrisburg also reports high rates of asthma-related deaths and high use of asthma medications, suggesting there may be many people in the city with unmanaged asthma.

Other factors that may contribute to the high ranking include heavy particle pollution in the air and relatively few smoking laws. Smoking and exposure to secondhand smoke can add to the development of asthma.

Read more about treatment options for asthma.

6. Charleston, South Carolina

Charleston places sixth out of the 100 most challenging places to live with asthma due to its high rates of asthma cases and asthma-related visits to emergency rooms. Trips to the emergency room may indicate that cases of asthma are not effectively-managed.

5. Fresno, California

Fresno previously ranked among the top 20 most challenging places to live with asthma on the AAFA’s 2021 list. It has now moved up to the fifth place.

Fresno’s higher ranking could be due to its high level of asthma cases and asthma-related visits to the emergency room. Additionally, Fresno has relatively high poverty rates and low air quality. The American Lung Association gave Fresno the lowest possible score for air quality in 2022, with a high average weight of particle pollutants.

Similar to Poughkeepsie, Fresno also has a low ratio of asthma specialists to people with asthma.

4. Lakeland, Florida

The AAFA places Lakeland in fourth place due to its high levels of asthma cases and asthma-related visits to the emergency room.

Lakeland may also have worse outcomes for asthma and a more frequent need for emergency care. This could be due to having a low overall ratio of asthma specialists to people with asthma.

Additionally, around 16% of people in Polk County, where Lakeland is located, may not have health insurance. This can make daily management of asthma unaffordable for some people and may contribute to a high usage of emergency treatment.

3. Allentown, Pennsylvania

Allentown was first on the AAFA list in 2021, and is now rated the third most challenging place to live with asthma.

Like other cities, this ranking is due to its high levels of asthma cases. The AAFA also suggests that Allentown has the second-highest level of visits to the emergency room for asthma in the report.

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

2. Cleveland, Ohio

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

A high 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 reduced outcomes for asthma care.

Challenges are further indicated by the high usage of quick-relief asthma medications in Cleveland.

1. Detroit, Michigan

The AAFA names Detroit as the most challenging place to live with asthma in 2022. This is higher than Detroit’s previous 15th place on the AAFA’s 2021 list.

Of all the 100 cities examined, Detroit now ranks the third-highest for asthma cases and eighth-highest for asthma-related deaths. It also is in the top 25 cities for asthma-related visits to the emergency room.

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

Things to consider

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

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

  • age
  • race
  • socioeconomic status

It is important to know that the above factors can contribute to developing asthma due to inequities in healthcare. Additionally, factors that affect one person may not affect another in the same way.

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

Read more about the causes and risk factors for asthma.

Summary

According to a study of 100 cities in the U.S., Detroit is one of the most challenging places to live with asthma.

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 difficult to receive effective treatment.

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

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Medical Reviewer: Thomas Johnson, PA-C
Last Review Date: 2022 Dec 22
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