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Asthma Capitals of the Year

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Updated: February 1, 2008

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Overview: According to the Asthma & Allergy Foundation of America (aafa.org), more than 20 million children and adults live with asthma in the U.S. It's easy to see that asthma is one of the most common and costly chronic diseases around.

However, it is also important to note that asthma triggers can be found everywhere. You simply can't move away from your triggers, so moving is not the answer to managing your asthma.

But, there are certain cities in America that are more challenging places to live with asthma, and knowing the risk factors in your area may affect how you approach your asthma treatment. For that reason, each year, the AAFA ranks the top 100 "Asthma Capitals" in the U.S.
How Cities Are Ranked: The AAFA analyzes 12 different factors in the following three categories to come up with their rankings of the 100 most populated cities.
  • Prevalence Factors – morbidity and mortality statistics
  • Risk Factors – air quality, pollen, smoking laws, poverty and more
  • Medical Factors – medication usage and access to specialists

For more information on the individual factors, which are not equally weighted, you can read the full Asthma Capitals document (pdf file).

Prevalence Factors: For these factors, experts looked at predicted rates of asthma, self-reported rates of asthma and reported asthma deaths in each area.
Risk Factors: For this set of factors, experts ranked things like calculated pollen scores, air quality, public smoking laws, poverty rates, numbers of residents who didn't have health insurance, and school rules governing student access to their inhalers.
Medical Factors: These factors included numbers of rescue and controller inhaler prescriptions per patient, and number of asthma, allergy, immunology and/or pulmonology specialists per 10,000 patients.
Top 10 Asthma Capitals: These are the top most challenging places to live with asthma in the U.S. That means they ranked highly for prevalence, risk, and medical factors overall.

  1. Knoxville, TN
  2. Tulsa, OK
  3. Milwaukee, WI
  4. Atlanta, GA
  5. Memphis, TN
  6. Allentown, PA
  7. Charlotte, NC
  8. Greenville, SC
  9. St. Louis, MO
  10. Greensboro, NC
Least 10 Challenging Asthma Capitals: The following cities are among the 100 cities in the US with the highest population. However, among those 100 cities, these are the ten that ranked the lowest overall in the prevalence, risk, and medical factors.

  1. Sarasota, FL
  2. Seattle, WA
  3. West Palm Beach, FL
  4. Spokane, WA
  5. Melbourne, FL
  6. Fort Myers, FL
  7. Daytona Beach, FL
  8. Minneapolis, MN
  9. San Francisco, CA
  10. Colorado Springs, CO

It is interesting that of those 10, half are located in Florida.

Other Significant Findings: It is also intriguing that cities one might think of as highly polluted, and so "bad" for asthma, such as New York City, didn't necessarily fall out that way in the rankings. Washington DC, one of the largest metropolitan areas in the U.S., was ranked at 60 out of 100, while Boston and Chicago were only 49 and 43, respectively.

See where your city ranks

Knoxville, which tops the list in 2008 (as it has 3 out of the last 5 years), was ranked #1 for the following reasons:
  • high year-round pollen levels
  • high levels of air pollution
  • a lack of "100% smoke-free" bans for restaurants, bars or workplaces
  • high level of use for quick-relief inhalers

In Summary

It's important not to view the Asthma Capitals rankings as a reason to move. Each area has its own unique challenges for people who have asthma. Instead, the AAFA urges everyone to look at these rankings as an opportunity to identify ways in which your community can improve quality of life for people who have asthma.

Consider working with your community leaders to improve air pollution, poverty and health insurance coverage. Campaign to establish public smoking bans. Asthma is an epidemic in this country, and uncontrolled asthma is common. The environment is just one obstacle to long-term health for people with asthma, however.

It's also essential to work with your doctor to develop an asthma management plan that is right for you. When asthma is poorly controlled over a long period of time, it can cause irreversible damage to your lungs.

The most important message here is that you don't have to live a life with limits just because you have asthma. Take action – for yourself and for your community – and make a difference.

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