Asthma Health Center

Asthma and Cities: Which Cities Rank Best?

For the past six years, the nonprofit Asthma and Allergy Foundation (AAFA) has released a list of the "Asthma Capitals" -- the worst cities for asthma. The top offenders for 2009: St. Louis, Milwaukee, and Birmingham, Ala.

But if those are the worst cities for asthma sufferers, does that mean other cities are relatively good for people with asthma -- or at least benign?

The AAFA doesn't rank the "best" cities for asthma, nor does any other medical or advocacy organization. But there are a number of factors that can make a city relatively good -- or bad -- for people with asthma. From geography to climate to pollen count, here's what you need to know about cities that are better for people with asthma.

'Best' Cities for Asthma?

When researchers at the AAFA rank cities for the Asthma Capitals survey, they look at the top 100 largest metropolitan areas and evaluate them on a number of criteria, including asthma prevalence, pollution levels, and pollen counts. The ten cities that ranked best in the AAFA survey are:

• Cape Coral, Fla.
• Seattle
• Minneapolis
• Colorado Springs, Colo.
• Portland, Ore.
• Palm Bay, Fla.
• Daytona Beach, Fla.
• San Francisco,
• Portland, Maine
• Boise City, Idaho

But are these the "best" cities for asthma in the U.S.? No, says Angel Waldron, Marketing and Communications Manager for the AAFA, who worked on the survey.

"We get so many people with asthma asking us, 'Where should I move?'" Waldron tells WebMD. "Unfortunately, it's just not a question we can answer. There are so many factors, and it all depends on what triggers your symptoms." A city that might be good for one person's asthma might be terrible for yours.

Still, while there's no such thing as a best city for asthma, experts say that certain factors in cities can influence a given person's asthma -- for better or worse. Here's the rundown.

Geography. Asthma experts say that geography can play a role in a person's asthma symptoms. Many of the cities that ranked well on the AAFA's survey were on the water. For instance, three of the ten better cities for asthma were on the coast in Florida.

"If you're living on the water, the wind can blow away a lot of the potential allergens and irritants," says Jonathan A. Bernstein, MD, an allergist at the University of Cincinnati College of Medicine.

Pollen counts also tend to be lower in areas on the water, says Cascya Charlot, MD, medical director of Allergy and Asthma Care of Brooklyn.

On the other hand, cities that don't get a lot of air circulation -- for instance, those located in valleys -- can be tough for people with asthma. "Valleys can sometimes trap pollutants," says Bernstein. "The air doesn't move as freely."

Still, while breezes from oceans and lakes may have a benefit, being on water is no guarantee for good air quality. "Other cities on the water like Milwaukee didn't score very well," says Waldron.