Asthma is a chronic disease of the airways that makes breathing difficult for more than 25 million Americans. Air pollution, secondhand smoke, and pollen are common triggers of an asthma attack. While there are no asthma-free cities, some are more challenging than others for people living with asthma. The Asthma and Allergy Foundation of America (AAFA) has released its "2012 Asthma Capitals." Here are the top 10.
No. 10: Allentown, Pa.
Picturesque rolling hills surround Allentown, Pa., but the city itself is not a pretty picture for people with asthma. Poor air quality, weak smoking bans in public places, and a high number of asthma sufferers pushed Allentown into the top 10 worst asthma capitals. Twelve factors are used to create the list, including air pollution, pollen, asthma rates, use of "rescue inhalers," and poverty.
No. 9: McAllen, Texas
In the border town of McAllen, Texas, the problem is access to treatment. Compared to other cities, more people lack insurance and need "rescue" medications for asthma that is not well-controlled. McAllen is also one of the poorest cities in the country. High poverty is linked to higher rates of asthma, and poverty is one of the elements included in the rankings.
No. 8: Oklahoma City, Okla.
Despite the efforts of the Oklahoma Asthma Initiative, the city moved up four spots to No. 8. The initiative tries to raise awareness about asthma, especially among children, their parents, and teachers. Children are more likely to have asthma than adults. Asthma is the most common health reason for repeated absences from school.
No. 7: St. Louis, Mo.
The Gateway Arch is not the only thing in the air in St. Louis. High pollen counts, a high poverty rate, and the lack of a widespread smoking ban in public places add up to big asthma issues here, according to the AAFA. Yet, life for asthma sufferers may have gotten a little better. St. Louis has improved in the rankings since it was named the worst city for people with asthma in 2009.
No. 6: Hartford, Conn.
This small state capital -- known as the insurance center of the world -- has a growing asthma problem, according to the AAFA. It jumped up from No. 40 on the worst asthma cities list to No. 6 in just a year. High pollen counts and a lack of strict smoking bans contribute to the poor score, and make life more difficult for people with asthma.
No. 5: Chattanooga, Tenn.
A beautiful riverfront park and nearby mountains make this a tourist destination for outdoor enthusiasts, but asthma sufferers might want to bring along their medicine. Poor air quality, pollen, and poverty help keep Chattanooga near the top of the worst asthma cities list. Like many Southern cities, Chattanooga lags behind in creating smoke-free laws that help clear the air of secondhand smoke in public places.
No. 4: Pittsburgh, Penn.
Black clouds from industrial smoke stacks no longer darken the skies here, but this former steel town still has among the worst air pollution in the country. With poor air quality, high pollen, and a lack of strict smoking bans, Pittsburgh also has a high rate of asthma. Nationally, asthma leads to about one-quarter of all emergency room visits each year, according to AAFA.
No. 3: Knoxville, Tenn.
Knoxville remains near the top of the rankings. It has been one of the worst asthma cities year after year, like other cities across the South and Southwest. Knoxville does have a better-than-average number of specialists to treat people with asthma. But the city is still vexed by poor air quality, incomplete smoke-free laws, and above-average use of asthma rescue medications.
No. 2: New Haven, Conn.
Asthma cases have been on the rise in New Haven, where pollution and pollen are common triggers and people still breathe second-hand smoke in public places. Nurses and other health care providers are making home visits to reduce asthma attacks among children. For about 6 in 10 people with asthma, the asthma is triggered by mold, dust mites, pet dander, and other tiny particles.
No. 1: Memphis, Tenn.
This Mississippi River town has many asthma sufferers singing the blues. Memphis topped the chart with high asthma death rates, weak smoking restrictions, poor air quality, and high poverty rates. Nationally, asthma causes more than 3,300 deaths each year and is a factor in another 7,000 deaths.
10 Best Cities for Asthma
This year's best asthma cities tend to have air quality that is much better than average. Here are the best cities for 2012 -- with the No. 1 city shown on the next slide.
San Francisco is known for its cool summers and fresh air that blows in off the water. It was the only city that ranked average or above in all 12 categories in the AAFA report. While cleaner air helps people with asthma breathe easier, experts say there's really no "best" place to live because each person's triggers are different. A good asthma management plan can help people with asthma breathe easier wherever they live.
Asthma and Allergy Foundation of America.
Centers for Disease Control: "Trends in Asthma Prevalence, Health Care Use, and Mortality in the United States, 2001-2010."
Connecticut Department of Public Health.
The Heinz Endowments, "Clearing the Haze: Understanding Western Pennsylvania's Air Pollution Problem," March 9, 2011.
Oklahoma Asthma Initiative.
U.S. Census Bureau.
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