There's no "best" place for asthma. What triggers it in one person might not bother someone else. But every year, the Asthma and Allergy Foundation of America ranks the 100 largest U.S. metro areas, based on how tough it is for people with asthma to live there. They’re ranked by the risk factors in the area, how many people have it, and how often people are being treated. Here’s a countdown of the best 10.
10. Madison, WI
Madison, WI, jumped 10 spots to make it into the top 10 for 2014, thanks in part to less medication use. The less medication use, the better asthma is. But beware: The city does have worse-than-average pollen.
9. Portland, OR
All the cities in the top 10 have laws banning smoking in public places like restaurants, workplaces, and bars. Recently, a handful of states have passed laws that make it illegal to smoke in cars with children inside. Oregon's smoke-free car law went into effect in January 2014. But Portland does have a higher-than-average percentage of people with asthma living there.
8. Des Moines, IA
Des Moines has a below-average number of people with asthma. Iowa’s state capital also has better-than-average air quality, great smoke-free laws, and a lot of doctors who treat allergies and the immune system. But it does have a high pollen count and high usage of allergy medications.
7. Provo, UT
If you’re managing your asthma well, you won't need to visit the emergency room to treat attacks much, if at all. Provo has fewer-than-average ER visits per asthma patient. And people in Provo use fewer medications to treat their asthma.
6. Albany, NY
Albany had fewer asthma-related ER visits than in past years, and a drop in the number of medications used to control it. The city has a lower percentage of people who are uninsured. Without insurance, people are less likely to be diagnosed and often don’t get the asthma treatment they need.
5. Rochester, NY
Rochester has improved its air quality, it has low poverty and uninsured rates, and its asthma sufferers have fewer-than-average prescriptions for quick-relief drugs. It also has an above average number of board-certified doctors who treat allergies, and lung and immune system problems.
4. Spokane, WA
The Spokane area gets an "A" from the American Lung Association for not having many high-ozone days. Ozone triggers asthma because it can irritate your lungs and airways. The more high-ozone days and higher ozone levels a city has, the more asthma attacks people have. Plus, they tend to need more medication and emergency care.
3. Boise, ID
Some things that trigger asthma are controllable, like whether you smoke or take your medicine. But other things you can't control, like air quality and pollen. Pollen from trees, grasses, and weeds triggers asthma for many people. Boise has a better-than-average pollen score and air quality.
2. Seattle, WA
Seattle has an above average score for air quality and pollution, and it also has a low poverty level. Along with limited access to health care, people living in poverty may be more likely to live in conditions with more asthma triggers, like places with older carpeting, cockroaches, and near highways.
1. San Francisco, CA
For the second year in a row, the City by the Bay has topped this list. It has good air quality, strong smoking laws, and lower rates of poverty and uninsured people.
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American Lung Association: "State of the Air 2014: Washington, Spokane."
Americans for Nonsmokers' Rights: "Smokefree Cars."
Asthma and Allergy Foundation of America: "Air Pollution," "Allergic Asthma Triggers," "Asthma Capitals 2014," "Treatment."
Mike Tringale, senior vice president, external affairs, Asthma and Allergy Foundation of America.
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.