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Did Your City Make the List?

If you have asthma, where you live makes a difference. High pollen counts and smog lead to flare-ups, and controlling symptoms can be tricky if your area is short on doctors. Every year, the Asthma and Allergy Foundation of America (AAFA) looks at these and other medical and environmental factors, then ranks the 100 hardest places in the U.S. for people with asthma. Here are 2015’s top “Asthma Capitals.”

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chicago illinois
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No. 10: Chicago

Air quality in Chi-town is poor, thanks to many days of high soot and smog levels. The city has an above-average number of ER visits and deaths because of asthma. Also, 38% of people in the region are uninsured, making it hard for them to control their symptoms or afford medicine. Some asthma inhalers cost close to $800 a month.

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jackson square new orleans
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No. 9: New Orleans

Like other cities on the list, poverty and lack of health insurance factor into NOLA’s higher-than-average death rate due to asthma. But the city’s hot, humid weather also makes breathing harder. Allergens in the environment are a problem here, too. The Big Easy has a high pollen score, and 2005’s Hurricane Katrina left an unhealthy legacy of indoor mold. Both can make breathing easy a serious struggle.

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View of Chattanooga from Lookout Mountain
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No. 8: Chattanooga, TN

Air quality isn’t the problem here. In the past year, Chattanooga has slashed pollution and is now considered one of the nation’s cleanest cities. Still, its nonsmoking laws are weak. Twenty percent of adults and 17% of high school students are smokers. A low number of asthma specialists in the area means ER visits are high.

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knoxville tn
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No. 7: Knoxville, TN

The AAFA also lists Knoxville as one of the worst for spring allergies, thanks to high levels of tree and grass pollen. Both can cause asthma symptoms to flare. But that might not be the only reason for a higher-than-average use of asthma medicines here. Studies show a link between weight gain and asthma, and in 2010, nearly two-thirds of people living here were overweight or obese.

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augusta ga
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No. 6: Augusta, GA

Located 150 miles from Atlanta, the “Garden City of the South” is the second largest and second oldest city in Georgia. It’s also the worst in the state for people with asthma. In just 2 years, nearly a dozen children in and around Augusta died from the condition. The area has a high pollen count, and nonsmoking laws also aren’t up to snuff. An effort to ban smoking from bars and public places has failed three times in recent years.

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oklahoma city skyline
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No. 5: Oklahoma City

As many as 23% of Sooners living in Oklahoma County have no health insurance. That, along with a serious lack of asthma specialists in the area, can make it hard for people to get the medical care they need. It doesn’t help that Oklahoma City is ranked 15th out of 220 cities for high ozone days. Ozone, which is more common on hot, humid days, can make asthma symptoms worse.

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Detroit Michigan
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No. 4: Detroit

The Motor City has a better-than-average pollen count, and its public smoking laws are on par with the rest of the U.S. Still, asthma rates here are 50% higher than the rest of Michigan. Many residents use quick-relief asthma inhalers, which means their disease isn’t well-controlled. While the air is a risk factor, some experts believe a bigger problem is that many residents are poor and uninsured.

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Phildelphia skyline
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No. 3: Philadelphia

Emergency room visits for asthma in the City of Brotherly Love are higher than average. The disease sends more than 16,000 kids to the ER each year. Since many who have the condition here live in low-income neighborhoods, a Community Asthma Prevention Program offers free home visits to explain how to control triggers like house dust and animal dander. Up to 60% of residents with asthma are also allergic to cockroaches.

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Richmond skyline
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No. 2: Richmond, VA

With its rich Civil War history, this town is popular with vacationers. But it’s not such a great place to live if you have asthma. Smog is a problem, especially in the hot, humid summer months. The city also has higher-than-average rates of people living in poverty and without insurance. They’re more likely to have asthma in part because they’re around more allergens at work and home.

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Nightlife on Beale Street in Memphis
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No. 1: Memphis, TN

About 14% of kids here have asthma. It causes 40% of stays at the city’s Le Bonheur Children’s Hospital. But a lot of ER visits and high use of asthma meds aren’t the only reasons the Home of the Blues nabbed this year’s No. 1 spot. Local steel and food processing plants pollute the air. An above-average pollen count and poor nonsmoking laws don’t help, either.

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san francisco
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Brighter Spots for Asthma

Of the 100 cities ranked, these 10 are the best.  For the most part, they have less poverty, better school asthma programs, and better access to health care. But they also have cleaner air and good smoking bans. The result: fewer ER visits and deaths, and easier living with asthma. Here’s the list:

10. Austin, TX
9. Raleigh, NC
8. Sarasota, FL
7. Cape Coral, FL
6. Palm Bay, FL
5. Abilene, TX
4. San Jose, CA
3. Seattle
2. Boise, ID
1. San Francisco

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Sources | Medically Reviewed on 5/12/2015 Reviewed by Luqman Seidu, MD on May 12, 2015

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Asthma and Allergy Foundation of America: “Asthma Capitals.”

Talisa White, external affairs manager, Asthma and Allergy Foundation of America.

American Lung Association: “State of the Air Report 2015.”

Illinois Health Matters: “Chicago Metro Area: Uninsured.”

Patient-Centered Outcomes Research Institute: “The Coordinated Healthcare Interventions for Childhood Asthma Gaps in Outcomes (Chicago) Trial.”

Consumer Reports Best Buy Drugs: “Asthma.”

Mitchell, H. Environmental Health Perspectives, November 2012.

Hayes, D. American Journal of Respiratory and Critical Care Medicine, June 1. 2012.

The Chattanoogan: “Hamilton County Regional Health Council Continues to Advance Tobacco-Free Policies.”

American Academy of Allergy, Asthma & Immunology: “National Allergy Bureau Pollen and Mold Report: Knoxville, TN.”

Delgado, J. Journal of Investigative Allergology and Clinical Immunology, 2008.

ET Index: “Healthy Living: Key Trends.”

Augusta Georgia, Official Website: “Augusta Visitor Information.”

Georgia Department of Public Health: “Camp Helps Kids Cope With Asthma While Having Summer Fun.”

The Augusta Chronicle: “Augusta Will Work on New Smoking Law,” May 6, 2014.

County Health Rankings: “Oklahoma County Snapshot.”

U.S. Environmental Protection Agency: “Ozone and Your Patients’ Health Training for Health Care Providers,”

U.S. Environmental Protection Agency: “National Environmental Leadership Award in Asthma Management.”

Chunrong, J. Atmospheric Environment, Sept. 13. 2013. “Epidemiology of Asthma in Michigan.”

Ownby, D. The Journal of Allergy and Clinical Immunology, March 30, 2015.

The Pediatric Asthma Initiative: “Community Coalitions: Philadelphia, PA.”

Community Asthma Prevention Program of Philadelphia: “Overview.”

News release, Environment Virginia.

National Heart, Lung and Blood Institute: “Reducing Asthma Disparities.”

Reviewed by Luqman Seidu, MD on May 12, 2015

This tool does not provide medical advice. See additional information.

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.