The list of worst cities to live in for people with asthma is drawn up by the Allergy and Asthma Foundation of America (AAFA). Cities are judged on parameters such as the number of asthma cases, asthma-related deaths and trips to emergency rooms, pollution, poverty, access to health insurance and asthma specialists, and exposure to smoke. These factors gravely affect the quality of life of people with asthma. The most challenging cities include:

Detroit, Michigan
In 2022, Detroit was named the most challenging city for people with asthma, according to the AAFA. This can be attributed to the city’s high poverty rates and low air quality. Detroit also ranks third highest for asthma cases and eighth highest for asthma-related deaths among the 100 cities that were examined.

Cleveland, Ohio
Cleveland’s high ranking on this list is due to the high levels of asthma cases, along with asthma-related deaths and visits to the emergency room. This is further worsened by high levels of poverty and ozone pollution, which have reduced the chances for asthma care in the city.

Allentown, Pennsylvania
Allentown has a high level of asthma cases in the city, along with the second highest level of visits to the emergency room for asthma, according to the AAFA. This is primarily due to the effects of pollen.

Lakeland, Florida
Lakeland ranks high on this AAFA list due to the high number of asthma cases and complications. The city may also have worse outcomes for asthma, and a more frequent need for emergency care, due to the low overall ratio of specialists for people with the condition.

Fresno, California
Fresno has a high level of asthma cases and asthma-related visits to the emergency room. Fresno received the lowest possible score for air quality in 2022, according to the American Lung Association, making it severely challenging for those with the breathing condition. The city also has high poverty rates and a low ratio of asthma specialists.

Harrisburg, Pennsylvania
Harrisburg has a high level of asthma-related deaths, and a high use of asthma prescriptions, indicating that there are many people in the city with unmanaged asthma. The city is also highly ranked in terms of heavy particle pollution in the air, which can further lead to complications among those with asthma.

Poughkeepsie, New York
Among the 100 cities that were examined, Poughkeepsie has the highest number of asthma cases. This could be a result of high pollen levels and a low ratio of asthma specialists to people with the condition. In addition to this, Poughkeepsie also does not record information about its air quality, making it difficult to track pollution.

Philadelphia, Pennsylvania
Philadelphia has high rates of asthma and asthma-related deaths. Being one of the most under-resourced major cities in the country, it also has a high poverty rate. The city also has high ozone levels and air particle pollution, which can trigger or worsen asthma symptoms.

Baltimore, Maryland
The high rates of poverty in Baltimore are a major factor contributing to the city’s asthma development. Poor living conditions such as low-quality housing, mold exposure, high rates of malnutrition, exposure to high levels of pollution, and lower ability to pay for treatment worsen the prevalence of asthma and asthma-related deaths in the city.