Best Cities for Asthma

The Asthma and Allergy Foundation (AAFA) releases a list of "Asthma Capitals" — the worst cities for asthma – annually.  And while the AAFA or any other medical or nonprofit group does not rank the best cities for asthma, there are a number of factors that can make a city good for people with asthma, such as geography, climate, and pollen count.

Best Cities for Asthma?

When AAFA researchers ranked cities for their Asthma Capitals survey, they looked at the top 100 metropolitan areas and assessed them based on a number of criteria such as asthma prevalence, pollution levels, and pollen counts. The results came up as follows:

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

However, this list does not mean that these cities are the best cities for asthma, says Angel Waldron, Marketing and Communications Manager for the AAF. "We get so many people with asthma asking us, ‘Where should I move?’. Unfortunately, it’s just not a question we can answer. There are so many factors, and it all depends on what triggers your symptoms." Waldron explains.

Factors that influence a person’s asthma include the following:


Experts say that geography is a factor that influences a person’s asthma symptoms. Many of the cities in the survey were on or near water. For example, three of the cities in the list above were in the coast of Florida. Jonathan A. Bernstein, MD, an allergist at the University Of Cincinnati College Of Medicine, explains "If you’re living on the water, the wind can blow away a lot of the potential allergens and irritants."

Cascya Charlot, MD, medical director of Allergy and Asthma Care of Brooklyn, adds that, pollen counts are often lower in areas on the water.

On the other end, cities that do not get a lot of air circulation (cities located in valleys) may not be the best place for people with asthma. "Valleys can sometimes trap pollutants," says Bernstein. "The air doesn’t move as freely."

But while gentle winds from oceans and lakes may be beneficial, being on water does not always guarantee air quality. "Other cities on the water like Milwaukee didn’t score very well," says Waldron.

Weather Conditions

Many of the cities that ranked high in the list have fairly mild weather conditions, like San Francisco and Seattle. According to asthma experts, extreme temperatures are a common nonallergic asthma trigger. "When the air gets really cold, it can almost shock the lungs and cause a bronchospasm that narrows the airways," Bernstein explains.

Still, the benefit of living in a mild climate depends upon your asthma triggers. For some people with asthma, moving away from frigid winters or hot, arid summers helps a lot. For others, it doesn’t make much of a difference. Also, though some coastal towns rank well on the AAFA list, their humidity could be a problem for other people with asthma. Asthma experts say that humidity is an irritant that can trigger symptoms. Plus, humidity encourages allergens such as mold and dust mites.

Pollen Count

Pollens are some of the most common triggers of asthma symptoms. Types of pollen differ according to region. According to Waldron, "In the spring, some of the toughest cities are in the southeast, because that’s when tree pollen from oak, maple, and elm is worst. Then in the fall, the ragweed in the northeastern cities becomes a real problem." Of course it depends on what type of pollen you are allergic to. If you live in area with a high pollen count but are not allergic to those particular types of pollen, then there’s nothing to worry about.


Pollutants can also be irritants, thus they have a huge effect on a person’s asthma symptoms. But what not everyone knows is that pollution indirectly can also indirectly increase pollen levels. This is because carbon dioxide, the waste product of combustion is also the gas that plants need to grow. "Studies have shown that in urban areas with a lot of pollution, the high carbon dioxide levels encourage plant growth," says Bernstein. "That increases the pollen levels."

Other Allergens

Cities and urban areas in general tend to have pests such as mice, rates, and cockroaches – all of which can trigger allergic reactions and asthma attacks. Pest problems are usually more rampant in poorer urban neighborhoods.

Smoking ordinances

When assessing a city’s effect on asthma, pollens count and weather are not the only considerations. According to Charlot, smoking laws (banning smoking inside establishments, etc.) may also be having a real impact on asthma symptoms.

"Some studies have found that in cities that enact smoking legislation, there’s a decrease in ER visits for asthma emergencies," Charlot says.

Source: WebMD


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