Asthma Capitals 2013

  • Currently, over 22 million people in the United States suffer from asthma. Can you believe it? Asthma has truly become an epidemic. Chances are, nearly every family you know has been touched by asthma to some extent. And there is no cure, so dealing with asthma is an ongoing burden, not only for those who have it, but also for our society.


    Each year, the Asthma and Allergy Foundation of America (AAFA), an advocacy, research and support group, performs an in-depth analysis of the 100 largest cities in the U.S. and then ranks them (as "Capitals") according to how challenging they are to live in if you have asthma. And believe me, this is one list you don't want to see your city at the top of!

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    Twelve Ranking Factors


    People tend to associate the environmental air quality with asthma risk, and that's not wrong. But this study looks at 12 different factors in 3 different categoris to assess the overall risk.



    • Estimated & self-reported cases of asthma in the population
    • Crude death rates from asthma

    Risk Factors

    • Annual pollen scores
    • Annual air quality scores
    • Public smoking bans
    • Poverty rate
    • Uninsured (for health insurance) rates
    • School inhaler access laws

    Medical Factors

    • ER visits for asthma
    • Rescue medication use (as evidenced by prescriptions)
    • Controller medication use
    • Number of asthma specialists in the area

    Figures for each of these factors are ranked comparatively to the whole as worse than average, average or better than average.


    The 2013 Asthma Capitals


    Drum roll... Richmond, Virginia tops the list once again, as it did in 2010 & 2011, after a brief drop down the list to #23 in 2012. Factors cited as responsible for this year's rise back to the top included very high levels of year-round pollen, high rates of poverty and uninsured, no city smoking bans, a high crude death rate for asthma and a large number of annual emergency room visits for asthma.


    Obviously, they've got some challenges to work on in that metropolitan area.


    But they're not alone. Here are the top 10 Asthma Capitals for 2013:

    • Richmond, VA
    • Chattanooga, TN
    • Memphis, TN
    • Philadephia, PA
    • Oklahoma City, OK
    • Detroit, MI
    • Dayton, OH
    • McAllen, TX
    • Atlanta, GA
    • Knoxville, TN

    Surprisingly, some of the largest metropolitan areas are quite a bit further down the list, including the notoriously smoggy Los Angeles, CA (46), Washington D.C. (43), New York City (51) and Houston, TX (74). I think this brings home the fact that it's not just about air pollution.


    What to Do With This Information


    One of the most important things to realize is that experts no longer recommend you move away from "asthma-challenging" areas. There is no perfect place to live with asthma any more, although certainly getting away from any of these larger metropolitan areas couldn't hurt.


    What makes more sense is for people with asthma to work with an asthma specialist to improve their overall asthma management plan--no matter where they live. In addition, I encourage you to get involved with asthma advocacy! Help educate the public about the factors that complicate asthma. Fight for public smoking bans in your community. Work with your local schools to improve staff education and policies concerning handling the challenges children with asthma face at school.


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    You can learn more about this annual study and what you can do to help at

Published On: November 08, 2013