The 2008 AAFA Honor Roll Report Summary

The six Honor Roll states that have passed comprehensive legislations allowing children to carry their asthma and anaphylaxis medication themselves or banning smoking on school grounds? Find out how your state compared.

In the U.S., more than 5 million children have asthma, 2.2 million children have food allergies and an estimated 10 million children have other allergic diseases such as nasal and skin allergies, according to the Asthma and Allergy Foundation's 2008 State Honor Roll report.

The report "recognizes [state] leadership in mandating comprehensive state-wide school policies that address the needs of students with asthma, food allergies, anaphylaxis and other related allergic diseases in elementary, middle and high schools," according to a press release.

All 50 states were scored using 18 "policy standards" in three categories:

• Medication & Treatment

• Awareness

• School Environment

The six states that had at least 15 of the 18 policies in place were named to the honor roll. The number one state, Connecticut, scored 17 out of a possible 18 points.

The AAFA report did not count pending or drafted legislation - only laws already passed and in place by the time the study was done.

You can click here to see how your state measures up in the State Honor Roll report (AAFA listed the states alphabetically, not by points).

The Honor Roll

Six states were named to the honor roll. They are listed here in order from the highest score (click each state for details):


New Jersey


Rhode Island



Rounding out the Top 10 were:


New Mexico

New York

West Virginia

(These four states were not on the Honor Roll, but they had the next highest scores).

The report also named 13 states as "Honorable Mentions." The first state in that list, Maryland, scored 14 out of 18.

The other Honorable Mentions were (not in any particular order): California, Hawaii, Maine, Minnesota, Nebraska, New Mexico, New York, North Carolina, Oregon, Tennessee, Virginia and West Virginia.

Click here to access the complete State Honor Roll Report

Facts about the Top 10 States

Facts about the Bottom 10 States

What's Important for Student Safety

AAFA did not weigh the 18 criteria. That means that each criteria - banning smoking on school grounds or requiring regular inspection of the air conditioning and heating systems - were each worth one point. Why are all the criteria considered equally? Because some policies matter more to some parents or school officials than others, explained Mike Tringale, AAFA's director of external affairs. A state with a large number of asthmatic students, but relatively few food allergic children, may be less concerned about requirements for anaphylaxis. Or states with few asthmatics in the schools may not see indoor air quality management as a major issue.

And some criteria that many people might think are very important were rarely implemented. A good example is school nurses -- only four out of all 50 states has state requirements that school districts have at least one school nurse for every 750 students. Three of those states are on AAFA's honor roll (Delaware is the remaining state).

The News Isn't All Bad... or All Good

AAFA examined state requirements, rather than requirements from individual school districts, in part because the requirements could be different all over the state. A child who got to carry his Epi-Pen in elementary school might find that he can't when he goes to middle school in a different school district -- in the same state. If the right-to-carry is mandated by the state, presumably it would be same all over.

But that's not exactly the case, Tringale said. There was no way to tell in the report if individual school districts actually enforced or complied with the state laws, or had their own interpretations. Maybe you can carry your Epi-Pen at school, but not on field trips.

Return to State Honor Roll Page

Don't see your state? Click here to see all 50 states and their scores

Is your state in the Top 10? Click here to read more about what these states have in common

The Bottom 10 States: See if your state had one of the lowest scores and why

Have a comment or question? Tell us