2018 Asthma Capitals of America
Stephanie Stephens | May 15, 2018
If you’re one of the 25 million people in the United States with asthma, you may wonder where you can breathe easier. Where are the most challenging places to live with asthma? The 2018 Asthma Capitals Report has your answers, courtesy of the Asthma and Allergy Foundation of America (AAFA). Genetics, respiratory infections, tobacco smoke, and more all play a part, says AAFA. Can your location increase your risk? Can the city you live in create challenges that make asthma harder to control?
How cities were rated
The report ranked 100 cities based on three health outcomes: asthma prevalence, asthma-related emergency department visits and asthma-related mortality rates. The outcomes were not weighted equally, says AAFA. The analysts also evaluated risk factors: Risk factors include poverty, air quality, access to specialists, pollen counts, medicine use, tobacco policies, and the rate of uninsured residents.
Facts about asthma prevalence
Less than 8 percent of people in the U.S. have asthma. It’s more common in children than in adults: Slightly more than 8 percent of kids under age 18 have it, compared to more than 7 percent of adults 18 or over. With children, it’s more common in males than females for children. Non-Hispanic blacks and Puerto Ricans are more likely to have the disease than non-Hispanic whites. Living below 100 percent of the poverty level raises risk, compared to living at any percentage above the poverty level.
Asthma and the emergency department
A flare-up or exacerbation can send you to the emergency department, and you’re not alone. More than 2 million visits to the E.D. occur every year. It’s one of the top 20 reasons for going there. If you’re paying out of pocket, before insurance, the average cost per visit is $1,502. You really can reduce your chances of going if you know and avoid asthma triggers, adhere to your medication, and follow an asthma action plan. Maintain an open dialogue with your doctor or nurse.
Taking asthma seriously
No one likes to think or talk about this, but asthma really can be fatal. That’s why it is so important to stay in control and manage yours. Approximately 10 people a day die from asthma, with older adults being at the highest risk. If finances prevent you or your child from getting treatment, ask about safety-net clinics close to you and about state pharmaceutical assistance programs, non-profit programs, and assistance programs offered by pharmaceutical companies.
Asthma in dollars and sense
- The annual U.S. economic cost: $81.9 billion
- Missed school and work days: $3 billion
- Average cost of asthma per person, per year: $3,266
- Annual cost of prescription medicine: $1,830
The most challenging places to live with asthma
These cities ranked highest on the report:
- Springfield, Massachusetts 100.00
- Richmond, Virginia 81.22
- Dayton, Ohio 77.31
- Philadelphia, Pennsylvania 75.76
- Louisville, Kentucky 75.43
And at the bottom we have…
The following cities, which really run the gamut geographically:
- San Antonio, Texas 48.66
- San Jose, California 47.74
- Cape Coral, Florida 45.43
- Houston, Texas 45.25
- McAllen, Texas 43.90
Surprising findings in this report
The AAFA was quick to spot two trends in its most recent report. First, the Eastern half of the country is home to all top 20 Asthma Capitals — Omaha is farthest west. Second, two “Asthma Belts” may be clearly noted when plotting the top 20 Asthma Capitals on a map. “These ‘Asthma Belts’ indicate that further examination of these areas is needed on local, state, and possibly even federal levels to improve asthma outcomes,” says AAFA.
The Northeast Mid-Atlantic Asthma Belt
These cities topped the list in this region:
- Springfield, Massachusetts
- Richmond, Virginia
- Philadelphia, Pennsylvania
- Greensboro, North Carolina
- Boston, Massachusetts
The Ohio-Lake Erie Asthma Belt
These cities topped the list in this region:
- Dayton, Ohio
- Louisville, Kentucky
- Cincinnati, Ohio
- Youngstown, Ohio
- Toledo, Ohio
Why asthma is where it is
“Warmer temperatures from climate change are increasing ground-level ozone levels, especially in more urban, industrialized areas,” says Kenneth Mendez, president and CEO of AAFA. “This, combined with a lack of policies to protect those with asthma living in poorly maintained rental housing and inadequate health care, creates a perfect storm of asthma prevalence. We’ve seen ways communities can make changes to help asthma patients."