Your City's Asthma

Asthma sufferers city can affect symptoms and quality of life

/ Author:  / Reviewed by: Robert Carlson, M.D

The city you live in could be affecting your asthma. Is your city one of the most challenging cities for asthma sufferers?

In their annual study of the 100 largest American cities, the Asthma and Allergy Foundation of America (AAFA) has determined the best and worst cities for asthma sufferers.

The AAFA considered 12 factors when ranking the cities from most challenging to least challenging.

The factors the AAFA took into consideration were:

  • annual air quality,
  • annual pollen score,
  • approximate death rate due to asthma,
  • estimated number of asthma sufferers per city,
  • number of self-reported asthma sufferers per city,
  • public smoking laws,
  • poverty rate,
  • uninsured rate,
  • school inhaler access laws,
  • reported rescue medication usage,
  • number of asthma specialists and
  • reported controller medication usage.

For Memphis, things did not turn out so well as it was ranked as the most challenging city to live in for individuals with asthma. San Francisco was the least challenging city to live in for individuals with asthma.

Your City, Your Asthma

Each city has its pros and cons in regards to asthma. The AAFA took into consideration 12 different factors that may affect a city. While Memphis was ranked as the most challenging city for asthma sufferers, it did fare well in a few categories. The number of self-reported asthma cases was better than average as was the number of asthma specialists. Like the other 100 cities, it also had a school inhaler access law in place.

San Francisco was the least challenging city for asthma sufferers and it ranked above average in many categories. San Francisco had better than average air quality, poverty rate, uninsured rate, controller medication usage, rescue medication usage and number of asthma specialists. San Francisco also has laws that banned smoking in public places.

Best Cities for Asthma

While San Francisco was the least challenging city for asthma sufferers, several other cities fared quite well.

Seattle, WA, Portland OR, Greenville, SC and Baton Rouge, LA rounded out the top five least challenging cities for asthma sufferers.

Seattle was better than average in most categories except for number of self-reported asthma sufferers (below average) and estimated number of asthma sufferers (average).

Kansas City, MO, Austin TX, Omaha, NE, Charleston, SC and Des Moines, IA rounded out the top ten. Each of the 10 least challenging cities were rated better than average by the AAFA.

Other cities that were better than average include Tucson, AZ, Minneapolis, MN, Palm Beach, FL and Jackson, MS.

Other notable cities included New York at number 48, Los Angeles at 33, Chicago at 44, Boston at 74 and Detroit at 22. 

Compared to AAFA's 2011 report, 2012 was a better year for asthma sufferers in several categories. There is still a lot to do in order to improve asthma management in America.

Asthma in America

According to the AAFA, asthma affects 25 million American adults and children. Asthma is second only to diabetes in regards to chronic diseases in America.

Asthma is also the most common chronic disease among children. While the prevalence of asthma has increased, America has also become a slightly better place for asthma sufferers.

Compared to the AAFA's 2011 report,  the 100 cities improved in several categories. Pollen counts were lower and air quality improved in the 2012 report compared to the 2011 report.

Overall asthma medication, including rescue and controller usage, increased in the AAFA's 2012. There were also more asthma specialists in the 2012 report. There are approximately 4.84 specialists per 10,000 asthma patients reported in 2012, compared to 3.45 specialists per 10,000 asthma patients in 2011.

Estimated number of asthma sufferers per city decreased in the 2012 report while the number of self-reported asthma sufferers increased.

The approximate annual crude death rate for asthma increased in the AAFA's 2012 report. The poverty rate and uninsured rate were also worse in the AAFA's 2012 report when compared to 2011.

Severe Asthma in America

Of the 25 million Americans with asthma, between 1.25 to 2.5 million Americans have severe asthma that's difficult to manage and does not respond well to controller medication or other types of treatment.

The city an individual lives in plays a critical role in the worsening of asthma symptoms.

Out of the 100 cities on the AAFA's 2012 report, 49 cities have worse than average air quality.The uninsured and poverty rates are also a concern for every asthma sufferer, especially for severe asthma sufferers. Without proper insurance or the ability to pay for medication, asthma symptoms cannot be managed which could lead to worsening symptoms or asthma attacks.

A factor that was not considered in the AAFA report, is the crowding of emergency rooms. An overly crowded emergency room can delay treatment for an asthma attack which is quite serious for individuals with asthma that is not controlled by rescue or controller medication.

Improving Asthma in Your City

There are many ways to help improve the quality of life for asthma sufferers. Volunteering to clean up parks or planting trees can help improve air quality. Joining a carpool or taking mass transit, can also reduce air pollution.

Developing an asthma action plan, which includes discussing management strategies with a specialist, is an important step to take control of your asthma. Many states have public asthma programs that can help improve asthma management. 

Reviewed by: 
Review Date: 
May 8, 2012