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The Asthma and Allergy Foundation of America (AAFA) has released the 2018 Asthma Capitals™ report. This report ranks the top 100 cities in the U.S. where it’s challenging to live with asthma. Kids With Food Allergies (KFA) is a division of AAFA.

More than 25 million people Americans have asthma. And where you live can make it harder to manage. This report highlights the factors in cities across the country that can impact asthma rates.

We ranked each city based on these asthma outcomes:

  • Asthma prevalence (or occurrence)
  • Asthma-related emergency room visits
  • Asthma-related deaths

Springfield, Massachusetts, is our #1 Asthma Capital for 2018. It has a high asthma rate overall. It also has the highest number of asthma-related emergency room visits in the U.S.

Here are the top 20 Asthma Capitals:

  1. Springfield, Massachusetts
  2. Richmond, Virginia
  3. Dayton, Ohio
  4. Philadelphia, Pennsylvania
  5. Louisville, Kentucky
  6. Cincinnati, Ohio
  7. Youngstown, Ohio
  8. Birmingham, Alabama
  9. Greensboro, North Carolina
  10. Toledo, Ohio
  11. Boston, Massachusetts
  12. Worcester, Massachusetts*
    1. Omaha, Nebraska*
  13. Milwaukee, Wisconsin
  14. Cleveland, Ohio
  15. Detroit, Michigan
  16. Winston-Salem, North Carolina
  17. Akron, Ohio
  18. Hartford, Connecticut
  19. New York, New York


“Asthma Belts”

This year’s report also revealed two “Asthma Belts.” One is in the Ohio-Lake Erie area. The other is on the Northeastern Mid-Atlantic coast. In our report, we look at factors that affect residents in these belts, like poverty, air quality and pollen.

“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. This report shows us where we can focus to provide solutions to improve the health and quality of life in urban areas for asthma patients.”

Ten people die every day from asthma. The 2018 Asthma Capitals™ report shows how important it is to improve these communities to make life better for those with asthma.


Learn More About the Report

The Asthma Capitals™ ranking is an annual research and educational project of AAFA, designed to help patients recognize, prevent and manage asthma symptoms. Through this ranking, AAFA raises awareness about the impact of asthma and highlights how communities can make improvements to better serve their residents and visitors with asthma. The ranking is based on asthma prevalence, emergency room visits and mortality rates. The report also looks at risk factors, including poverty, air quality and access to specialists. Visit to see the full list of 100 cities, methodology and to learn more about asthma management.

To see the full list of Top 100 Asthma Capitals, download our report.

The 2018 Asthma Capitals report is an independent research project of AAFA made possible by Sanofi Genzyme and Regeneron.

Do you or someone in your family have asthma symptoms? Join our community to chat with others who have asthma. And follow our blog for more news and tips on managing your asthma symptoms.



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Kids With Food Allergies
A Division of the Asthma and Allergy Foundation of America
1235 South Clark Street Suite 305, Arlington, VA 22202
Phone: 1-800-7-ASTHMA (1.800.727.8462)
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