Top 10 Cities With the Highest Asthma Prevalence (2025)

Asthma, a chronic respiratory disease that affects millions of people across the globe, is shaped by a variety of contributing factors, such as environmental conditions, healthcare access, and socioeconomic disparities.

In the United States, certain cities experience significantly higher rates of asthma, making it a pressing public health issue in these regions.

This article highlights the top U.S. cities with the highest prevalence of asthma, based on data from the Asthma and Allergy Foundation of America (AAFA). We’ll explore the unique challenges faced by these cities, examining potential causes behind their elevated asthma rates.

Cities With the Highest Asthma Prevalence in the United States

Each year, the AAFA publishes a detailed report called the “Asthma Capitals,” which ranks U.S. cities based on factors such as asthma prevalence, emergency room visits, and asthma-related mortality.

Here is an overview of the top 10 cities from the report, shedding light on why asthma rates are notably high in these areas:

1. Poughkeepsie, NY

Poughkeepsie, located in New York State, is known for its picturesque views of the Hudson River and educational institutions like Vassar College. Despite its scenic appeal, Poughkeepsie has one of the highest asthma prevalence rates in the country. Contributing factors include poor air quality, limited access to healthcare services, and economic hardships in certain communities.

2. Albany, NY

As the state capital of New York, Albany faces significant asthma challenges. The city’s air quality is frequently impacted by industrial emissions and traffic congestion, which may worsen asthma symptoms. Additionally, disparities in healthcare access can make effective asthma management difficult for some residents.

3. Detroit, MI

Detroit, Michigan’s largest city, has a long-standing struggle with asthma due to high levels of air pollution from its industrial past and current manufacturing activities. Socioeconomic inequalities and limited healthcare resources in certain areas of the city exacerbate asthma risks, making Detroit a primary focus for asthma intervention programs.

4. Lakeland, FL

Situated in central Florida, Lakeland’s humid climate and frequent pollen exposure contribute to its high asthma rates. Airborne allergens, combined with potential socioeconomic challenges, can make it difficult for residents to control their asthma symptoms effectively.

5. Fresno, CA

Fresno, known for its large agricultural industry, often experiences elevated air pollution levels due to farming activities and nearby wildfires. This, paired with socioeconomic barriers and healthcare access issues, places Fresno among the cities with the highest asthma rates.

6. Harrisburg, PA

As the capital of Pennsylvania, Harrisburg faces unique environmental challenges, including pollution from nearby industries and high vehicle emissions. Limited healthcare access and economic disparities further complicate asthma management for many of its residents.

7. Cleveland, OH

Despite being home to renowned healthcare institutions like the Cleveland Clinic, Cleveland has one of the highest asthma prevalence rates in the U.S. Poor air quality, combined with socioeconomic issues and substandard housing conditions, may contribute to the city’s high asthma burden.

8. McAllen, TX

McAllen, a city located near the southern border of Texas, is known for its warm climate and agricultural surroundings. However, McAllen’s high asthma rates may be linked to environmental allergens, economic disparities, and barriers to healthcare access, particularly for its low-income residents.

9. Allentown, PA

Allentown’s high asthma prevalence is likely influenced by poor air quality, socioeconomic challenges, and limited access to healthcare facilities. The city’s industrial history and reliance on automotive transportation contribute to the environmental factors affecting asthma.

10. Philadelphia, PA

Philadelphia, the largest city in Pennsylvania, is rich in history and culture but struggles with high asthma rates. Environmental triggers, such as vehicle emissions and industrial pollution, along with socioeconomic inequities, play a significant role in the city’s asthma statistics.

Watch this video or keep reading to learn more about the factors at play that can influence the prevalence of asthma in these locations.

Factors That Influence Asthma Prevalence

Asthma prevalence is shaped by a complex set of factors, ranging from socioeconomic conditions to environmental exposures.

Here are the key elements that contribute to the rates of asthma within communities:

• Poverty: Financial hardship directly impacts the ability to access asthma care, including the costs of emergency department visits, hospital stays, medications, and routine management. Even with insurance coverage, the out-of-pocket expenses can be prohibitive, preventing many individuals from receiving the necessary treatment to control their asthma.
• Lack of Health Insurance: Without adequate health insurance, individuals often struggle to afford essential medications, inhalers, and specialist visits, leading to poorly managed asthma and increased hospitalizations.
• Air Pollution: Air quality plays a significant role in asthma prevalence. Exposure to pollutants such as vehicle emissions, industrial chemicals, and particulate matter can trigger asthma symptoms and exacerbate the condition in those already diagnosed.
• Pollen: Seasonal spikes in pollen levels can contribute to increased asthma symptoms and attacks, particularly in regions with high pollen counts during spring and fall. Individuals sensitive to pollen may find it challenging to maintain good asthma control during these periods.
• Smoking and Secondhand Smoke: Smoking cigarettes, cigars, and e-cigarettes—or even exposure to secondhand smoke—can significantly worsen asthma symptoms and increase asthma rates. Smoke is a known irritant that inflames the airways, making it a critical factor in both the development and management of asthma.
• Overuse of Quick-Relief Medications: Relying heavily on quick-relief (rescue) inhalers often indicates poor asthma management. While these medications provide temporary relief, frequent use may signal that underlying asthma is not well-controlled, contributing to higher prevalence rates.
• Use of Asthma Control Medications: Regular use of asthma control medications, such as corticosteroids, can effectively manage chronic asthma and reduce the frequency of symptoms. A lack of adherence or access to these medications can lead to higher prevalence and poorer outcomes.
• Access to Specialists: Limited access to specialists, such as allergists and pulmonologists, can hinder effective asthma management. These professionals can provide tailored treatment plans, perform specialized testing, and offer guidance on controlling environmental triggers, making access critical for asthma control.
• Health Disparities and Equity: Asthma prevalence is higher among certain racial and ethnic groups due to disparities in healthcare access, economic stability, and environmental exposures. For instance, Black Americans and Hispanic Americans are disproportionately affected by asthma, experiencing higher rates of emergency room visits and asthma-related deaths compared to non-Hispanic whites.

Racial and Ethnic Disparities in Asthma Prevalence

Asthma rates vary significantly across different racial and ethnic groups. Black Americans have the highest rates of asthma prevalence, emergency department visits, and asthma-related deaths.

Hispanic Americans also have a higher prevalence of asthma compared to non-Hispanic whites, with notable differences within the Hispanic community. For example:

• Puerto Ricans have the highest asthma prevalence among Hispanic subgroups.
• Mexican Americans have the lowest prevalence of asthma, highlighting the need for tailored approaches within this diverse population.

Note: These disparities are influenced by various factors, including socioeconomic status, healthcare access, and exposure to environmental triggers.

Final Thoughts

Asthma is a widespread health issue that affects communities across the United States, but its prevalence varies significantly based on location and demographics. Understanding the specific challenges faced by high-prevalence areas is essential for developing targeted interventions and effective policies.

While some cities have particularly high asthma rates due to poor air quality, limited healthcare access, and socioeconomic disparities, asthma remains a nationwide concern.

Ongoing research, advocacy, and education are crucial in managing this chronic condition and reducing its impact on individuals and communities.