Top 10 Cities With Emergency Department Visits Due to Asthma

Asthma is a chronic respiratory condition that affects millions globally, posing a major public health challenge. Its impact goes beyond just reducing quality of life; it also places a significant burden on healthcare systems, leading to a high number of emergency department visits each year.

However, these visits aren’t evenly spread across the United States. In some cities, a combination of environmental factors, socioeconomic disparities, and limited access to quality healthcare drives up the rate of asthma-related emergencies.

This article takes a closer look at the cities with the highest rates of asthma-related emergency visits, uncovering the unique obstacles faced by residents in these areas and highlighting the need for targeted interventions.

Cities With the Most Asthma-Related Emergency Department Visits

Every year, the Asthma and Allergy Foundation of America (AAFA) releases a comprehensive report highlighting the “Asthma Capitals” — cities with the highest rates of asthma-related emergency department visits.

These rankings are influenced by various factors such as environmental conditions, healthcare accessibility, and socioeconomic disparities.

Here are some of the top cities where asthma poses a significant public health challenge:

1. Wichita, KS

As the largest city in Kansas, Wichita is known for its high pollen levels, which can easily trigger asthma attacks. Additionally, the city has a high rate of uninsured residents, making it difficult for many to access necessary treatments and management strategies for their condition.

2. Allentown, PA

Allentown, located in the Lehigh Valley of Pennsylvania, faces unique challenges due to its industrial history and geographic location, which traps pollutants and worsens air quality. This, combined with a high prevalence of asthma among children, makes it a hotspot for asthma-related emergencies.

3. Columbus, OH

Columbus, the state capital of Ohio, sees a high number of asthma-related emergency department visits due to elevated pollen levels, particularly from ragweed. Air pollution from traffic congestion and industrial sources also exacerbates the issue, contributing to poor respiratory health among residents.

4. Dayton, OH

Dayton, another Ohio city, struggles with high asthma rates due to its large manufacturing sector, which contributes significantly to air pollution. Additionally, high poverty levels in the area limit access to quality healthcare and asthma management resources, further compounding the problem.

5. Louisville, KY

Situated in the Ohio River Valley, Louisville frequently experiences poor air quality, especially in the warmer months. The city also has high pollen levels, making it a difficult environment for those with asthma to manage their symptoms effectively.

6. Jacksonville, FL

Jacksonville’s warm, humid climate fosters high levels of mold and dust mites—both potent asthma triggers. These environmental conditions, combined with a relatively high prevalence of asthma, contribute to a significant number of emergency department visits each year.

7. Akron, OH

Known as the “Rubber Capital of the World,” Akron has a long history of industrial pollution that impacts respiratory health. High poverty rates and a large number of uninsured residents further exacerbate the city’s struggle with asthma management and healthcare access.

8. New Orleans, LA

New Orleans’ humid climate creates a breeding ground for mold and dust mites, both of which are common asthma triggers. The city’s high poverty rate also limits many residents’ ability to access necessary healthcare and asthma management resources.

9. Stockton, CA

Located in California’s Central Valley, Stockton experiences poor air quality due to agricultural practices and vehicle emissions. A high percentage of uninsured residents complicates efforts to manage asthma effectively, resulting in higher emergency department visits.

10. Lakeland, FL

Lakeland’s warm, humid climate contributes to elevated levels of mold and dust mites, which can worsen asthma symptoms. This environmental challenge, coupled with a high prevalence of asthma, leads to a considerable number of emergency department visits each year.

Watch this video or keep reading to learn more about the factors at play that can influence the prevalence of emergency department visits due to asthma.

Factors Contributing to Asthma-Related Emergency Department Visits

Several factors influence the rate of asthma-related emergency department (ED) visits in a city. Understanding these factors is crucial for developing strategies to reduce the burden of asthma and improve the quality of life for those affected.

Key contributors include:

• Poverty: Poverty significantly impacts the ability to manage asthma effectively. Direct costs such as emergency room visits, hospital stays, and medications can be financially overwhelming, even for those with insurance. Additionally, indirect costs—such as lost wages from missed work due to asthma exacerbations—can further hinder individuals from seeking timely and appropriate care, leading to higher rates of ED visits.
• Lack of Health Insurance: Without health insurance, individuals often cannot afford the necessary treatments or medications to manage their asthma, resulting in uncontrolled symptoms. This lack of access to routine care and preventive treatments increases the likelihood of severe asthma attacks and more frequent ED visits.
• Air Pollution: Air pollution is a major environmental trigger for asthma. Pollutants such as ozone, particulate matter, and emissions from vehicles and industries can irritate the airways, triggering asthma attacks and worsening symptoms. Cities with high levels of air pollution often experience a greater number of asthma-related ED visits.
• High Pollen Levels: Seasonal pollen—particularly from grasses, trees, and weeds—can exacerbate asthma symptoms and lead to increased ED visits, especially in areas with high pollen counts. Those with allergic asthma are particularly vulnerable during peak allergy seasons, making asthma management more challenging.
• Smoking and Secondhand Smoke: Smoking and exposure to secondhand smoke can severely aggravate asthma. Smoke is a powerful respiratory irritant that inflames the airways, making asthma symptoms worse and triggering attacks. This results in a higher incidence of ED visits among individuals exposed to tobacco smoke, whether through direct use or secondhand exposure.
• Inappropriate Use of Quick-Relief Asthma Medications: Frequent reliance on quick-relief inhalers, such as albuterol, is a sign of poorly controlled asthma. These medications are meant to provide short-term relief during an asthma attack but do not address the underlying inflammation. Overuse of quick-relief medications often indicates that a patient’s asthma management plan needs adjustment, leading to a greater risk of ED visits.
• Inadequate Use of Asthma Control Medications: Asthma control medications, such as inhaled corticosteroids, are essential for managing chronic asthma and preventing attacks. When patients are not using these medications as prescribed, or lack access to them, they are more likely to experience severe symptoms that require emergency care.
• Limited Access to Asthma Specialists: Access to asthma specialists, such as pulmonologists and allergists, can significantly reduce the frequency of ED visits. These healthcare professionals provide individualized care and management plans, which are crucial for preventing asthma exacerbations. In areas with limited access to specialists, patients often lack the guidance needed to effectively control their asthma.
• Health Disparities and Inequities: Racial and ethnic health disparities play a significant role in asthma outcomes. Black and Hispanic Americans, for instance, have disproportionately higher rates of asthma-related ED visits compared to non-Hispanic whites. These disparities are often driven by a combination of socioeconomic factors, environmental exposures, and reduced access to quality healthcare, underscoring the need for health equity interventions.
• Health Equity Gaps: Health inequities, including disparities in income, education, and housing, contribute to differences in asthma control among communities. Addressing these gaps is essential to reducing asthma-related ED visits and improving overall health outcomes.

Asthma-related emergency department visits are influenced by a complex interplay of socioeconomic, environmental, and healthcare access factors. Understanding these contributors is key to developing effective strategies for reducing the burden of asthma and improving outcomes, particularly in underserved and high-risk communities.

By addressing these issues holistically, healthcare providers and policymakers can help minimize asthma emergencies and enhance the quality of life for those living with this chronic condition.

Related: The Best (and Worst) Places to Live With Asthma

Final Thoughts

The prevalence of emergency department visits due to asthma varies widely across cities in the United States, influenced by a combination of factors such as air quality, healthcare access, socioeconomic conditions, and lifestyle behaviors like smoking.

Each of the cities discussed faces its own set of challenges that contribute to elevated rates of asthma-related emergencies. Understanding these localized issues is essential for implementing targeted interventions and policies that can reduce the burden of asthma, improve patient outcomes, and ultimately lower mortality rates.

While these cities may have the highest rates of asthma-related ED visits, it’s crucial to recognize that asthma is a nationwide public health issue that affects individuals and families in communities across the country.

Addressing asthma effectively requires ongoing research, increased awareness, and a commitment to advocacy and education. By taking a comprehensive and proactive approach, we can work towards minimizing the impact of this chronic respiratory condition and improving the quality of life for those affected.