10 Best Big Cities for People With Asthma

Each year, the Asthma and Allergy Foundation of America (AAFA) ranks the 100 largest metropolitan areas in the U.S. from worst to first, based on how challenging it is for people with asthma to live there. (The areas include major cities and their surroundings.) The AAFA considers a wide range of variables, including asthma rates, air quality, pollen counts, and the number of asthma specialists in the area.

The AAFA emphasizes the 10 worst cities for asthma. (This year St. Louis was named the worst of the worst.) But in this slideshow we take a look at the 10 best big cities for asthma. Is your city on the list?

10. Boise, Idaho

• Population: 587,689
• 2008 rank: 11

The estimated asthma rate of this city is higher than the national average, but Boise received good marks for its air quality and low poverty rate.

Poverty is an important asthma risk factor. Although the relationship between poverty and asthma is a very complicated one, people living in poverty are believed to be more vulnerable to asthma in part because they tend to be more exposed to allergens, airborne irritants (such as traffic exhaust), and emotional stress.

9. Portland, Maine

• Population: 513,102
• 2008 rank: n/a (too small to be considered)

Thanks to its cultural scene, low crime rate, and strong economy, Portland ranked number one on the 2009 Forbes magazine list of America’s Most Livable Cities.

People with asthma will find it livable, too. The city features good air quality and strict no-smoking laws in public places. (Tobacco smoke is a potent asthma trigger that can bring on an asthma attack in some people.)

8. San Francisco, California

• Population: 4,203,898
• 2008 rank: 2

The San Francisco Bay area (which includes the cities of Oakland and Fremont) is the largest urban area to make the AAFA’s top 10. Of the 12 criteria considered by the AAFA, San Francisco was rated “below average” in just one, annual pollen score.

San Francisco has made fighting asthma a civic priority. In 2001, the city’s Board of Supervisors created an Asthma Task Force—a group of community leaders, health professionals, and asthmatics that works to manage and prevent asthma.

7. Daytona Beach, Florida

• Population: 500,413
• 2008 rank: 4

This sunny seaside city—the smallest in the AAFA’s top 10—is ranked “worse than average” in just one category, the percentage of people without health insurance.

The air quality, on the other hand, is above average—as long as you stay away from the Daytona International Speedway, where the Daytona 500 NASCAR race is held each year. Auto exhaust—which contains carbon monoxide, nitrogen oxide, and hydrocarbons—is a major asthma trigger.

6. Palm Bay, Florida

• Population: 536,161
• 2008 rank: n/a

Palm Bay is located on the Atlantic Ocean, just 100 miles south of Daytona Beach. Unlike many of the other cities at the top of the AAFA’s list, Palm Bay scored highly on asthma rates and air quality measures (including pollen count).

The city's motto (“A Perfect Place to Grow”) certainly applies to kids with asthma.