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Asthma Capitals of the United States: What Are the Worst Places to Live if You Have Asthma?

Asthma Capitals of the United States: What Are the Worst Places to Live if You Have Asthma?


Over 25 million American adults live with asthma. That’s one in every 12, and the percentage has steadily gone up in recent decades. Once you add the one in 10 children who have also been diagnosed with asthma, you get some shocking statistics.


Although scientists are still very much working on uncovering the reasons behind the growing asthma rates in the United States as well as many other countries, some working hypotheses have been developed. They include the fact that climate change is prolonging pollen seasons, higher general outdoor air pollution in some areas, particularly caused by industry and vehicles, and even the possibility that more energy-efficient construction causes many of us to live in homes that don’t allow irritant particles to escape.


If you do have asthma, especially if you have moved around a fair bit, you will know from personal experience that the region you live in can have a significant impact on the severity of your symptoms — including how often you need to turn to your rescue inhaler. What are the worst places in the United States to live if you have asthma? More importantly, what can you do to improve your quality of life with asthma regardless of where you live?


What Are the Asthma Capitals of the United States?


Every year, the Asthma and Allergy Foundation of America (AAFA) compiles two lists, highlighting both the nation’s allergy capitals and its asthma hot spots. In doing so, they examine numerous different factors to determine the very worst places to live with asthma. Not all of those will apply to you personally, as they include:


  • The prevalence of asthma (based on diagnosed cases) in a location.
  • The number of people in a city or town who visit the Emergency Room for asthma-related reasons each year.
  • The number of asthma-related deaths in a place.
  • Access to asthma specialists.
  • Quantities of asthma medications being used in a place each year.
  • Numerous other variables that influence the risk of asthma — smoking rates, pollen counts, access to health insurance, poverty rates, and anti-smoking laws.


Based on these factors, the current worst places to live with asthma are:


  • Allentown, Pennsylvania
  • Baltimore, Maryland
  • Richmond, Virginia
  • Milwaukee, Wisconsin
  • New Haven, Connecticut
  • Cleveland, Ohio
  • Philadelphia, Pennsylvania
  • Dayton, Ohio
  • Oklahoma City, Oklahoma
  • Tucson, Arizona

These are not the only places in which people with asthma are likely to have a hard time, however. Two regions are so problematic that they are being called “asthma belts” — the Ohio Valley area as well as the North-East Mid-Atlantic asthma belt.


In the Ohio Valley region, other very challenging places to live with asthma include Columbus, Ohio, Detroit, Michigan, and Louisville, Kentucky. The North-East Mid-Atlantic belt includes, besides those places that are already included in the Top 10 of asthma capitals, Worcester, Springfield, and Boston (Massachusetts), Hartford, Connecticut, and Greensboro, North Carolina.


Circumstances that Exacerbate Asthma: What Else Do You Need to Know?


Certain regions, states, and cities are considered to be hot spots for asthma, but the fact remains that living with asthma can be challenging no matter what place you call home. Unfortunately, very often, the worst place to live with asthma is in your own home. Does that sound like a shocking statement? Let’s consider it in more detail.


Did you know that the average American spends approximately 90 percent of their time indoors, and much of that at home? Did you know that the air quality in most American homes is between two and five times worse than the air quality outside, and that it may be up to 100 times more polluted in some cases? Did you know that some of the very same factors that generally contribute to poor indoor air quality also trigger both asthma and allergy symptoms?


Thankfully, medications that can control asthma quite effectively are now available — but to improve your quality of life and reduce your reliance on those medications, it is always crucial to also thoroughly examine the factors in your home that can make your asthma worse.


Some of the most common asthma triggers are, unfortunately, present in high concentrations in too many homes. How many of them do you still need to deal with?


  • Tobacco smoke. If you have asthma or someone in your household does, it must be assumed that no smoking is taking place in your home. However, if you live in multi-family housing, tobacco smoke from neighboring units may find its way into your home, in turn triggering symptoms.
  • Dust mites. These tiny arachnids are present, at detectable levels, in at least one bedroom in the majority of American homes. You can’t see them, but the allergenic proteins they release can trigger allergy symptoms as well as worsening asthma. Dust mites thrive in homes with high humidity levels.
  • Pests like cockroaches and rodents also commonly worsen asthma symptoms, and may provoke an asthma attack.
  • Pet dander is another common cause of asthma attacks in people who also have allergies. Did you know that pet dander may find its way into your home even if you do not have any pets yourself, nor let any in as guests?
  • Outdoor air pollution may find its way into your home, too, and easily exacerbates symptoms.
  • High humidity levels, in general, worsen asthma symptoms. That is for several reasons. Hot and humid weather is associated with higher ozone levels, which can easily make it hard to breathe. This type of weather also causes a rise in outdoor air pollution, while allowing pests like dust mites to thrive, along with mold.


Last but very certainly not least, mold is a common trigger for asthma symptoms and even asthma attacks. Anyone with asthma will likely have experiences with situations in which they immediately started coughing, wheezing, and suffering from shortness of breath when they entered a damp basement. Mold is often to blame, and it is important to note that mold can irritate your airways severely even if you do not also have a mold allergy. Symptoms are likely to worsen after prolonged exposure.


What Can You Do To Control Mold and Other Asthma Triggers in Your Home?


You may live in one of the infamous “asthma capitals”, or you could live somewhere that isn’t even on the AAFA’s radar at all. Either way, you will breathe more easily if you take proactive steps to improve your indoor air quality and reduce your exposure to asthma triggers. The most important things you can do to make your home more livable with asthma are:


  • Purchasing a true HEPA air purifier for all the most important rooms in your home, such as your bedroom and living room. These air purifiers trap over 99 percent of airborne particles, including those that commonly trigger asthma symptoms.
  • Vacuuming and dusting your home frequently, at least every couple of days, to reduce the presence of household dust.
  • Keep the relative humidity levels in your home between 30 and 50 percent. These are the humidity levels that the Environmental Protection Agency recommends for everyone, whether they have asthma or not, but maintaining healthy humidity levels is even more important for asthma sufferers. Many common asthma triggers, like mold, dust mites, and roaches, are attracted to humid spaces. You can check your humidity levels with inexpensive tools designed for the purpose, and where they are too high, you may consider investing in a dehumidifier.
  • Increasing ventilation. If you know that pollen and outdoor air pollution trigger your asthma, you probably keep the windows closed a lot. This also, however, causes indoor pollution to accumulate over time, worsening your symptoms. Consider installing exhaust fans in your bathroom and kitchen if you do not already have them, but also discuss how often to open your windows with your health care provider.


Do You Need to Have a Mold Inspection?


Because of the established connection between asthma symptoms and mold infestations in the home, it is important to take immediate action if you do spot mold growth anywhere in your property. Smelling mold, which often has a musty odor, is another clue that you likely have a mold problem.


However, not all indoor mold infestations are easily visible — and some remain undetected for long periods of time. In such cases, the mold may be building up in hidden spots like attics, basements, crawl spaces, and around pipes. If you have asthma, and you have noticed a recent worsening of your symptoms while you are at home, a mold inspection may be the right step toward the solution. In addition, people who are in the market for a new home may also opt to have a mold inspection carried out before making an offer. Thorough mold inspections are usually not included in a typical home inspection.


Eliminating a mold infestation starts with a full mold inspection. MI&T is, as a nationwide independent mold inspection only company, your trusted partner no matter where in the US you live. We begin by performing a detailed visual mold inspection that covers even those areas of the property you likely never see yourself. MI&T’s professional mold inspectors then take air samples, which will, after lab analysis, tell you precisely what types of mold may be present in your air, and in what concentrations.

Having the full picture is your first crucial step on your way to being able to remediate your mold infestation — and once all the steps to fight mold in your home have been completed, MI&T’s clearance testing can let you know whether the problem is well and truly solved.