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. But in this slideshow we take a look at the 10 best big cities for asthma. Is your city on the list?

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• Population: 1,883,051
•2014 rank: 13

One of the nation's fastest-growing cities has managed to expand without some of the environmental woes plaguing other urban explosions. The estimated asthma rate in the Austin metro area (which includes Round Rock) is lower than the national average.

The annual pollen count, though, is higher than average. This is probably no surprise to those who have experienced the region's legendary "cedar fever," caused by Ashe juniper pollen and bringing on the same symptoms as

hay fever.

• Population: 1,214,516
•2014 rank: 20

Raleigh, along with neighbors Durham and Chapel Hill, is known for its "Tees, trees, and PhDs," all of which make it an attractive habitat for people with or without asthma.

The city scores high for air quality, although it still lags in the area of no-smoking laws in public places. (Tobacco smoke is a potent asthma trigger that can bring on an asthma attack in some people.)

• Population: 732,535
•2014 rank: 26

Miles of beaches and near-perfect temperatures aren't all Sarasota has to offer. Add great air quality, at least outdoors.

Like many other parts of the South, Sarasota still lacks good indoor air-quality legislation. This may contribute to an asthma rate that's only on par with the national average.

• Population: 661,115
• 2014 rank: 19

Located on the Gulf of Mexico, fast-growing Cape Coral-Fort Myers jumped 12 spots on this year's AAFA list.

Three cities in Florida appear in the top 10, interestingly enough. Although heat and humidity can aggravate asthma symptoms in some people, the Sunshine State’s near-tropical climate actually

provides relief for some asthmatics.

• Population: 550,823
• 2014 rank: 25

Palm Bay is located on the Atlantic Ocean, just 100 miles south of Daytona Beach. It scored highly on air quality, including annual pollen rate.

It also boasts a 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.

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

• Population: 534,578
•2014 rank: 27

Abilene is the only one of the top 10 asthma cities with a low asthma rate (the rest are average).

In 2006, the city adopted a ban on smoking in workplaces and in public places. Despite this, the frontier town only has an average rating for smoke-free laws. Maybe similar legislation in the works to regulate e-cigarettes and liquid nicotine will help.

• Population: 1,919,641
• 2014 rank: 15

Tough anti-smoking laws and a low poverty rate probably helped boost San Jose's standing. In fact, San Jose scored well across the board, with not one "below average" ranking and only three "average" rankings.

San Jose is part of the Bay Area's "Spare the Air" initiative, supporting more clean energy, more trees and less junk mail.

• Population: 3,610,105
• 2014 rank: 2

Seattle got solid marks overall from the AAFA, but it wasn't perfect. Unlike most of the cities on this top 10 list, Seattle earned only an “average” score for its air quality.

Fortunately, that may improve. In August 2008, after a 90-degree heat wave and light winds caused smog, ozone, and other pollutants to accumulate over the city, Seattle violated the Clean Air Act for the first time since the 1990s. As a result, state and local officials were required to prepare a plan to improve air quality.

• Population: 650,288
• 2014 rank: 3

Boise received no "below average" marks and gets kudos for good air quality and low poverty rate.

It also excels in medical indicators for asthma. There were fewer emergency-room visits for asthma and patients needed less medication to control their asthma.

• Population: 4,516,276
• 2014 rank: 1

The San Francisco Bay area (which includes the cities of Oakland and Hayward) is the largest urban area to make the AAFA’s top 10. Of the 13 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.