Research and Reports
Asthma Capitals: Health Outcomes That Impact Ranking
Outcome factors measure the real-life impact of asthma on individuals, families, and communities. To determine the Asthma Capitals™ ranking, AAFA looks at 3 health outcomes:
- Asthma prevalence (how many people have asthma)
- Asthma-related emergency department (ED) visits
- Asthma-related mortality (death) rates
The outcomes are not weighted equally in calculating rankings.
Estimated Asthma Rates (Prevalence)
Over 28 million people living in the United States have asthma.1,2 This equals about 1 in 12 people. Nationally, the prevalence of “current asthma” increased from 20.3 million people in 2001. The CDC determines the prevalence of asthma using a national survey. People who answer “yes” to the questions “Have you EVER been told by a doctor or other health professional that you had asthma?” and “Do you still have asthma?” have current asthma.
Asthma prevalence rates differ significantly by socioeconomic status, race, ethnicity, age and sex.
Income
- People living below 100% of the Federal Poverty Level (FPL) are more likely to have asthma than people living at any percentage above the poverty level.
- Around 12.5% of adults with family income below 100% of the FPL have asthma, compared to 11.1% of adults with family income of 100%-199% of the FPL and 7.9% of persons with family income of at least 200% of the FPL.2
Race
- Black people in the U.S. are also disproportionally diagnosed with asthma compared to White people.3
- Around 11.3% of Black people in the U.S. have asthma, compared to 8.5% of White people.2
Ethnicity
- Data on asthma prevalence in Hispanic subgroups are limited; however, previous research suggests Puerto Ricans have the highest rate of asthma prevalence compared to any other racial or ethnic group in the United States.
Age
- While there are more adults with asthma than children, asthma is a leading chronic disease in children.4
- Only dental cavities are more common in kids than asthma.5
Sex
- In adults, asthma is more common in females than males. Around 11.0% of female adults have asthma, compared to 6.8% of male adults.2
- In children, asthma is more common in males than females. Around 7.6% of male children have asthma, compared to 5.7% of female children.4
The cities with the highest estimated asthma prevalence† are:
| 2025 Asthma Capital Ranking Overall | 2025 Asthma Prevalence Ranking | Metropolitan Area |
| 2 | 1 | Rochester, NY |
| 1 | 2 | Detroit, MI |
| 8 | 3 | Albany, NY |
| 3 | 4 | Allentown, PA |
| 7 | 5 | Hartford, CT |
| 4 | 6 | Philadelphia, PA |
| 6 | 7 | Fresno, CA |
| 5 | 8 | Cleveland, OH |
| 15 | 9 | Harrisburg, PA |
| 9 | 10 | Providence, RI |
†For each city included in the 2025 Asthma Capitals, AAFA obtained an estimated asthma prevalence for its respective metropolitan statistical area (MSA). MSAs include cities and their surrounding areas (like suburbs). For this report, asthma prevalence is estimated using claims data for individuals who sought asthma care at any point in the 2024 calendar year. While this is not an exact measure of prevalence, it helps provide data that can be compared from city to city. Other prevalence estimates, such as those from the CDC, use self-reported data through surveys. Download image of Figure 1 table
Emergency Department (ED) Visits
Asthma can trigger severe symptoms that require a visit to the ED. Increased ED visits are a sign of poor asthma control. Nationally, asthma accounts for nearly 1 million emergency department visits each year.6
Most asthma-related ED visits can be prevented. Effective asthma management—including reducing exposure to asthma triggers, having access to and taking prescribed asthma medicine, and following an Asthma Action Plan—may help reduce ED visits and hospitalizations.
Asthma-related ED visits are 6 times higher for Black patients than for White patients. Children are more likely than adults to have asthma-related ED visits, with children ages 0 to 4 having the highest rates of asthma-related ED visits.7 Asthma-related ED visits spike every year in September when children return to school.
The cities with the highest asthma-related ED visits† are:
| 2025 Asthma Capital Ranking Overall | 2025 Asthma Emergency Visits Ranking | Metropolitan Area |
| 10 | 1 | Milwaukee, WI |
| 49 | 2 | Louisville, KY |
| 42 | 3 | Memphis, TN |
| 23 | 4 | Virginia Beach, VA |
| 82 | 5 | Madison, WI |
| 3 | 6 | Allentown, PA |
| 60 | 7 | Oklahoma City, OK |
| 30 | 8 | Stockton, CA |
| 51 | 9 | Dayton, OH |
| 57 | 10 | Columbus, OH |
†For each city included in the 2025 Asthma Capitals, AAFA obtained the total number of ED visits where an asthma ICD-10 code was included in a diagnosis field, for the respective census-designated metropolitan statistical area, or MSA, for calendar year 2024. Analysis included estimating the ED rate per 10,000 asthma patients. Download image of Figure 2 table
Asthma-Related Deaths (Mortality)
On average, between 9 to 11 people in the U.S. die from asthma each day. Nationally, there were 3,190 deaths attributed to asthma in 2023.7 There hasn’t been meaningful improvement in these numbers in the last decade. In 2020, deaths due to asthma rose for the first time in 20 years but have since returned to pre-pandemic level.8
Some populations are at higher risk of dying from asthma than others. The causes of higher asthma death rates are complex but must be addressed to save lives. The top 10 cities for asthma-related deaths must take action to prevent more tragedies.
The cities with the highest asthma-related deaths† are:
| 2025 Asthma Capital Ranking Overall | 2025 Asthma-Related Deaths Ranking | Metropolitan Area |
| 13 | 1 | Baltimore, MD |
| 32 | 2 | St. Louis, MO |
| 16 | 3 | Richmond, VA |
| 47 | 4 | Jackson, MS |
| 42 | 5 | Memphis, TN |
| 77 | 6 | Chattanooga, TN |
| 25 | 7 | New York, NY |
| 6 | 8 | Fresno, CA |
| 4 | 9 | Philadelphia, PA |
| 22 | 10 | Tucson, AZ |
†For each city included in the 2025 Asthma Capitals, AAFA obtained the estimated asthma-related crude death rate per 100,000 people for its respective county from 2019-2023 (most recent available data). Download image of Figure 3 table
To reduce the risk of death from asthma, it is important to:
- Have access to asthma medicines and take them as prescribed
- Seek medical care if symptoms occur more than twice per week
- Avoid or reduce exposure to asthma triggers
- Learn the signs and symptoms of asthma, including early warning signals
- Have an Asthma Action Plan and take quick action according to the plan
If someone’s life is in danger, seek emergency care immediately. An Asthma Action Plan can help identify when asthma is a medical emergency. Visit aafa.org/actionplan to download a sample plan.
About the Report
AAFA publishes the Asthma Capitals™ report to raise awareness about the nationwide impacts of asthma. The report analyzes asthma data across the United States and ranks cities by the most critical of health outcomes – asthma prevalence, emergency department visits due to asthma attacks, and asthma-related mortality. The outcomes are not weighted equally. The report also examines asthma risk factors that influence the outcomes.
AAFA only evaluates the top 100 populated places (based on metropolitan statistical areas or MSAs) in the contiguous (“lower 48”) states for this report. MSAs are cities and their surrounding areas (like suburbs and nearby rural areas). The report does not reflect:
- Cities and areas not in the top 100 list by population size
- Completely rural areas that are not located within a metropolitan statistical area
- Anchorage, Alaska and Honolulu, Hawaii due to lack of matching data with other cities, counties, states
Acknowledgements
The 2025 Asthma Capitals report is an independent research project of the Asthma and Allergy Foundation of America (AAFA) and made possible by support from Amgen, AstraZeneca, Chiesi, GSK, and Sanofi and Regeneron. AAFA also thanks Komodo Health and Pollen Sense, LLC for additional support for data used in this report. The views and opinions expressed in this report are those of the AAFA authors and do not necessarily reflect the policies or positions of the sponsors or other individuals, organizations, or companies.
Recommended Citation
Asthma and Allergy Foundation of America, (2025). 2025 Asthma Capitals. Retrieved from asthmacapitals.org.
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References
1. National Center for Health Statistics. (2024). Percentage of current asthma for adults aged 18 and over, United States, 2023. U.S. Department of Health and Human Services. https://wwwn.cdc.gov/NHISDataQueryTool/SHS_adult/index.html
2. National Center for Health Statistics. NHIS Adult Summary Health Statistics. Data accessed April 16, 2025. Available from https://data.cdc.gov/d/25m4-6qqq
3. National Center for Health Statistics. NHIS Child Summary Health Statistics. Data accessed April 16, 2025. Available from https://data.cdc.gov/d/wxz7-ekz9
4. Asthma and Allergy Foundation of America. (2020). Asthma Disparities in America: A Roadmap to Reducing Burden on Racial and Ethnic Minorities. https://www.aafa.org/asthmadisparities
5. Ferrante, G., & La Grutta, S. (2018). The Burden of Pediatric Asthma. Frontiers in Pediatrics, 6. https://doi.org/10.3389/fped.2018.00186
6. Fleming, E., Afful, J. (2018). Prevalence of total and untreated dental caries among youth: United States, 2015–2016. NCHS Data Brief, no 307. https://www.cdc.gov/nchs/products/databriefs/db307.htm
7. Agency for Healthcare Research and Quality. (2023). Healthcare Cost and Utilization Project (2020). U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. https://www.cdc.gov/asthma/healthcare-use/2020/table_a.html
8. Centers for Disease Control and Prevention. (2023). Most recent national asthma data. U.S. Department of Health and Human Services. https://www.cdc.gov/asthma/most_recent_national_asthma_data.htm
9. National Center for Health Statistics. National Vital Statistics System: Mortality (2018-2022). U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. https://wonder.cdc.gov/ucd-icd10-expanded.html
