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Allergy Capitals

It’s the season for sneezing and itching! If you live in one of the top 2024 Allergy Capitals™, use our report to recognize and prevent your seasonal pollen allergies symptoms to help improve your quality of life.

More than 100 million people in the United States live with various types of allergies every year.1,2 ​Many of them have seasonal pollen allergies. The Asthma and Allergy Foundation of America’s (AAFA) yearly Allergy Capitals report explores how challenging it is to live with seasonal allergies in the top 100 U.S. cities.*

 

The top 10 most challenging places to live with seasonal allergies are:

  1. Wichita, Kansas
  2. Virginia Beach, Virginia
  3. Greenville, South Carolina
  4. Dallas, Texas
  5. Oklahoma City, Oklahoma
  6. Tulsa, Oklahoma
  7. Richmond, Virginia
  8. Des Moines, Iowa
  9. Raleigh, North Carolina
  10. Fayetteville, Arkansas

*AAFA studied data from the 100 most-populated U.S. metropolitan areas.

2024 Allergy Capitals

Our report looks at how challenging it is to live with seasonal allergies in the top 100 most-populated U.S. cities. Download our full report to see where each city ranks.

10. Fayetteville, Arkansas

Fayetteville is #10 for 2024. It has average pollen and number of allergy specialists but a worse-than-average amount of over-the-counter allergy medicine use.

9. Raleigh, North Carolina

Raleigh is #9 for 2024. It has average pollen but a worse-than-average amount of allergy specialists and over-the-counter allergy medicine use.

8. Des Moines, Iowa

Des Moines is #8 for 2024. It has average pollen and over-the-counter allergy medicine use but a worse-than-average number of allergy specialists.

7. Richmond, Virginia

Richmond is #7 for 2024. It has average pollen and worse-than-average over-the-counter allergy medicine use but a better-than-average number of allergy specialists.

6. Tulsa, Oklahoma

Tulsa is #6 for 2024. It has worse-than-average pollen and over-the-counter allergy medicine use but an average number of allergy specialists.

5. Oklahoma City, Oklahoma

Oklahoma City is #5 for 2024. It has worse-than-average pollen and over-the-counter allergy medicine use but an average number of allergy specialists.

4. Dallas, Texas

Dallas, Texas, is #4 for 2024. It has worse-than-average pollen and over-the-counter allergy medicine use but an average number of allergy specialists.

3. Greenville, South Carolina

Greenville is #3 for 2024. It has average pollen and number of allergy specialists but a worse-than-average amount of over-the-counter allergy medicine use.

2. Virginia Beach, Virginia

Virginia Beach is #2 for 2024. It has worse-than-average pollen and over-the-counter allergy medicine use but an average number of allergy specialists.

1. Wichita, Kansas

Wichita is #1 for 2024. It has average pollen but a worse-than-average amount of allergy specialists and over-the-counter allergy medicine use.

2024 Allergy Capitals: Full Report

The report looks at these important factors:

  • Tree, grass, and weed pollen scores
  • Over-the-counter allergy medicine use
  • Availability of board-certified allergists/immunologists

This year’s report named Wichita, Kansas, as the top 2024 Allergy Capital for the second year in a row due to its:

  • Higher-than-average tree and grass pollen
  • Higher-than-average allergy medicine use
  • Fewer board-certified allergists/immunologists

 

Report Highlights

This year’s report focuses on these topics related to seasonal allergies:

  • Allergic rhinitis and allergic asthma
  • Climate change and botanical sexism
  • Pollen counting

Allergic Rhinitis and Allergic Asthma

In the spring, the warm weather brings people outdoors to face one of the season’s biggest problems: tree pollenGrass pollen follows later in spring into summer. Then in the late summer and early fall, weed pollen – especially ragweed pollen – can trigger symptoms just as kids are returning to school. And some parts of the United States now have pollen year-round.

Pollen can cause symptoms for people with two common allergic conditions: seasonal allergic rhinitis (“hay fever”) and allergic asthma.

Common symptoms of allergic rhinitis caused by seasonal allergies include:

  • Runny nose (also known as rhinorrhea – usually a thin, clear discharge)
  • Stuffy nose (due to blockage or nasal congestion)
  • Sneezing
  • Red and watery eyes
  • Itchy nose, eyes, ears, or mouth
  • Swelling around the eyes

Common signs and symptoms of allergic asthma include:

  • Shortness of breath
  • Cough
  • Chest tightness or pain
  • Wheeze (a whistling sound when you breathe)
  • Waking at night due to asthma symptoms
  • A drop in lung function

Managing your seasonal allergies can help you keep your allergic rhinitis and allergic asthma well-controlled. Now more than ever there are a number of available and accessible options to help you find relief.

Work with your doctor to include the steps below in your allergy treatment plan:

  • Manage your contact with pollen
  • Use allergy medicines and treatments
  • Rinse out your nose
  • Ask your doctor about immunotherapy

Climate Change and Botanical Sexism

Climate change is leading to longer and more intense allergy seasons.1,2,3 More exposure to pollen can trigger asthma and other allergic responses.

Due to climate change, there is also an increase of carbon dioxide in the air, causing trees to make more pollen. Since 1990, pollen seasons have 21% more pollen. Tree pollen levels saw bigger increases than grass or weed pollen.4

“Botanical sexism” may also be partly to blame for the increase in tree pollen. This refers to the preference to plant “male” (wind-pollinating) trees instead of “female” (fruit-, seed-, and nut-bearing trees). More wind-pollinating trees can lead to more pollen.

Read the report to learn more about the effects of climate change and botanical sexism.

Chart of differences between wind-pollinating (male) and fruiting (female) trees

 

Pollen Counting

Pollen reports are valuable tools in helping you manage your seasonal allergies. But not all reports are equal. Some reports are pollen counts and some are pollen forecasts. While pollen forecasts can be helpful, pollen counts are more accurate.

Pollen sensors play an important role in gathering accurate pollen counts to help diagnose and treat allergies, study the impact of climate change, and produce crop forecasts.5,6 The 2024 Allergy Capitals report looks at the importance of pollen counts and possible solutions to improve pollen monitoring.

Frequently Asked Questions about Allergy Capitals

What Does It Mean If I Live in an Allergy Capital Lower on the List?

You may still be greatly affected by seasonal allergies. On one or more of the ranked factors, your city may be doing better compared to other cities. For example, your city may have more allergists available compared to other cities.

What Does It Mean If My City Isn’t Listed on the Report?

AAFA’s Allergy Capitals report ranks the top 100 populated metro areas in the United States. If your hometown is near a major city, your area may be included in the metro area of the major city. For example, the Seattle metropolitan area includes Tacoma, Bellevue, Everett, and all cities and suburbs in the surrounding area.

If your city’s population is lower than the population of the 100th most populated city, then your city will not be ranked. You may be greatly affected by seasonal allergies, but your town is not reflected in the report. This is why Scranton, Pennsylvania – a city that was named an Allergy Capital for the past few years – is not ranked on this year’s report. As of 2022, Scranton is no longer one of the 100 most-populated cities. Instead, it has been replaced by Fayetteville, Arkansas, moving it off our list.

How Can I Get Relief from Seasonal Allergies?

No matter where you live, it’s hard to escape pollen. But you can manage your pollen allergy.

There are a number of available and accessible options to help you find relief. Work with your doctor to include the steps below in your allergy treatment plan:

  • Manage your contact with pollen
  • Use allergy medicines and treatments
  • Rinse out your nose
  • Ask your doctor about immunotherapy

Learn more about managing pollen allergies.

 

Acknowledgement

AAFA thanks Pollen Sense, Komodo Health, and Circana for their support with data and report content.

Recommended Citation

Asthma and Allergy Foundation of America, (2024). 2024 Allergy Capitals. Retrieved from allergycapitals.com.

Media Inquiries

For media and related inquiries, contact gro.afaa@aidem.

References​
  1. Barnes, C. S. (2018). Impact of climate change on pollen and respiratory disease. Current Allergy and Asthma Reports, 18(11). https://doi.org/10.1007/s11882-018-0813-7
  2. Poole, J. A., Barnes, C. S., Demain, J. G., Bernstein, J.A., Padukudru, M. A., Sheehan, W. J., Fogelbach, G. G., Wedner, J., Codina, R., Levetin, E., Cohn, J. R., Kagen, S., Portnoy, J. M., & Nel, A. E. (2019). Impact of weather and climate change with indoor and outdoor air quality in asthma: A work group report of the AAAAI Environmental Exposure and Respiratory Health Committee. Journal of Allergy and Clinical Immunology, 143(5), 1702–1710. https://doi.org/10.1016/j.jaci.2019.02.018
  3. Ziska, L. H., Makra, L., Harry, S. K., Bruffaerts, N., Hendrickx, M., Coates, F., Saarto, A., Thibaudon, M., Oliver, G., Damialis, A., Charalampopoulos, A., Vokou, D., Heidmarsson, S., Gudjohnsen, E., Bonini, M., Oh, J.-W., Sullivan, K., Ford, L., Brooks, G. D., & Myszkowska, D. (2019). Temperature-related changes in airborne allergenic pollen abundance and seasonality across the northern hemisphere: A retrospective data analysis. The Lancet Planetary Health, 3(3), e124–e131. https://doi.org/10.1016/S2542-5196(19)30015-4
  4. Climate Central. (2023). Seasonal allergies: pollen and mold. https://assets.ctfassets.net/cxgxgstp8r5d/6HEq6ZLb0QpvXxScvaM7sc/ae3024a9c4f2bcdd9b563d09b1bd07c3/FINALSeasonal_allergies_pollen_and_mold_2023__EN_.pdf
  5. Maya-Manzano, J. M., Tummon, F., Abt, R., Allan, N., Bunderson, L., Clot, B., Crouzy, B., Daunys, G., Erb, S., Gonzalez-Alonso, M., Graf, E., Grewling, Ł., Haus, J., Kadantsev, E., Kawashima, S., Martinez-Bracero, M., Matavulj, P., Mills, S., Niederberger, E., & Lieberherr, G. (2023). Towards European automatic bioaerosol monitoring: Comparison of 9 automatic pollen observational instruments with classic Hirst-type traps. Science of the Total Environment, 866, 161220. https://doi.org/10.1016/j.scitotenv.2022.161220
  6. Buters, J., Clot, B., Galán, C., Gehrig, R., Gilge, S., Hentges, F., O’Connor, D., Sikoparija, B., Skjoth, C., Tummon, F., Adams-Groom, B., Antunes, C. M., Bruffaerts, N., Çelenk, S., Crouzy, B., Guillaud, G., Hajkova, L., Seliger, A. K., Oliver, G., & Ribeiro, H. (2022). Automatic detection of airborne pollen: an overview. Aerobiologia. https://doi.org/10.1007/s10453-022-09750-x
2024 Allergy Capitals Report Cover
A picture of a man holding his nose with a list of seasonal allergic rhinitis symptoms against a green background
A picture of weeds with the text: Allergy Capitals: It's best to start allergy treatment before your pollen season begins.

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