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Asthma Capitals

Asthma Capitals

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2026 Asthma Capitals®

The Asthma and Allergy Foundation of America’s (AAFA) Asthma Capitals® report [3] ranks the largest 100 cities in the contiguous (“lower 48”) U.S. by how challenging they are to live in when you have asthma. AAFA publishes this report to show the nationwide burden of asthma. It is a call to action to help the nearly 28 million people in the U.S. with asthma.

Asthma is greatly influenced by where someone lives. People who have affordable and accessible health care, clean air, and economic stability have a greater chance of managing and controlling their asthma. The report ranks cities based on: asthma rates, emergency room visits, and deaths. These outcomes are influenced by various risk factors that can make asthma harder to manage and control.

Asthma Capitals 2026

Hover over each state to see more information about cities that rank in this year’s report [3].

AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY DC
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Alabama


Birmingham ranks #86

 

Click on state to read full report.

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Alaska


Alaska is not included in the ranking because finding data
that matches the data from the contiguous U.S. is challenging.

 

Click on state to read full U.S. report.

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Arizona


Phoenix ranks #20 due to
higher-than-average asthma rates
Air pollution is a major risk factor

Tucson ranks #21

 

Click on state to read full report.

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Arkansas


Little Rock ranks #92
Fayetteville ranks #97

 

Click on state to read full report.

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California


Sacramento ranks #10 due to
higher-than-average asthma rates
and emergencies
Risk factors in Sacramento include
poor air quality, few asthma specialists,
and low RSV vaccination rates which can
lead to higher asthma rates and emergencies

Fresno ranks #12 due to high
asthma rates and deaths

Fresnso has the fewest asthma
specialists of all cities

San Francisco ranks #30
Stockton ranks #31
Los Angeles ranks #34
Riverside ranks #49
San Diego ranks #50
San Jose ranks #56
Oxnard ranks #66
Bakersfield ranks #72

 

Click on state to read full report.

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Colorado


Denver ranks #69
Colorado Springs ranks #90

 

Click on state to read full report.

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Connecticut


Hartford ranks #8 due to
higher-than-average asthma
rates and deaths
Poverty is a major risk factor in Hartford

Bridgeport ranks #33
New Haven ranks #60

 

Click on state to read full report.

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Delaware


Though no Delaware metropolitan area falls within the top 100 most populated metropolitan areas in the contiguous United States, Wilmington is included in the Philadelphia MSA. 

Click on state to read full U.S. report.

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Florida


Lakeland ranks #6 due to
higher-than-average asthma rates
and emergency visits (3rd highest)
Risk factors in Lakeland include
lack of health insurance,
few asthma specialists, and
low vaccination rates for flu and COVID-19

Miami ranks #39
Orlando ranks #42
Palm Bay ranks #64
Daytona Beach ranks #76
Jacksonville ranks #81
Sarasota ranks #88
Tampa ranks #89
Cape Coral ranks #98

 

Click on state to read full report.

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Georgia


Atlanta ranks #44
Augusta ranks #83

 

Click on state to read full report.

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Hawaii


Hawaii is not included in the ranking because finding data
that matches the data from the contiguous U.S. is challenging.

 

Click on state to read full U.S. report.

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Idaho


Boise ranks #94

 

Click on state to read full report.

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Illinois


Chicago ranks #58

 

Click on state to read full report.

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Indiana


Indianapolis ranks #45

 

Click on state to read full report.

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Iowa


Des Moines ranks #96

 

Click on state to read full report.

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Kansas


Wichita ranks #67

 

Click on state to read full report.

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Kentucky


Louisville ranks #63

 

Click on state to read full report.

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Louisiana


New Orleans ranks #47
Baton Rouge ranks #65

 

Click on state to read full report.

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Maine


Maine does not have an Asthma Capital because its largest metropolitan area, Portland, falls just outside the 100 most populated metropolitan areas in the contiguous United States, and there are no other Maine cities that fall within other MSAs in the top 100 list.  

Click on state to read full U.S. report.

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Maryland


Baltimore ranks #16 overall
and has the highest number
of asthma-related deaths 

Poverty and air pollution are
major risk factors in Baltimore

Click on state to read full report.

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Massachusetts


Worcester ranks #43
Boston ranks #75

 

Click on state to read full report.

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Michigan


Detroit ranks #2 due to
higher-than-average asthma rates 

and asthma-related deaths

Detroit\'s risk factors include
high poverty rates, significant
air pollution, and health care barriers

Grand Rapids ranks #85

 
Click on state to read full report.

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Minnesota


Minneapolis ranks #54

 

Click on state to read full report.

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Mississippi


Jackson ranks #36
 

Click on state to read full report.

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Missouri


St. Louis ranks #28
Kansas City ranks #82

 

Click on state to read full report.

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Montana


Montana does not have an Asthma Capital because its largest metropolitan area, Billings, is not in the 100 most populated metropolitan areas in the contiguous United States, and there are no other Montana cities that fall within other MSAs in the top 100 list.  

Click on state to read full U.S. report.

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Nebraska


Omaha ranks #25

 

Click on state to read full report.

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Nevada


Las Vegas ranks #46
Reno ranks #51

 

Click on state to read full report.

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New Hampshire


Though no New Hampshire metropolitan area falls within the top 100 most populated metropolitan areas in the contiguous United States, some New Hampshire cities, such as Manchester and Concord, are included in the Boston metropolitan statistical area. 

Click on state to read full U.S. report.

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New Jersey


Though no New Jersey metropolitan area falls within the top 100 most populated metropolitan areas in the contiguous United States, some New Jersey cities are included in the MSAs for New York City (Newark, Jersey City), Philadelphia (Camden), and Allentown (Easton). 

Click on state to read full U.S. report.

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New Mexico


Albuquerque ranks #38

 

Click on state to read full report.

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New York


Rochester ranks #3 due to having
the highest asthma rates of all analyzed cities

Rochester\'s risk factors include lack of asthma
specialists and too much air pollution

Syracuse ranks #7 due to higher-than-
average asthma rates and deaths

Albany ranks #15
Poughkeepsie ranks #22
New York ranks #26
Buffalo ranks #73

New York has the most cities in the top 20
(and top 30) of this year\'s ranking.

Click on state to read full report.

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North Carolina


Greensboro ranks #53
Raleigh ranks #59
Charlotte ranks #77
Durham ranks #84
Winston-Salem ranks #87

 

Click on state to read full report.

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North Dakota


North Dakota does not have an Asthma Capital because its largest metropolitan area, Fargo, is not in the 100 most populated metropolitan areas in the contiguous United States, and there are no other North Dakota cities that fall within other MSAs in the top 100 list.  

Click on state to read full U.S. report.

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Ohio


Cleveland ranks #5 due to
higher-than-average asthma
rates, emergency visits, and deaths
Air pollution is a major risk factor 

Cincinnati ranks #23
Columbus ranks #37
Dayton ranks #41
Toledo ranks #48
Akron ranks #55

 

Click on state to read full report.

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Oklahoma


Oklahoma City ranks #40
Tulsa ranks #62

 

Click on state to read full report.

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Oregon


Portland ranks #71

 

Click on state to read full report.

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Pennsylvania


Allentown ranks #1 due to having the
highest rate of asthma emergencies

Philadelphia ranks #4 due to high rates
of asthma and higher-than-average
asthma-related deaths

Air pollution and poverty are major risk factors
affecting people of Allentown and Philadelphia

Harrisburg ranks #32
Pittsburgh ranks #68 

 

Click on state to read full report.

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Rhode Island


Providence ranks #17 due to
higher-than-average asthma rates

Poverty is a major risk factor:
1 in 5 people in Providence live in poverty

Click on state to read full report.

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South Carolina


Charleston ranks #9 due to
higher-than-average asthma rates
and high rates of asthma emergencies

Columbia ranks #11 due to
high asthma rates and
higher-than-average emergencies


Greenville ranks #35

Statewide, flu vaccination rates are low, and
can contribute to asthma emergencies 

Click on state to read full report.

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South Dakota


South Dakota does not have an Asthma Capital because its largest metropolitan area, Sioux Falls, is not in the 100 most populated metropolitan areas in the contiguous United States, and there are no other South Dakota cities that fall within other MSAs in the top 100 list.  

Click on state to read full U.S. report.

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Tennessee


Chattanooga ranks #29 (up from #77 in 2025)
due to higher rate of asthma emergencies

Nashville ranks #57
Memphis ranks #61
Knoxville ranks #99

 

Click on state to read full report.

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Texas


Dallas ranks #18 due to
higher-than-average asthma
rates and emergencies

Dallas has the 3rd highest rate of
people without health insurance

El Paso ranks #70
San Antonio ranks #74
Austin ranks #78
McAllen ranks #79
Houston ranks #95

 

Click on state to read full report.

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Utah


Ogden ranks #80
Salt Lake City ranks #93
Provo ranks #100

 

Click on state to read full report.

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Vermont


Vermont does not have an Asthma Capital because its largest metropolitan area, Burlington, is not in the 100 most populated metropolitan areas in the contiguous United States, and there are no other Vermont cities that fall within other MSAs in the top 100 list.  

Click on state to read full U.S. report.

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Virginia


Virginia Beach ranks #13
Virginia Beach has the 2nd highest
number of asthma emergencies 

Strengthening public smoking laws and
supporting RSV vaccination would help protect
residents and visitors

Richmond ranks #27

Click on state to read full report.

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Washington


Spokane ranks #14
Spokane has one of the highest
pollen scores (5th in the nation)

Seattle ranks #52

Click on state to read full report.

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West Virginia


Though no West Virginia metropolitan area falls within the top 100 most populated metropolitan areas in the contiguous United States, Jefferson County is included in the Washington, DC MSA. 

Click on state to read full U.S. report.

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Wisconsin


Milwaukee ranks #19 due to
higher-than-average asthma
rates and emergencies

Poverty and air pollution are major
risk factors for Milwaukee

Madison ranks #91

 

Click on state to read full report.

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Wyoming


Wyoming does not have an Asthma Capital because its largest metropolitan area, Cheyenne, is not in the 100 most populated metropolitan areas in the contiguous United States, and there are no other Wyoming cities that fall within other MSAs in the top 100 list.  
 
Click on state to read full U.S. report.

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District of Columbia


Washington ranks #24

 

Click on state to read full report.

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The colors on the map indicate if the state has cities in the top #1 spot, top 20, rank 21-100, or has no Asthma Capital. Asthma Capitals map color key

2026 Asthma Capitals report cover
[3]
2026 Asthma Capitals Spotlight of the Top 3 Cities
[4]

Report Ranking Criteria

The Asthma Capitals report ranking is based on 3 health outcomes.

Asthma fact graphic with the copy nearly 26 million Americans have asthma. This equates to about 1 in 13 Americans. [5]
Asthma fact graphic with the copy Black Americans are six times more likely than White Americans to visit the emergency department due to asthma. [5]
Allergy Fact graphic with the copy allergies are the 6th leading cause of chronic illness in the U.S. [5]

Report Ranking Criteria

The Asthma Capitals report ranking is based on 3 health outcomes.

Asthma fact graphic with the copy nearly 26 million Americans have asthma. This equates to about 1 in 13 Americans. [5]
Asthma fact graphic with the copy Black Americans are six times more likely than White Americans to visit the emergency department due to asthma. [5]
Allergy Fact graphic with the copy allergies are the 6th leading cause of chronic illness in the U.S. [5]

Risk Factors

Social and environmental influences can worsen asthma rates and increase the risk of emergencies and deaths related to asthma. The report analyzes the following risk factors:

Asthma fact graphic with the copy nearly 26 million Americans have asthma. This equates to about 1 in 13 Americans. [7]
Allergy Fact graphic with the copy allergies are the 6th leading cause of chronic illness in the U.S. [7]
Allergy Fact graphic with the copy allergies are the 6th leading cause of chronic illness in the U.S. [7]
Asthma capitals risk factors respiratory infections [7]

Risk Factors

Social and environmental influences can worsen asthma rates and increase the risk of emergencies and deaths related to asthma. The report analyzes the following risk factors:

Asthma fact graphic with the copy nearly 26 million Americans have asthma. This equates to about 1 in 13 Americans. [7]
Allergy Fact graphic with the copy allergies are the 6th leading cause of chronic illness in the U.S. [7]
Allergy Fact graphic with the copy allergies are the 6th leading cause of chronic illness in the U.S. [7]
Asthma capitals risk factors respiratory infections [7]
Asthma fact graphic with the copy Black Americans are six times more likely than White Americans to visit the emergency department due to asthma. [7]
Asthma fact graphic with the copy Black Americans are six times more likely than White Americans to visit the emergency department due to asthma. [7]
Allergy Fact graphic with the copy allergies are the 6th leading cause of chronic illness in the U.S. [7]
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About the Report

AAFA publishes the Asthma Capitals® [9] report to monitor 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, Honolulu, Hawaii, or San Juan, Puerto Rico, Navajo Nation Reservation, or Cherokee Nation Reservation due to lack of matching data with other cities, counties, state

Acknowledgements

The 2026 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, 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, (2026). 2026 Asthma Capitals®. Retrieved from asthmacapitals.org.

Media Inquiries

For media and related inquiries, contact media@aafa.org [10].