In addition to health conditions, various environmental factors can trigger asthma and its ensuing complications. Some of these environmental factors could include air pollution, smoke, and geographical location. According to the Allergy and Asthma Foundation of America (AAFA), here is a list of the most challenging US cities to live in for asthma patients.

1. Springfield
This is a city tucked away in a valley region in Massachusetts and is known to have some of the worst pollutants with dense carbon dioxide levels. Close to 60% of the young population has been recorded as having asthma due to the high pollen count in the region. Given the compromised quality of the air, at any given time, an asthma patient is at high risk for flare-ups that could end up with a visit to the emergency rooms.

2. Dayton
This city in Ohio is part of the “asthma belt” identified by the AAFA, wherein the prevalence of asthma is quite common. This city is marked as one of the top five in the country for the highest number of recorded emergency room visits for asthma. It is also a high-ranked city. In this city, there is maximum use of both quick-relief medication and controller medication for long-term management of the condition.

3. Greensboro
This city in North Carolina is well-known around the country for its advancement in both technology and medical research. However, the access to asthma specialists is quite low despite its other progressions. Given the number of individuals without insurance in the city, access to primary healthcare remains a challenge and thereby ends up causing complications for the poor.

4. Cleveland
This is perhaps one of the worst-hit cities in Ohio for asthma patients, as the air quality makes the quality of life severely compromised. This couple with poverty rates in the city makes it hard for people with asthma to fend for themselves during an emergency asthma attack. According to statistics, this is one of the cities where quick-relief asthma medication (that is used to help breathe immediately) is used in high numbers.

5. Boston
This city in Massachusetts is popular in terms of development. However, in terms of environmental factors, it has a severe and high seasonal pollen count that ends up causing significant distress for asthma patients. This leads to a high prevalence of asthma cases in the city and is quite risky for those with allergic forms of asthma.

In addition to natural factors that trigger flare-ups, economic factors such as access to healthcare and healthcare specialists also outline the impact of the environment on asthma patients. Some of the other cities which are listed as worse cities to live in with asthma, in addition to these five listed above, are Milwaukee, Omaha, Louisville, Memphis, and Allentown.