2025 asthma capitals: The most challenging places to live with asthma

Asthma remains one of the most common chronic diseases in the United States, affecting more than 28 million people. While many people manage their asthma successfully, others face ongoing challenges that can disrupt daily life, limit opportunities, and increase the risk of health complications. Where a person lives plays a significant role in shaping asthma outcomes.
AAFA’s Asthma Capitals report ranks 100 cities in the contiguous U.S. based on three outcomes factors: asthma prevalence, emergency department (ED) visits for asthma, and deaths due to asthma. The report also discusses risk factors that contribute to these outcomes: poverty, indoor and outdoor air quality, access to specialist medical care, pollen allergy, medicine use, tobacco policies, and the rate of uninsured residents. Together, these factors help explain why some communities experience higher levels of asthma burden than others.
The data in this report includes the 100 most populated U.S. cities (metro areas), and does not include information from Alaska, Hawaii, Puerto Rico, or tribal nations. The residents of these areas are greatly affected by asthma, but more data is needed to get a better picture of the impact.
This year’s findings highlight the ongoing influence of environmental and social conditions—from longer pollen seasons to barriers in health care access—that affect how well people are able to manage their asthma.
We hope this report serves as a resource for action. Community leaders and advocates can draw on the data to raise awareness, mobilize support, and press for local solutions. Policymakers can use it to guide investments in healthier housing, cleaner air, and health care access. Health care providers and public health agencies can apply the insights to strengthen education, prevention, and management programs. 
By identifying areas of highest burden and pointing to contributing factors, the Asthma Capitals report aims to inform solutions that improve outcomes and support healthier, more equitable environments for people living with asthma. (author introduction)