Cities with the most asthma cases

Photo Credit: Alamy Stock Photo

By David Heacock

In less than one year, more than 11 million Americans have been diagnosed with COVID-19. As winter months approach and case numbers continue to surge, over 200,000 people have died. While there is still much to learn about the disease, we do know that it can affect the nose, throat, and lungs. In fact, according to the American Lung Association, the lungs are the first organs impacted, as the virus can cause a cough and difficulty breathing. As such, various pre-existing respiratory conditions may increase the risk of developing severe illness from COVID-19, including pulmonary fibrosis and asthma.

According to the CDC, almost 10 percent of American adults have asthma, a respiratory condition marked by spasms in the bronchi of the lungs, often causing difficulty in breathing. Prior to the pandemic, the percentage of adults with asthma in the U.S. had been rising steadily for years, peaking at 9.7 percent in 2019.

The coronavirus has not been the only major cause for concern for those with asthma in 2020. Residents of Western states such as California and Oregon, as well as many in Colorado, have dealt with record-breaking fires for much of the year while fire season continues to rage on. Smoke from wildfires can make breathing more difficult for those with asthma. For the same reason, smoking cigarettes is discouraged for those with asthma, yet—somewhat surprisingly—a higher rate of American adults afflicted with asthma smoke than those who do not have asthma. Tobacco smoke, including secondhand smoke, is especially unhealthy for people with asthma, as asthma attacks are triggered when airways become irritated.

Looking at overall health, recent CDC data shows that locations with higher percentages of adults with asthma report higher rates of poor physical health in adults. In fact, obesity is associated significantly with the development of asthma. Not surprisingly, locations throughout the U.S. with higher percentages of adults with asthma also have higher obesity rates.

Some populations are more susceptible to developing asthma than others. On a national level, impoverished Americans—those whose family income is below the poverty threshold—are nearly twice as likely to have asthma as those whose family income is 200 percent of the poverty threshold or greater. Furthermore, a study conducted by UCLA found that low-income families suffer more extreme consequences from having asthma, citing strained access to quality health care and the proximity to high-risk environments.

The prevalence of asthma in adults ranges significantly by location as well, with some cities experiencing reports of asthma at a rate two times higher than others. For example, 14.3 percent of adults surveyed in Detroit report having asthma compared to just 7.0 percent and 7.2 percent in California’s Sunnyvale and Fremont, respectively. At the regional level, residents of Northeastern and Midwestern states such as Michigan and Ohio report the highest rates of asthma, while those in Southern states tend to experience lower rates.

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To determine the cities with the most asthma cases, researchers at Filterbuy analyzed the most recent data from the CDC’s 500 Cities survey. Cities were ranked according to the percentage of adults who reported having asthma. The report also includes the percentage of adults who reported being smokers, who are in poor physical health, and who are obese, in addition to the poverty rate of each location.

To improve relevance, only cities with at least 100,000 residents were included in the analysis. Additionally, separate rankings were generated for small (100,000–149,999 residents), midsize (150,000–349,999 residents), and large cities (350,000 residents or more).

Here are the cities with the highest percentage of adults with asthma.

Cities with the highest percentage of adults with asthma

1. Photo Credit: Alamy Stock Photo

   Sacramento, CA

   • Percentage of adults with asthma: 10.3%
   • Percentage of adults who smoke: 15.0%
   • Percentage of adults in poor physical health: 12.6%
   • Obesity rate: 30.2%
   • Poverty rate: 13.9%

2. Photo Credit: Alamy Stock Photo

   Nashville, TN

   • Percentage of adults with asthma: 10.3%
   • Percentage of adults who smoke: 20.0%
   • Percentage of adults in poor physical health: 12.5%
   • Obesity rate: 31.1%
   • Poverty rate: 12.6%

3. Photo Credit: Alamy Stock Photo

   Tulsa, OK

   • Percentage of adults with asthma: 10.5%
   • Percentage of adults who smoke: 20.6%
   • Percentage of adults in poor physical health: 14.2%
   • Obesity rate: 36.1%
   • Poverty rate: 18.6%

4. Photo Credit: Alamy Stock Photo

   Oklahoma City, OK

   • Percentage of adults with asthma: 10.5%
   • Percentage of adults who smoke: 20.0%
   • Percentage of adults in poor physical health: 14.4%
   • Obesity rate: 34.2%
   • Poverty rate: 15.8%

5. Photo Credit: Alamy Stock Photo

   Phoenix, AZ

   • Percentage of adults with asthma: 10.6%
   • Percentage of adults who smoke: 18.3%
   • Percentage of adults in poor physical health: 13.3%
   • Obesity rate: 31.1%
   • Poverty rate: 15.6%

6. Photo Credit: Alamy Stock Photo

   Mesa, AZ

   • Percentage of adults with asthma: 10.6%
   • Percentage of adults who smoke: 17.3%
   • Percentage of adults in poor physical health: 12.9%
   • Obesity rate: 29.2%
   • Poverty rate: 11.6%

7. Photo Credit: Alamy Stock Photo

   Louisville, KY

   • Percentage of adults with asthma: 10.8%
   • Percentage of adults who smoke: 23.2%
   • Percentage of adults in poor physical health: 15.5%
   • Obesity rate: 34.5%
   • Poverty rate: 15.4%

8. Photo Credit: Alamy Stock Photo

   Boston, MA

   • Percentage of adults with asthma: 11.1%
   • Percentage of adults who smoke: 16.4%
   • Percentage of adults in poor physical health: 10.8%
   • Obesity rate: 24.6%
   • Poverty rate: 17.1%

9. Photo Credit: Alamy Stock Photo

   Memphis, TN

   • Percentage of adults with asthma: 11.2%
   • Percentage of adults who smoke: 24.7%
   • Percentage of adults in poor physical health: 15.9%
   • Obesity rate: 38.4%
   • Poverty rate: 21.7%

10. Photo Credit: Alamy Stock Photo

    Indianapolis, IN

    • Percentage of adults with asthma: 11.3%
    • Percentage of adults who smoke: 22.1%
    • Percentage of adults in poor physical health: 13.7%
    • Obesity rate: 35.4%
    • Poverty rate: 15.8%

11. Photo Credit: Alamy Stock Photo

    Baltimore, MD

    • Percentage of adults with asthma: 11.3%
    • Percentage of adults who smoke: 21.8%
    • Percentage of adults in poor physical health: 13.0%
    • Obesity rate: 38.7%
    • Poverty rate: 20.2%

12. Photo Credit: Alamy Stock Photo

    Milwaukee, WI

    • Percentage of adults with asthma: 11.4%
    • Percentage of adults who smoke: 22.4%
    • Percentage of adults in poor physical health: 13.7%
    • Obesity rate: 35.0%
    • Poverty rate: 22.4%

13. Photo Credit: Alamy Stock Photo

    Philadelphia, PA

    • Percentage of adults with asthma: 11.5%
    • Percentage of adults who smoke: 23.8%
    • Percentage of adults in poor physical health: 14.9%
    • Obesity rate: 33.0%
    • Poverty rate: 23.3%

14. Photo Credit: Alamy Stock Photo

    Cleveland, OH

    • Percentage of adults with asthma: 11.8%
    • Percentage of adults who smoke: 28.4%
    • Percentage of adults in poor physical health: 18.7%
    • Obesity rate: 41.0%
    • Poverty rate: 30.8%

15. Photo Credit: Alamy Stock Photo

    Detroit, MI

    • Percentage of adults with asthma: 14.3%
    • Percentage of adults who smoke: 28.9%
    • Percentage of adults in poor physical health: 19.4%
    • Obesity rate: 44.5%
    • Poverty rate: 30.6%

Methodology & detailed findings

Researchers used the most recent health data from the CDC’s 500 Cities survey to calculate which cities have the most adults with asthma in the United States. National and state-level health data came from the CDC’s 2019 Behavioral Risk Factor Surveillance System (BRFSS) survey. The percentages of adults with asthma, who smoke, who are in poor physical health, and who are obese, were determined based on responses to questions in the BRFSS survey. Poverty rates for each location came from the U.S. Census Bureau’s 2019 American Community Survey. Only cities with at least 100,000 residents were included in the report. Cities were also grouped into the following cohorts based on population:

• Small cities: 100,000–149,999 residents
• Midsize cities: 150,000–349,999 residents
• Large cities: 350,000 residents or more