Slideshow Pictures: 10 Worst Cities for Asthma, 2011

Did Your City Make the List?

Asthma is a chronic disease of the airways that makes breathing difficult for 1 in 15 Americans. Air pollution, secondhand smoke, and pollen are common triggers of an asthma attack. While there are no asthma-free cities, some are more challenging than others for people living with asthma. The Asthma and Allergy Foundation of America (AAFA) has released their “2011 Asthma Capitals.” Here are the top 10.

No. 10: Nashville, Tenn.

Nashville jumped up 10 spots this year to land on this dubious top 10 list of the worst cities for people with asthma. Twelve factors are used to formulate the list, including air pollution, pollen scores, asthma prevalence, use of "rescue inhalers," and poverty. Nashville fares worse than many other cities in air quality and smoke-free laws -- though its pollen score is better than average.

No. 9: Philadelphia

Philly remains one of the 10 worst asthma cities in the U.S. again this year. It scores worse than many others in air quality and pollen. There's also a high prevalence of asthma and high use of asthma medicine among residents -- though there not enough asthma specialists for all those struggling to breathe.

No. 8: Virginia Beach, Va.

Summer visitors know Virginia Beach for its beautiful, sandy beaches, but residents with asthma know a different side. Air quality, smoke-free laws, and the pollen score are all worse than many other cities. Asthma rates are higher than average here, while the number of medical specialists is too low, according to the AAFA.

No. 7: Augusta, Ga.

Golf lovers see endless rows of blooming flowers during the Master's tournament here each April, yet flowers, grasses, and their pollen are only a minor player in Augusta's asthma ranking. Poverty, poor air quality, high asthma death rates, and incomplete smoke-free laws make this city one of the 10 worst asthma cities again this year, despite its relatively small size.

No. 6: St. Louis

The Gateway Arch is not the only thing in the air in St. Louis. High pollen counts, poor air quality, and the lack of a comprehensive smoking ban in all public places contribute to big asthma issues here, according to the AAFA. St. Louis fares a little better this year, compared to previous rankings as the worst city, and the runner-up worst city for people with asthma.

No. 5: Tulsa, Okla.

Dry, dusty Oklahoma can have a surprising amount of pollen, and that's one reason Tulsa remains in the top 10 worst asthma cities. Residents' use of asthma "quick relief" medicine is higher than average, while the number of asthma specialists is too low, according to the AAFA. And smoke-free laws in Tulsa haven't caught up with many other cities.

No. 4: Chattanooga, Tenn.

A beautiful riverfront park and nearby mountains make this a tourist destination for outdoor enthusiasts, but asthma sufferers might bring along their medicine. Poor air quality and an above-average asthma death rate help keep Chattanooga near the top of the worst asthma cities list. Like many Southern cities, Chattanooga lags behind in implementing smoke-free laws that help clear the air of secondhand smoke in public places.

No. 3: Memphis, Tenn.

This Mississippi river town has many asthma sufferers singing the blues. Memphis moves up to No. 3 this year. Weak public smoking restrictions, poor air quality, and high poverty rates continue to be problematic. While asthma doesn't discriminate based on socio-economic status, people living in poverty often have less access to the health care and medications needed to manage their condition.

No. 2: Knoxville, Tenn.

Knoxville moves up to No. 2 from No. 4 last year. It has ranked in the top 10 worst asthma cities year after year, like other cities in Tennessee and across the South. Knoxville does have a better-than-average number of specialists to treat people with asthma. But the city is still vexed by poor air quality, incomplete smoke-free laws, and above-average use of asthma medications.

No. 1: Richmond, Va.

This historic city on the James River is the AAFA's top "Asthma Capital" for the second year in a row. Richmond earned this unhealthy title with a high pollen score, high poverty rate, and poor air quality. Fourteen of the 25 worst cities this year are in the South, largely because Southern tobacco-producing areas have been slow to adopt smoke-free laws -- and they continue to have frequent ozone days and high overall levels of air pollution.

10 Best Cities for Asthma

This year's best asthma cities tend to have air quality that is much better than average. Here are the best cities for 2011 -- with the No. 1 city shown on the next slide.

10. Omaha, Neb.
9. Sarasota, Fla.
8. Cape Coral, Fla.
7. Austin, Texas
6. Kansas City, Mo.
5. Minneapolis
4. Des Moines, Iowa
3. Colorado Springs, Co.
2. San Francisco

Breathe Better: Portland, Ore.

This Northwest city known for roses, microbreweries, and coffee took top honors in this year's asthma cities ranking. Better-than-average air quality and a low pollen score helped it beat 99 other U.S. cities in the AAFA ranking. While cleaner air helps asthmatics breathe easier, experts say there's really no "best" place to live because each person's triggers are different.

More Reading on Asthma

• Asthma Feature Article
• Asthma FAQs
• Asthma in Children
• Take the Asthma Quiz
• Asthma: An Inflammatory Disorder of the Airways
• Asthma Myths Quiz: Test Your Asthma IQ
• Worst Cities for Asthma, 2009: Did Your City Make the List?