Slideshow: 10 Worst Cities for Asthma, 2009

Did Your City Make the List?

Asthma is a chronic disease of the airways that makes breathing difficult. Many things in the environment can trigger an attack, including air pollution, secondhand smoke, and pollen. Asthma affects one in 5 Americans and is on the rise. 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), a nonprofit patient organization, has released their "2009 Asthma Capitals." Here are the top 10.

No. 10: Little Rock, Ark.

While this capital city may feature scenic parks and river walks, there's nothing pretty about the asthma picture here. It comes in at No. 10 on the list of "worst" asthma cities. Twelve factors were used to formulate the list, including asthma prevalence, pollen scores, air quality, poverty levels, and asthma death rates. "Each factor is given a weighted value by medical and research experts according to its effect on 'quality of life' for asthma patients," says the AAFA.

No. 9: Atlanta

Southern hospitality? While Atlanta wasn't so hospitable for asthma sufferers this past year, things are continuing to improve. Atlanta edged its way down the list again this year, from its No. 1 spot in 2007 and its No. 4 spot in 2008.

No. 8: McAllen, Texas

If "everything is big in Texas" then McAllen's asthma problems are no exception. A worse than average pollen score, poverty rate, and a lack of "100% public smoke-free laws" contribute to its ranking as one of the worst cities for asthma in the U.S. It jumped to No. 8, from No. 28 in 2008.

No. 6: Memphis, Tenn.

This Mississippi river town has many asthma sufferers singing the blues. While Memphis skyrocketed from the No. 30 spot in 2007 to No. 5 in 2008, they fell one spot to No. 6 this year. Public smoking policies, 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 health care and medications needed to manage their condition.

No. 5: Charlotte, N.C.

The population isn't the only thing on the rise in the Queen City. Its ranking on the "Asthma Capitals" list is, too. It's up from No. 7 in 2008. High pollen counts, poor air quality, and public smoking policies are among the reasons they make the top 5.

No. 4: Chattanooga, Tenn.

This town may be a mecca for outdoor enthusiasts, but it's not so amiable for asthma suffers. Poor air quality and above average use of controller medications helped propel Chattanooga from the No. 16 spot in 2008 to its current ranking at No. 4.

No. 3: Birmingham, Ala.

Birmingham's poor air quality, its public smoking policies, and heavy use of controller medications by asthma suffers contribute to its ranking as one of the worst cities for asthma in the U.S. It jumped to No. 3, from No. 13 in 2008.

No. 2: Milwaukee, Wis.

Asthma problems are brewing in this Lake Michigan city. Milwaukee bubbled up from the No. 3 spot in 2008 to second place this year. The town gets low marks for air quality and is worse than the national average for its high use of "rescue" asthma medications. The lack of a smoking ban in all public places and a high poverty rate also contribute.

No. 1: St. Louis, Mo.

The Gateway Arch is not the only thing in the air in St. Louis. High pollen counts, poor air quality, the lack of a smoking ban in all public places, and above average use of asthma medications contribute to big asthma issues -- and its ranking as the worst city for asthma suffers in America, according to the AAFA. That's a leap from the No. 9 spot it held in 2008.