Asthma is a chronic, inflammatory disease of the airways, it results in inflammation that leads to  narrowing of the bronchial tubes, excess mucus, coughing, wheezing, and breathing difficulties, or what’s known as an asthma attack.  There are different triggers that set off an asthma attack. Some triggers are food, exercise, or cold weather. However, the leading cause of asthma is environmental factors, such as outdoor and indoor pollution from the air, pet dander, mold spores, exhaust from cars, and pollen.

Below you will find a list of American cities with the highest asthma rates:

1. Springfield, MA
Springfield, Massachusetts is described as the number one ranked place to avoid living if you are asthmatic. Springfield has the highest asthma-related emergency room visits in the United States and the highest asthma prevalence. The main trigger for people with asthma in Springfield is its high pollen counts. According to state Councilor, Jesse Lederman, Springfield’s rank is high because residents do not have access to long term and short-term health care. Also, there is an issue with poverty, with residents not being able to afford healthcare. Another issue is that most of the housing there needs repairing and therefore become a health hazard. Springfield and the surrounding areas have some of the oldest housing stocks, which allows conditions favorable for asthma.

2. Dayton, OH
Asthma is a prevalent issue in Dayton, Ohio. Because of its location in Dayton within the Ohio valley, persons who live there are at a higher risk because in the springtime, especially there is a lot of concentrated pollen, and they can go into people’s lungs and cause an infection. Since Dayton’s location is in the valley; therefore, airflow and weather are a significant issue. Dayton will continue to have high temperatures, therefore increasing asthmatic triggers.

3. Greensboro, NC
Greensboro has major housing issues causing visits to the emergency room to be very high. Issues such as molds, cockroaches, and rat infestation have been a trigger for most persons living there. Also, low-income families are living in Greensboro, which means that being able to afford healthcare is a problem. Because many homes are in disrepair, there is plumbing, exhaust from vehicles, poor ventilation, and an overall dirty environment; these causes trigger asthmatic persons. Research done showed that most cases of asthma in Greensboro are associated with poorer, minority populations.

4. Philadelphia, PA
Another American city to avoid living in if you suffer from asthma is Philadelphia, according to a report the Asthma and Allergy Foundation of America (AAFA). Significant contributing factors to asthma in Philly are poor environmental conditions such as inferior air quality, high amounts of hospital visits for asthma-related symptoms, and high death rates due to asthma related illnesses.

5. Cleveland, OH
Cleveland ranks as the fifth most challenging city to live in if you have asthma. The city has a high number of emergency room visits due to asthma attacks. One reason is that healthcare workers are in demand in this city. Patients at most risk are those who live in urban areas because there are many pollution triggers, including high exhaust from vehicles. Research conducted shows that traffic pollution in Cleveland is a major trigger for those who are asthmatic. About 31% of asthma cases in Cleveland are because of traffic pollution.