Asthma is an obstructive lung disease identified by narrowing of the airway, inflammation of the airway, and bronchial hyperreactivity. There are many environmental asthma triggers including air pollution, car exhaust, smoking, dust, or changes in weather. Other factors include genetic predisposition, gender, infection, obesity, socioeconomic status, stress, and exercise.
Asthma is common in males under the age of fourteen but more common in female adults. Common asthma symptoms include cough, expiratory wheezing, shortness of breath, and chest tightness. The U.S. states with the highest asthma rates include:

1. Ohio
There are two “asthma belts” in the United States including the Ohio Valley and the Northeast Mid-Atlantic U.S. region. There are five cities that rank in the top twenty most difficult areas to live in the United States with asthma. The five cities include Cincinnati, Columbus, Akron, Cleveland, and Dayton. These cities are known for their environmental asthma triggers including poor air quality and high pollen counts. The high poverty levels are a major factor as well. These cities also have a large volume of ER visits related to asthma and high usage of asthma medications compared to other U.S. cities.

2. Kentucky
Louisville is part of the “asthma belt” and has among the worst in the United States for air quality. Louisville is also known for high pollen counts and high rates of obesity as well. All of these contribute to Louisville having the second highest asthma prevalence in the United States.

3. Michigan
Detroit is known for high rates of asthma in its population and high death rates due to asthma. It ranks in the top ten in U.S. cities with asthma related deaths. The high poverty rates contribute to Detroit’s asthma challenges as well as its high rates of obesity.

4. Massachusetts
The United States’ second “asthma belt” encompasses cities including Boston and Springfield Massachusetts. It also runs through Philadelphia, Allentown, and Richmond. Springfield has been ranked as the worst city to live with asthma in the United States. They have the second largest amount of emergency department visits for asthma in the U.S. Boston has a significant number of asthma-related deaths compared to other cities in the U.S. Both Springfield and Boston have high overall rates of asthma overall.

5. Virginia
Richmond, Virginia, as part of the “asthma belt,” has a very high poverty rate contributing to lack of resources for asthma related care and medication. Because of this, they are known for a large number of deaths due to asthma.

6. Pennsylvania
Allentown and Philadelphia are some of Pennsylvania’s worst cities for asthma. There are few smoking laws in Allentown and significant rates of poverty in Philadelphia. One of the poorest cities in the U.S. is Philadelphia. High ozone and high particle pollution contribute to Philadelphia’s asthma problem as well.

Over 8% of the population, or more than 25 million Americans, live with asthma. It is in the top five leading causes of hospitalization in kids under the age of fifteen. The severe health consequences and large financial burden are significant reasons to better control asthma. Since there is no cure to asthma, the best solution is prevention by avoiding environmental triggers.