Asthma attacks have been triggered by everything from exercise to respiratory infections and exposure to pollen and tobacco smoke. Numerous studies have demonstrated that there is a clear link between environmental factors such as air pollution and asthma. In fact, places that experience high air pollution have high emergency room visits. In this list we take a look at some of the worst cities in the country for asthma patients:

1. Dayton, OH
From a historical perspective, rates have always been high in the State of Ohio, Dayton. Studies have suggested that within the state of Ohio, Dayton appears to be the worst place which experiences more ER visits than any other city in the state. Experts have highlighted the fact that Dayton scored “worse than average” in several categories such as pollen count, poverty rate and emergency room visits. In addition to that, the city was also ranked as being ‘below average’ for air quality, crude death rate for the condition, the number of experts and uninsured rate. Interestingly enough, the city was also ranked ‘better than average’ when it comes to inhaler access and public smoke laws. This indicates that other environmental factors are in play such as poor air quality and high pollen count.

2. Springfield, MA
Springfield is regarded as being the worst city to go to if you have this condition. The reason why it has been deemed the single worst city for sufferers, stem from the fact that it lies within a valley that traps a vast amount of carbon dioxide. The city also has a high pollen count, which is tied to three surrounding cities. Meaning, people in Springfield are essentially trapped in a bubble of high pollen count. The situation is so dire that the city records the highest number of hospital visits in the country. As such, the AAFA has given it the number one position for being the worst city for patients.

3. Philadelphia, PA
Philadelphia is one of the poorest cities in the United States. In impoverished areas, people tend to live close together in large complexes. Impoverished areas also have a lack of adequate health care facilities. These are contributing factors that can increase the chances of getting an attack. In addition to that, the city has high levels of air particle pollution and ozone levels.

4. Cleveland, OH
According to the AAFA, Cleveland, Ohio, has the fifth highest use of medicines known as rescue drugs. This is the medicine that sufferers take when they are in the midst of an attack. The city has very poor air quality and a high poverty rate of over 10%. Experts proclaim that these two factors affect the number of emergency room visits the city experiences on a yearly basis.

5. Greensboro, NC
As mentioned before, impoverished communities face obstacles that privileged communities do not, such as access to health care. As a result of these facts, rates tend to be the highest in poor communities. Greensboro is one of the most impoverished cities of North Carolina. Interestingly enough, while the air quality is regarded as being average in this city, almost every other factor is a concern for patients. For instance, the recurrence rate is high, the death rate is high, the number of experts they have is low and the pollen count, like the poverty rate, is significantly high.