Environmental asthma is asthma that is triggered by many factors of the environment. Many of the factors can not be changed by the individual living with asthma. Some of the common triggers of environmental asthma include: air pollution, chemical fumes, car exhausts, dust mites, mold, tobacco smoke, etc. All of these common triggers and more exacerbate the symptoms of asthma, and worsen it.

There are many cities in the world that make living with asthma even more of a challenge than it already is. Here are the 5 worst cities to live in with asthma, in order:

1. Springfield, MA
This city has been ranked at the top of the worst cities to live in with asthma list, for a number of years. A few factors play into this city remaining at the top of this list. Poor air quality caused by high levels of carbon dioxide, and high pollen count make up a few of those factors. This city has a high number of ER visits from individuals coming in for asthma related care, which isn’t surprising because the city has a high number of asthma cases in general.

2. Dayton, OH
In terms of asthma related ER visits, this city has the highest in number of cases. Like the city before, asthma is very prevalent in Dayton, Ohio. Unfortunately, so is poverty. Given how common asthma is in this city, the ER visit rates, and the high level of poverty, this city has a high rate of using medication to quickly resolve and control asthma.

3. Greensboro,NC
The state of North Carolina in general is known to be on a low scale in terms of air quality, and pollen is very prevalent there. The city of Greensboro has communities of individuals who are not properly insured, or able to afford treatment for their asthma. The city also lacks connection to specialists trained in this department. Because of these factors, the rates for ER asthma visits go up, and the number of individuals with uncontrolled asthma rises.

4. Philadelphia, PA
With this city being known to have a very high rate of poverty, it is unfortunate to note that asthma is also prevalent in this city. With the high poverty level, many individuals in this city don’t have access to adequate healthcare. So naturally, the rate of ER visits for asthma care in this city is also high. The city’s air pollution and increased ozone levels also don’t help with the rise of asthma in this city.

5. Cleveland, OH
This city has more of a city like environment, which contributes to the poor air quality. Factors like diesel particles affect their air. This city is another city known to use quick medicine to treat asthma quickly, which isn’t surprising because their ER rate of asthma related care is also quite high. With a 10% poverty rate, some individuals in this city can’t afford other care.

While there are many cities with known factors that contribute to poor air quality and other factors, these are the top 5 worst cities for asthma. From poverty, to lack of adequate healthcare and insurance, to lack of connections with specialists, these cities make it even more challenging to live with this condition that is already challenging enough.