[\/et_pb_text][et_pb_text admin_label=” Intro Content” module_class=”secondary-intro” _builder_version=”4.27.6″ _module_preset=”default” text_text_color=”#505050″ text_font_size=”24px” text_line_height=”1.5em” header_2_font=”|600|||||||” header_2_text_color=”#008c99″ header_2_font_size=”39px” custom_margin=”||3%||false|false” global_colors_info=”{}”]<\/p>\n
A risk factor is any attribute, characteristic, or exposure of an individual that increases the likelihood of developing or worsening a disease like asthma.<\/p>\n
While AAFA’s Asthma Capitals report<\/a> does not include risk factor data in the calculation of the overall ranking, the report does provide data on various top risk factors as they contribute to rates of asthma prevalence, emergency department (ED) visits, and deaths.<\/p>\n [\/et_pb_text][et_pb_text admin_label=”Intro Content Top Risk Factors” module_class=”secondary-intro” _builder_version=”4.27.6″ _module_preset=”default” text_text_color=”#505050″ text_line_height=”1.5em” header_2_font=”|600|||||||” header_2_text_color=”#008c99″ header_2_font_size=”39px” custom_margin=”||3%||false|false” locked=”off” global_colors_info=”{}”]<\/p>\n The report includes data and information on these top risk factors<\/a> for asthma that contribute to increased asthma prevalence, emergencies, and death:<\/strong><\/p>\n Other risk factors that can influence poor asthma outcomes include:<\/strong><\/p>\n The data for these risk factors are not included in AAFA’s Asthma Capitals report, but can have a profound impact on asthma control.<\/p>\n [\/et_pb_text][et_pb_accordion open_toggle_text_color=”#FFFFFF” open_toggle_background_color=”#f0f0f0″ closed_toggle_text_color=”#FFFFFF” closed_toggle_background_color=”#f0f0f0″ toggle_icon=”L||divi||400″ icon_color=”#FFFFFF” use_icon_font_size=”on” icon_font_size=”20px” admin_label=”Accordion” module_id=”accordions” module_class=”accord pa-accordion” _builder_version=”4.27.6″ _module_preset=”default” toggle_text_color=”#FFFFFF” toggle_font=”|600|||||||” toggle_font_size=”22px” closed_toggle_font=”|600|||||||” closed_toggle_font_size=”22px” body_font=”||||||||” body_text_color=”#505050″ body_line_height=”1.5em” body_link_font=”||||on|||#008C99|” text_orientation=”left” height_tablet=”” height_phone=”” height_last_edited=”on|desktop” custom_margin=”||2%||false|false” custom_css_free_form=”.et_pb_toggle_title:before {|| font-size: 22px;|| position: absolute;|| color: #FFFFFF;|| font-family: ETmodules !important;|| font-weight: 400 !important;|| content: %22%924c%22 !important;|| right: 2% !important;|| display: inline-block !important;||}||.et_pb_toggle_content {|| font-size: 20px !important;||font-weight: 400 !important}||||table, th, td {|| border: none !important;|| border-collapse: collapse;||}” border_width_all=”0px” saved_tabs=”all” locked=”off” global_colors_info=”{}”][et_pb_accordion_item title=”Closed” open=”on” _builder_version=”4.18.0″ _module_preset=”default” global_colors_info=”{}”][\/et_pb_accordion_item][et_pb_accordion_item title=”Poverty \/ Income Level” open_toggle_background_color=”#FFFFFF” toggle_icon=”L||divi||400″ _builder_version=”4.27.6″ _module_preset=”default” body_text_color=”#505050″ body_line_height=”1.5em” global_colors_info=”{}” toggle_level=”h5″ toggle_font=”|600|||||||” toggle_font_size=”22px” open=”off”]<\/p>\n Numerous studies have explored and confirmed the link between poverty and poor asthma outcomes. For example, living in poverty directly affects:<\/p>\n Many cities in our report have poverty as a top risk factor. Good asthma management can be difficult when families are worried about paying for housing, clothing, utilities, and food. The cost of care may affect the decision to seek medical care. A lack of reliable transportation and paid sick leave may influence a person\u2019s ability to attend regular health care appointments.<\/p>\n These cities have the highest rates of poverty\u2020<\/sup>:<\/strong><\/p>\n\n
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![\"Asthma](\"https:\/\/aafa.org\/wp-content\/uploads\/2025\/07\/poverty-risk-factors.png\")
Socioeconomic status plays a major role in the development of asthma and a person\u2019s ability to manage it. People living below 100% of the Federal Poverty Level (FPL) are more likely to have asthma than people living at any percentage above the poverty level.1<\/sup><\/p>\n\n
![\"Asthma](\"https:\/\/aafa.org\/wp-content\/uploads\/2025\/07\/health-insurance-risk-factors.png\")
Insurance status is one of the strongest predictors of consistent access to asthma care. Asthma medications can be expensive, particularly newer, targeted options. People with asthma may choose to ration their inhalers, delay refills, or skip doses to save money. In some cases, families must choose between asthma medicine and other household expenses. These financial pressures lead to worse control, higher risks of asthma attacks, and greater reliance on emergency care. Racial and ethnic minority populations disproportionately experience barriers to health insurance, contributing to disparities in health care.<\/p>\n![\"Asthma](\"https:\/\/aafa.org\/wp-content\/uploads\/2025\/07\/specialist-access-risk-factors.png\")
Effective asthma management begins with access to the right providers. Many people with asthma rely on primary care providers, who diagnose the condition, prescribe medicines, and offer follow-up management. But for many people \u2013 especially those with severe or uncontrolled asthma \u2013 specialist care can make a significant difference. Allergists and pulmonologists can provide advanced diagnostic testing, offer advanced therapies, and create individualized management plans.<\/p>\n![\"Find](\"https:\/\/acaai.org\/wp-content\/uploads\/2021\/08\/Artboard_new.svg\")
![\"Asthma](\"https:\/\/aafa.org\/wp-content\/uploads\/2026\/08\/resp-infection-risk-factors.png\")
Respiratory infections (also called respiratory illnesses) are caused by viruses or bacteria that make you sick. Respiratory infections are a significant asthma trigger, and lead to more asthma flare-ups, ED visits, hospital stays, and deaths. Vaccines can help protect against some respiratory infections and reduce the risk of serious illness and death. They also can help stop the spread of respiratory infections to others. Seasonal vaccines, like those for flu and COVID-19, are available each year to help protect against the most current strains of these illnesses.<\/p>\n![\"Asthma](\"https:\/\/aafa.org\/wp-content\/uploads\/2025\/07\/air-quality-risk-factors.png\")
Poor air quality can negatively affect everyone\u2019s health. The people at highest risk from exposure are children, older adults, people with lung or heart disease, are pregnant, have lower incomes, or who live or work outside. Outdoor air pollution is a significant asthma trigger. It\u00a0 causes increased rates of ED visits, hospital admissions, and missed school days related to asthma. Air pollution includes gases, smoke from fires, volcanic ash, dust particles, emissions from transportation, and other substances that can harm the lungs.<\/p>\n![\"Asthma](\"https:\/\/aafa.org\/wp-content\/uploads\/2025\/07\/tobacco-policies-risk-factors.png\")
Tobacco smoke and e-cigarette aerosol can be especially harmful to people who have asthma.<\/p>\n![\"Asthma](\"https:\/\/aafa.org\/wp-content\/uploads\/2025\/07\/pollen-allergy-risk-factors.png\")
Pollen is a common allergen that can worsen allergic asthma (asthma triggered by allergens). In the U.S., about 25 out of 100 adults and 21 out of 100 children have seasonal allergies such as pollen allergy.9,10<\/sup><\/p>\n![Download image of Figure 1 table <\/a><\/p>\n*Four of the cities with the top poverty rates also have the top asthma death rates.<\/strong><\/p>\n <\/p>\nThese cities have the highest number of uninsured residents\u2020<\/sup>:<\/strong><\/p>\n\n\n\n2026 Lack of Insurance Ranking<\/strong><\/td>\nMetropolitan Area<\/strong><\/td>\n2026 Asthma Capital Ranking Overall<\/strong><\/td>\n<\/tr>\n\n1<\/td>\nMcAllen, TX<\/td>\n79<\/td>\n<\/tr>\n\n2<\/td>\nEl Paso, TX<\/td>\n70<\/td>\n<\/tr>\n\n3<\/td>\nDallas, TX<\/td>\n18<\/td>\n<\/tr>\n\n4<\/td>\nHouston, TX<\/td>\n95<\/td>\n<\/tr>\n\n4<\/td>\nSan Antonio, TX<\/td>\n74<\/td>\n<\/tr>\n\n6<\/td>\nCape Coral, FL<\/td>\n98<\/td>\n<\/tr>\n\n7<\/td>\nOklahoma City, OK<\/td>\n40<\/td>\n<\/tr>\n\n8<\/td>\nMiami, FL<\/td>\n39<\/td>\n<\/tr>\n\n9<\/td>\nLakeland, FL<\/td>\n6<\/td>\n<\/tr>\n\n10<\/td>\nTulsa, OK<\/td>\n62<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\u2020 For each city included in the 2026 Asthma Capitals, AAFA obtained the uninsured rate for its respective county. The estimates range from 3.2% to 27.5%.\u00a0Download image of Figure 2 table<\/a><\/p>\n <\/p>\nThese cities have the fewest asthma specialists per asthma patient\u2020<\/sup>:<\/strong><\/p>\n\n\n\n2026 Fewest Specialists Ranking<\/strong><\/td>\nMetropolitan Area<\/strong><\/td>\n2026 Asthma Capital Ranking Overall<\/strong><\/td>\n<\/tr>\n\n1<\/td>\nFresno, CA<\/td>\n12<\/td>\n<\/tr>\n\n2<\/td>\nPoughkeepsie, NY<\/td>\n22<\/td>\n<\/tr>\n\n3<\/td>\nLakeland, FL<\/td>\n6<\/td>\n<\/tr>\n\n4<\/td>\nBakersfield, CA<\/td>\n72<\/td>\n<\/tr>\n\n4<\/td>\nProvo, UT<\/td>\n100<\/td>\n<\/tr>\n\n6<\/td>\nPalm Bay, FL<\/td>\n64<\/td>\n<\/tr>\n\n7<\/td>\nRiverside, CA<\/td>\n49<\/td>\n<\/tr>\n\n8<\/td>\nSpokane, WA<\/td>\n14<\/td>\n<\/tr>\n\n9<\/td>\nOgden, UT<\/td>\n80<\/td>\n<\/tr>\n\n10<\/td>\nSacramento, CA<\/td>\n10<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\u2020 For each city included in the 2026 Asthma Capitals, AAFA obtained data on specialists per 10,000 asthma patients.\u00a0Download image of Figure 3 table<\/a><\/p>\n <\/p>\nThese\u00a0cities all received an F rating from the American Lung Association\u2019s 2026 State of the Air Report for high ozone days and particle pollution\u2020<\/sup>:<\/strong><\/p>\n\n\n\nMetropolitan Area<\/strong><\/td>\n](\"https:\/\/aafa.org\/wp-content\/uploads\/2026\/08\/asthma-capitals-poverty-risk-factor.jpg\"){kind=link}
![Download image of Figure 2 table<\/a><\/p>\n <\/p>\nThese cities have the fewest asthma specialists per asthma patient\u2020<\/sup>:<\/strong><\/p>\n\n\n\n2026 Fewest Specialists Ranking<\/strong><\/td>\nMetropolitan Area<\/strong><\/td>\n2026 Asthma Capital Ranking Overall<\/strong><\/td>\n<\/tr>\n\n1<\/td>\nFresno, CA<\/td>\n12<\/td>\n<\/tr>\n\n2<\/td>\nPoughkeepsie, NY<\/td>\n22<\/td>\n<\/tr>\n\n3<\/td>\nLakeland, FL<\/td>\n6<\/td>\n<\/tr>\n\n4<\/td>\nBakersfield, CA<\/td>\n72<\/td>\n<\/tr>\n\n4<\/td>\nProvo, UT<\/td>\n100<\/td>\n<\/tr>\n\n6<\/td>\nPalm Bay, FL<\/td>\n64<\/td>\n<\/tr>\n\n7<\/td>\nRiverside, CA<\/td>\n49<\/td>\n<\/tr>\n\n8<\/td>\nSpokane, WA<\/td>\n14<\/td>\n<\/tr>\n\n9<\/td>\nOgden, UT<\/td>\n80<\/td>\n<\/tr>\n\n10<\/td>\nSacramento, CA<\/td>\n10<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\u2020 For each city included in the 2026 Asthma Capitals, AAFA obtained data on specialists per 10,000 asthma patients.\u00a0Download image of Figure 3 table<\/a><\/p>\n <\/p>\nThese\u00a0cities all received an F rating from the American Lung Association\u2019s 2026 State of the Air Report for high ozone days and particle pollution\u2020<\/sup>:<\/strong><\/p>\n\n\n\nMetropolitan Area<\/strong><\/td>\n](\"https:\/\/aafa.org\/wp-content\/uploads\/2026\/08\/asthma-capitals-uninsured-risk-factor.jpg\"){kind=link}
![Download image of Figure 3 table<\/a><\/p>\n <\/p>\nThese\u00a0cities all received an F rating from the American Lung Association\u2019s 2026 State of the Air Report for high ozone days and particle pollution\u2020<\/sup>:<\/strong><\/p>\n\n\n\nMetropolitan Area<\/strong><\/td>\n](\"https:\/\/aafa.org\/wp-content\/uploads\/2026\/08\/asthma-capitals-lack-of-specialists-risk-factor.jpg\"){kind=link}