Richmond, Virginia has been selected as 2013’s most challenging place to live for people with asthma in the United States.
In May, the Asthma and Allergy Foundation of America (AAFA) released its annual Asthma Capitals list – which ranks the 100 largest U.S. cities by how problematic they are for people living with asthma.
Richmond ranked at No. 1, shooting up from spot No. 23 last year. Chattanooga came in second, worsening from last year’s fifth place position. Memphis, last year’s most challenging city in the U.S. to live with asthma, marginally improved, dropping to the third spot.
Tennessee was the only state to have three cities within the top 10, including two out of the top three, suggesting the state has much room for improvement for those living with asthma.
For two years running, San Francisco was ranked at No. 100, meaning it remains the least problematic of the 100 largest metro areas in the U.S. for people living with asthma.
In order to determine the ranking of the cities, 14 factors were examined. These included asthma prevalence, asthma death rate, pollen and air quality scores, ER visits for asthma, number of asthma specialists, and asthma medicine use.
Here are Top 10 2013 Asthma Capitals:
1. Richmond, VA
2. Chattanooga, TN
3. Memphis, TN
4. Philadelphia, PA
5. Oklahoma City, OK
6. Detroit, MI
7. Dayton, OH
8. McAllen, TX
9. Atlanta, GA
10. Knoxville, TN
Not surprisingly, there was some overlap between this list and the AAFA’s Spring Allergy Capitals  list released in April. All but four of the top 10 asthma capitals were also found in the top 10 spring allergy capitals list. Chattanooga ranked in the top 3 for each list, suggesting it may be a very difficult place to live for people with asthma, environmental allergies, or other respiratory issues.