Where to Live

Reviewed by: HU Medical Review Board | Last Reviewed: January 2021. | Last updated: December 2021

If you are considering a move, you might be thinking that it would be nice to leave your asthma behind. Where you choose to live can have a big impact on your asthma symptoms.

What are the best places to live with asthma?

The best places to live with asthma depends on your triggers. There are many potential asthma triggers, including allergens, weather, and pollution. Most likely, not all of them bother you, so focus on the ones that do. You may be tempted to move away from certain triggers. Unfortunately, it is hard to anticipate what new triggers or allergies you may discover at your new home.

In the United States, asthma is more common in the Northeast and Midwest than in the South and West. However, people with asthma who live in the West and South report more asthma attacks than residents of the Midwest and Northeast.1,2

Every year, the Asthma and Allergy Foundation of America (AAFA) compiles a list of “The Most Challenging Places to Live with Asthma.” The list is based on statistics for rates of asthma, emergency room visits, and mortality. The AAFA also considers risk factors such as poverty, air quality, access to specialists, and pollen counts.3,4

The 5 “best” places to live with asthma in 2019 were:3

  • Cape Coral, Florida
  • McAllen, Texas
  • Houston, Texas
  • Sarasota, Florida
  • Daytona Beach, Florida

The 5 “worst” places to live with asthma were:3

  • Springfield, Massachusetts
  • Dayton, Ohio
  • Greensboro, North Carolina
  • Philadelphia, Pennsylvania
  • Cleveland, Ohio

Pollen, mold, and thunderstorms

Pollen or mold allergies often cause sneezing, itchy eyes, and runny nose. If you are allergic to pollen and mold, your asthma and allergy symptoms will get worse during peak pollination times.4,5

The AAFA compiles a list of “The Most Challenging Places to Live with Seasonal Allergies” every year. The ranking is based on pollen counts, use of allergy medicine, and the number of local allergy specialists.4

The 5 “best” places to live with seasonal allergies in 2020 were:4

  • Stockton, California
  • Salt Lake City, Utah
  • Seattle, Washington
  • Provo, Utah
  • Durham, North Carolina

The 5 “worst” places to live with seasonal allergies were:4

  • Richmond, Virginia
  • Scranton, Pennsylvania
  • Springfield, Massachusetts
  • Hartford, Connecticut
  • McAllen, Texas

Asthma “outbreaks” have been linked to thunderstorms, especially during pollen season. The storm’s moving air and rain bring pollen to the ground level and causes it to burst open into small, inhalable particles. This increases the number of people who seek medical care for asthma attacks. These outbreaks are rare but may be something worth considering before moving to subtropical regions.6

Impact of climate change

Climate change can impact asthma. Ozone or particle pollution can cause or aggravate asthma. These pollutant levels can be different depending on where you live. The American Lung Association produces an annual report listing the cities with the most and least ozone and particle pollution. You can also find information about daily pollution levels in your area at Airnow.7,8

Higher temperatures due to climate change can also increase ground-level ozone. Ground-level ozone can be the most harmful ozone for people with asthma. Spikes in ground-level ozone on hot days correspond to increased emergency room visits related to asthma. Warmer summers have also caused flowers to bloom earlier and longer, releasing more pollen. This can aggravate allergies and asthma.7

It may be better to live in a place with less overall air pollution or allergens so that the spikes are not as bad. On warm days, you can also check the air quality index before going outside.


Cold is a common asthma trigger, and symptoms typically start when the temperatures drop to about 36°F. Alaska, the northernmost state, is also the coldest. The 5 coldest continental states are:9,10

  • North Dakota
  • Maine
  • Minnesota
  • Wyoming
  • Montana

Dust mites

Dust mites are hard to avoid. They prefer humid climates and are found in about 80 percent of the United States. You may be able to escape dust mites by moving to the deserts of the Southwest or high-altitude cities.4,11

If moving is not an option, you can take measures to reduce dust mite exposure in your own home. Cover mattresses and pillows in dust mite-proof covers. Wash your bedding in hot water or bleach each week. Remove carpets from bedrooms or vacuum frequently with a HEPA vacuum.12

Smoking laws

If you can, try to live in a city or county with bans on smoking in public places. Studies have shown that people who live in smoke-free counties have less second-hand smoke exposure. They also go to the hospital less often.13,14

If you are not able to move, you can still take steps to control your asthma by paying attention to air quality inside. North Americans spend nearly 90 percent of their time indoors. Taking steps to limit the irritants, allergens, and mold in your home can improve asthma symptoms in any zip code.15

Where is the best place you have lived with asthma? Share in the comments below!

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