Asthma "Hot Spots" 2004

2004: America's Asthma 'Hot Spots' Identified

The U.S. Asthma Capitals™ rankings are identified each year by the Asthma and Allergy Foundation of America as part of our ongoing public awareness campaign about asthma. These rankings indicate the worst cities in America for people with asthma, based on 15 individual factors measured and compared each year, including:

Prevalence Factors, such as asthma morbidity and mortality;

Risk Factors, such as air quality, smoking laws and inhaler access laws; and,

Medical Factors: such as number of prescriptions and asthma specialists per capita.

From Knoxville to San Francisco, asthma has a significant impact on every major city in the United States, yet most people are not aware of the most common form of asthma – allergic asthma. To educate the public about allergic asthma this year, AAFA has joined with the American Academy of Allergy Asthma and Immunology (AAAAI) to develop a new educational campaign, “Is Your Asthma Allergic? Know Your IgE.”

More than 20 million Americans suffer from asthma, and 12 million have allergic asthma.
Yet, awareness of this disease remains low; in fact, a recent survey showed that only 37% of asthma sufferers surveyed had heard of allergic asthma. To enable asthma patients to better recognize whether or not they may suffer from allergic asthma, AAAAI has created a simple self-screener, available at www.aaaai.org/allergicasthma

2004 Ranking	Metropolitan Area	Total Score	Subtotal: Prevalence Factors	Subtotal: Risk Factors	Subtotal: Medical Factors
1	Knoxville, TN	100.00	90.29	90.35	100.00
2	Little Rock, AR	87.02	100.00	92.26	61.90
3	St. Louis, MO	86.37	93.91	100.00	64.72
4	Madison, WI	83.32	90.50	62.93	84.93
5	Louisville, KY	82.32	88.86	87.16	68.20
6	Memphis, TN	82.13	98.25	81.96	55.39
7	Toledo, OH	82.08	89.74	61.68	82.91
8	Kansas City, MO	81.96	90.77	88.72	62.76
9	Nashville, TN	81.69	90.68	78.75	68.69
10	Hartford, CT	81.67	92.45	57.88	79.57
11	Buffalo-Niagra Fall, NY	81.53	90.84	65.15	76.92
12	Johnson City, TN	81.51	91.72	56.27	81.32
	Allentown-Bethlehem-Easton, PA	81.51	87.98	86.91	67.11
14	Springfield, MA	80.99	91.34	65.93	73.79
15	Pittsburgh, PA	80.97	89.80	87.42	61.95
16	Milwaukee-Waukesha, WI	80.68	93.62	51.86	78.32
17	Chattanooga, TN	80.39	90.64	58.89	77.62
18	Detroit, MI	80.23	94.11	62.56	68.87
19	Dayton-Springfield, OH	80.04	91.82	66.61	69.34
20	Indianapolis, IN	79.71	86.43	76.37	70.74
21	Columbus, OH	79.70	89.61	74.51	66.64
22	Fresno, CA	79.60	87.24	72.38	71.68
23	Wichita, KS	79.42	88.54	68.00	71.82
24	Harrisburg-Lebanon-Carlisle, PA	78.96	89.99	75.82	62.68
25	Lexington, KY	78.95	90.50	56.28	74.79
26	Albany-Schenedtady-Troy, NY	78.95	89.67	50.08	79.89
27	Philadelphia, PA	78.45	91.34	61.14	68.52
28	Greensboro-Winston Salem-High Point, NC	78.26	88.37	87.02	55.57
29	Oklahoma City, OK	78.12	90.09	67.24	65.42
30	Syracuse, NY	78.03	90.84	49.81	75.48
31	Lansing-East Lansing, MI	77.88	92.68	57.02	67.13
32	Scranton-Wilkes Barre-Hazleton, PA	77.85	89.99	66.16	65.41
	New York, NY	77.85	89.26	70.74	63.58
34	Columbia, SC	77.65	89.63	84.87	52.87
35	Grand Rapids-Muskegon-Holland, MI	77.56	92.94	66.21	59.50
36	Birmingham, AL	77.36	94.45	71.69	52.65
37	Jackson, MS	77.31	98.12	66.82	49.62
	Omaha, NE	77.31	90.06	66.57	63.21
39	Minneapolis-St. Paul, MN-WI	77.30	90.12	71.05	60.10
40	Kalamazoo-Battle Creek, MI	77.26	94.06	54.90	64.18
41	Tusla, OK	77.24	89.83	74.03	58.39
42	Cincinnati, OH	77.10	90.74	74.70	55.96
43	Des Moines, IA	77.03	85.70	59.73	74.12
44	Baltimore, MD	77.01	96.05	61.03	55.93
45	Phoenix-Mesa, AZ	76.80	87.99	80.27	55.84
46	Charlotte-Gastonia-Rock Hill, NC-SC	76.71	89.00	83.63	51.61
47	Atlanta, GA	76.56	91.39	76.12	52.13
48	Canton-Massillon, OH	76.46	90.54	67.20	59.16
49	Raleigh-Durham-Chapel Hill, NC	76.44	87.98	71.65	60.40
50	Washington, DC	76.18	99.83	64.40	44.63

2004 Ranking	Metropolitan Area	Total Score	Subtotal: Prevalence Factors	Subtotal: Risk Factors	Subtotal: Medical Factors
51	Cleveland-Lorain-Elyria, OH	76.17	89.78	64.40	44.63
52	Richmond-Petersburg,VA	75.95	91.48	70.17	53.94
53	Albuquerque, NM	75.74	88.15	75.66	55.10
54	Greenville-Spartanburg-Anderson, SC	75.58	89.63	70.13	55.80
55	Rochester, NY	75.50	90.84	49.37	67.37
56	Chicago, IL	75.27	93.10	60.19	55.59
57	Youngstown-Warren, OH	75.14	90.54	69.12	53.48
58	Fort Wayne, IN	74.63	86.17	63.13	63.05
59	Boston, MA	74.49	86.71	50.10	70.38
60	Augusta-Aiken, GA	74.44	91.13	66.25	52.09
61	Bakersfield, CA	74.40	87.76	84.14	45.65
62	Tuscon, AZ	74.28	87.02	65.03	59.21
63	Las Vegas, NV	73.76	85.72	77.51	51.32
64	Charleston-North Charleston, SC	73.70	89.63	70.15	49.53
65	Modesto, CA	73.26	87.59	56.44	59.72
66	Mobile, AL	73.09	93.80	67.56	42.25
67	Lancaster, PA	72.91	89.99	53.86	57.15
68	Spokane, WA	72.08	87.59	56.44	56.65
69	Baton Rouge, LA	71.78	92.25	73.94	36.22
70	New Orleans, LA	71.09	93.42	53.11	45.87
71	Orlando, FL	70.95	86.94	59.85	51.72
72	Dallas-Fort Worth, TX	70.91	85.07	66.99	49.91
73	Denver, CO	70.65	85.76	70.56	45.52
74	Salt Lake City-Ogden, UT	70.19	86.39	74.08	40.59
75	Colorado Springs, CO	69.99	88.62	61.79	44.40
76	Tampa-St. Petersburg-Clearwater, FL	69.43	86.09	48.78	55.44
77	Norfolk-Virginia Beach-Newport News, VA	69.29	90.48	57.65	41.73
78	Jacksonville, FL	69.19	88.50	51.28	48.95
79	Sacramento, CA	69.11	85.81	55.47	50.35
80	Austin-San Marcos, TX	68.80	84.16	62.87	47.15
81	San Antonio, TX	68.54	85.33	59.92	46.31
82	Stockton-Lodi, CA	68.39	87.24	39.87	55.98
83	Boise City, ID	67.73	85.66	52.69	47.87
84	Providence, RI	67.37	85.93	26.85	63.44
85	Los Angles-Long Beach, CA	67.08	85.70	66.37	36.51
86	Mcallen-Edinburg-Mission, TX	66.85	85.83	49.60	46.72
87	El Paso, TX	66.60	86.76	65.79	33.53
88	Sarasota-Bradenton, FL	66.38	86.93	45.88	45.80
89	Pensacola, FL	66.17	86.93	45.98	45.04
90	Fort Meyers-Cape Coral, FL	66.15	86.93	35.07	52.25
91	Houston-Galveston-Brazoria, TX	65.79	85.20	56.49	39.63
92	San Diego, CA	65.65	84.77	61.33	36.66
93	Lakeland-Winter Haven, FL	64.99	86.93	32.89	49.84
94	Melbourne-Titusville-Palm Bay, FL	64.39	86.93	31.05	49.04
95	Seattle-Bellevue-Everett, WA	64.09	86.23	33.85	47.34
96	Portland, OR	63.85	87.95	32.27	44.74
97	West Palm Beach-Boca Raton, FL	62.81	86.93	26.75	46.65
98	Daytona Beach, FL	62.78	86.93	34.801	41.20
99	Miami, FL	62.58	85.51	30.49	45.77
100	San Fransisco-Oakland-San Jose, CA	61.61	84.12	39.95	38.55

Methodology: Rankings for the Asthma Capitals™ are based on analysis of data from 15 individual factors in 3 primary groups -- Prevalence Factors, Risk Factors and Medical Factors – for the 100 largest U.S. metropolitan areas.

Prevalence Factors: Quantitative city and state outcomes data including morbidity and mortality for the most recent 12-month period from government and industry sources, including: estimated asthma prevalence, self-reported prevalence and annual crude death rate for asthma.

Risk Factors: Qualitative and quantitative city, county and state environmental and legal data for the most recent 12-month period from government and industry sources, including: comprehensive annual pollen measurements, average annual outdoor temperature, annual outdoor air quality, poverty rate, uninsured rate, inhaler access laws and public smoking laws.

Medical Factors: Quantitative city and state medical data for the most recent 12-month period from government and industry sources, including: number of asthma rescue and controller medication prescriptions per patient, and number of Board Certified allergy, immunology, pulmonology and asthma specialists per capita.

Weights were applied to each factor in consultation with medical and research experts reflecting the relative importance of each factor’s effect on asthma sufferers. Final total scores and factor subtotals were rescaled assigning 100 points to the largest score and presenting all other scores as a percentage of the largest. The metro area with a total score of 100 points did not necessarily have the “most severe” score for every factor, but rather, it achieved the highest composite score after all subtotal scores were weighted, tabulate and compared.