Pennsylvania cities rank among nation’s ‘asthma capitals’

The Asthma and Allergy Foundation of America report finds that poverty increases asthma risk. People living below the federal poverty line are more likely to have the condition. Philadelphia ranks sixth for poverty-related asthma risk. (Bobex73/Adobe Stock)

By Public News Service

October 3, 2025

By Danielle Smith

In the Keystone State, Philadelphia and Allentown are among the most difficult cities U.S. for people suffering from asthma. The latest Asthma and Allergy Foundation of America report places Philadelphia fourth on its list and Allentown third.

Ana Santos Rutschman, professor of law and director of the health innovation lab at Villanova University, said Allentown ranked first last year, while Philadelphia’s situation is worsening. Pittsburgh is faring better at 44th, and Harrisburg is 15th.

“There’s the urban part of things,” she said. “So you’re seeing relatively large cities being listed. Pollution is another of the big factors here, so a contributing cause of hospitalizations and deaths, because it exacerbates asthma.”

The report says more than 28 million Americans have asthma. Santos Rutschman noted it measures how well the disease is managed, especially for children who may lack access to care and medication, emergency-room visits and asthma-related complications.

Santos Rutschman added that Pennsylvania’s aging, outdated industrial infrastructure is a major factor that triggers asthma for school kids, and noted that less than 4% of schools in Pennsylvania have an indoor air quality plan.

“The buildings now operate as schools, and some of the most asthma-prone populations are young kids, and they just spend a lot of time inhaling a lot of things in these environments,” she continued. “That’s one of the reasons it’s infrastructural and historical, and we have not kept up with maintenance.”

She added that asthma medication have gotten harder to afford over the past 15 years, and noted that while some inhalers are capped at $35, other drugs can still cost patients thousands. She urged Pennsylvania lawmakers to consider state laws capping inhaler costs to be more affordable, and said that patients can use online tools such as GoodRx to search for lower-cost medications.