ALLENTOWN, Pa. – A report has ranked Allentown as the #1 most challenging city to live with asthma.

The Asthma and Allergy Foundation of America released its report this week.

AAFA said Allentown earned the top spot for the third time in the last four years due to high asthma prevalence and a high number of asthma-related emergency department (ED) visits. 

AAFA said it evaluates data for the 100 most-populated cities in the continental United States, based on metropolitan statistical data in the contiguous (“lower 48”) states.

MSAs are cities and their surrounding areas (like suburbs and nearby rural areas).

Here’s the 2026 list of Top 10 Asthma Capitals (out of 100 cities ranked):

1. Allentown, PA

2. Detroit, MI

3. Rochester, NY

4. Philadelphia, PA

5. Cleveland, OH

6. Lakeland, FL

7. Syracuse, NY

8. Hartford, CT

9. Charleston, SC

10. Sacramento, CA

AAFA said it publishes the Asthma Capitals® report to monitor the nationwide impacts of asthma.

The organization said asthma prevalence, asthma-related ED visits, and asthma-related mortality are the three factors driving the rankings.

The outcomes are not weighted equally, AAFA said. The report also examines asthma risk factors that influence the outcomes.

The organization said the report does not reflect:

Cities and areas not in the top 100 list by population size.

Completely rural areas that are not located within a metropolitan statistical area.

Anchorage, Alaska; Honolulu, Hawaii; San Juan, Puerto Rico; Navajo Nation Reservation; or Cherokee Nation Reservation, due to lack of matching data with other cities, counties, and states.