New report ranks Philadelphia and Allentown among toughest cities in America for people with asthma
- Asthma Capital Report: Philadelphia ranks No. 4 among the toughest cities for people with asthma in the US, according to the Asthma and Allergy Foundation of America’s 2025 report.
- Allentown has improved its ranking from No. 1 in 2024 to No. 3, while Philadelphia’s ranking has worsened by one place compared to last year.
- The September asthma peak month is a challenging time for many asthma patients, with high rates of asthma attacks and hospital visits nationwide due to triggers like fall pollen, mold levels, and poor indoor air quality in schools.
- Asthma medication affordability remains a significant issue, with some inhalers costing thousands of dollars per year, although resources like GoodRx can help patients compare prices across pharmacies.
- Pennsylvania lawmakers can take steps to address the asthma crisis by passing legislation that imposes price caps on certain types of asthma medication and offering funding or incentives for schools to upgrade their ventilation systems and improve indoor air quality.
Philadelphia has once again been named one of the “asthma capitals” of the U.S. – ranking No. 4 in a report released on Sept. 9, 2025, by the Asthma and Allergy Foundation of America. Allentown was ranked No. 3, Harrisburg No. 15 and Pittsburgh No. 44.
The AAFA, which is the largest patient group in the country for people with asthma and allergies, ranks cities based on “how challenging they are to live in” for people with asthma. The ranking combines data on asthma prevalence rates, visits to the ER and deaths related to asthma.
Compared with 2024 data, Allentown’s ranking has improved: It went from No. 1, a position now occupied by Detroit, to No. 3. Philadelphia is doing worse, one place higher than in 2024.
I am a health law professor and the director of the Health Innovation Lab at Villanova University, where I have researched ways to make asthma medication more affordable for patients.
Here are some steps that individuals, schools and state leaders in Pennsylvania can take to reduce asthma triggers and the cost of asthma medications in their families and communities.
The September asthma peak in Pennsylvania
The ranking was published at an especially challenging time of the year for many asthma patients.
September is known as the “asthma peak month.” The third week of September typically registers the highest number of asthma attacks, as well as asthma-related hospital and ER visits, nationwide.
Asthma triggers include fall pollen and mold levels, which start increasing in the late summer and stay high through early fall.
Also contributing to the September asthma peak is poor indoor air quality, especially in older or poorly maintained school buildings where children are exposed to concentrated amounts of allergens and irritants.
A report released in August 2025 found that Pennsylvania schools face a variety of asthma triggers, such as exposure to radon, mold and lead paint. Yet, less than 4% of schools in Pennsylvania have an indoor air quality plan. The problem is especially acute in cities like Philadelphia, where many school buildings are over 70 years old and in disrepair.
Solving a problem as complex and widespread as asthma may require taking creative steps. These include initiatives led by schools and students. For example, students in Australia led a successful initiative to improve air quality around their schools by having parents cut down on engine idling time.
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Affordable asthma medications
Asthma patients often need medication to manage their symptoms. Yet, over the past 15 years that medication has become increasingly unaffordable.
Last year, some pharmaceutical companies capped the price of their asthma inhalers at US$35 each.
But not all types of inhalers are covered. And other asthma medications, such as some drugs taken orally, remain unaffordable for many patients. Asthma drugs that are not subject to a price cap or other type of price control may cost patients thousands of dollars a year.
There are resources for asthma patients and parents of children with asthma that may help them save some money when filling their prescriptions. A good starting point is GoodRx, a free online platform that allows users to search and compare medication prices across pharmacies. The website currently lists 65 different types of asthma medication and their varying prices.
What Pennsylvania lawmakers can do
Since price caps don’t apply to all types of inhalers and asthma medication, states can pass legislation that imposes such caps, instead of relying solely on industry compliance. Before there was a federal Medicare price cap on insulin, several states took this route and implemented state caps.
Some states have now begun passing similar legislation for certain types of asthma medication. Minnesota, for instance, beginning Jan. 1, 2025, capped inhalers at $25, lower than the industry cap. Pennsylvania could follow suit and even consider asthma medication besides inhalers.
Pennsylvania can also address other facets of the asthma crisis. For instance, the state could offer funding or other incentives for schools to upgrade their ventilation systems or otherwise address poor indoor air quality.
Read more of our stories about Philadelphia.
Ana Santos Rutschman does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.