10 Worst Cities for Fall Allergies

As the globe slowly orbits from summer to winter, those of us in the northern hemisphere get to enjoy the pleasures of autumn. But for the nearly 50 million Americans have suffer from nasal allergies or allergic asthma, the next few months might be more of a mad dash to avoid the symptoms of fall allergies: runny nose and congestion, itchy and watery eyes, violent sneezing, and even coughing and wheezing.

Since 2004, the Asthma and Allergy Foundation of America (AAFA) has provided an annual list of 100 Fall Allergy Capitals, the cities they describe as the most challenging places to live with fall allergies. Following are the top 10 offenders, as well as allergy facts and statistics from the AAFA.

10. Tulsa, OK
Score: 89.2

The rankings are based on scientific analysis of 3 factors for the 100 largest metro areas in the U.S. The data measured and compared each year includes:
• Pollen scores (airborne grass/tree/weed pollen and mold spores)
• Number of allergy medications used per patient
• Number of allergy specialists per patient

9. St. Louis, MO
Score: 90.72

Allergy is characterized by an overreaction of the human immune system to a foreign protein substance (“allergen”) that is eaten, breathed into the lungs, injected or touched. This immune overreaction can results in symptoms such as coughing, sneezing, itchy eyes, runny nose and scratchy throat. In severe cases it can also result in rashes, hives, lower blood pressure, difficulty breathing, asthma attacks, and even death.

8. Madison, WI
Score: 90.75

Allergies have a genetic component. If only one parent has allergies of any type, chances are 1 in 3 that each child will have an allergy. If both parents have allergies, it is much more likely (7 in 10) that their children will have allergies. More Americans than ever before say they are suffering from allergies. It is among the country’s most common, yet often overlooked, diseases.

7. Wichita, KS
Score: 94.50

Allergy is the 5th leading chronic disease in the U.S. among all ages, and the 3rdmost common chronic disease among children under 18 years old. Allergies are the most frequently reported chronic condition in children, limiting activities for more than 40% of them. There are no cures for allergies. Allergies can be managed with proper prevention and treatment.

6. Louisville, KY
Score: 95.03

Approximately 40 million Americans have indoor/outdoor allergies as their primary allergy. (Many people with allergies usually have more than one type of allergy.) Approximately 10 million people are allergic to cat dander, the most common pet allergy. The most common indoor/outdoor allergy triggers are: tree, grass and weed pollen; mold spores; dust mite and cockroach allergen; and, cat, dog and rodent dander.

5. Oklahoma City, OK
Score: 95.67

For adults, allergies (hay fever) is the 5th leading chronic disease and a major cause of work absenteeism and “presenteeism,” resulting in nearly 4 million missed or lost workdays each year, resulting in a total cost of more than $700 million in total lost productivity

4. Jackson, MS
Score: 96.65

Allergic (extrinsic) asthma is characterized by symptoms that are triggered by an allergic reaction. Allergic asthma is airway obstruction and inflammation that is partially reversible with medication. Allergic asthma is the most common form of asthma, affecting over 50% of the 20 million asthma sufferers. Over 2.5 million children under age 18 suffer from allergic asthma. Many of the symptoms of allergic and non-allergic asthma are the same (coughing, wheezing, shortness of breath or rapid breathing, and chest tightness). However, allergic asthma is triggered by inhaled allergens such as dust mite allergen, pet dander, pollen, mold, etc. resulting in asthma symptoms.


3. McAllen, TX
Score: 97.43

Many people turn to alternative medicine to help alleviate their asthma or allergy symptoms. These treatment approaches may include, but are not limited to, one or more of the following:
• Acupuncture
• Ayruvedic medicine
• Biofeedback; mental imaging; stress reduction; Relaxation techniques
• Chiropractic spinal manipulation
• Diet, exercise, yoga, lifestyle changes
• Herbal medicine, vitamin supplements
• Folk medicine from various cultures
• Laser therapy
• Massage
• Hypnosis
• Art or music therapy

2. Dayton, OH
Score: 97.95

Allergies cannot be cured. But the symptoms of the allergy can be reduced by avoiding contact with the allergen.
• Limit outdoor activity during pollination periods when the pollen or mold count is high. This will lessen the amount you inhale.
• Use central air conditioning set on “recirculate” which exclude much of the pollen and mold from the air in your home.
• Vacationing away from an area with a high concentration of the plants that cause your allergies may clear up symptoms. However, if you move to such an area, within a few years you are prone to develop allergies to plants and other offenders in the new location.

1. Knoxville, TN
Score: 100.00

There is no place free from asthma triggers, and some cities are more challenging places to live than others. Knoxville was named the #1 Fall Allergy Capital this year due to high pollen counts, high use of allergy medications by patients and too few allergists to treat the burgeoning allergy population.

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Aud Nordby
Aud nordby2 years ago


Donna Hamilton
Donna Hamilton2 years ago

Thanks for the info.

Arlene M. Baladi

Northern New Jersey is pretty bad, I have lived here my entire life.

Jennifer C.
Past Member 3 years ago


Kat K.
Kat K.4 years ago

It seems that in America everybody is allergic to something! Could it be that the doctors are over diagnosing allergies so they can make more money from giving out shots etc?
I think you guys over medicate!

Michelie B.
Michelie B.4 years ago

Always keep on track, since I live in such an awesome city, Savannah, GA, but am 58, disabled w/chronic pain, OMG, rain, allergy season is horrible, but that just comes w/young age, Amen! come visit though. Been here all my life, would never leave. Best of Dr.s, movies made here all the time, historical. Lovely place to live. Ck it out on Savannahnow.com

Julija S.
Julija S.4 years ago


Brenda P.
Brenda P.4 years ago

It is bad here in Georgia to.

sheila d.
sheila d.4 years ago

o my.... killer cities.

Fadia C.
Fadia C.4 years ago