Asthma affects an estimated 26.5 million people in the United States, and the challenges of living with the condition can be amplified by environmental factors like poor air quality. High pollution levels, more irritants in the air, and inadequate access to medical care all contribute to more severe symptoms.

According to the Asthma and Allergy Foundation of America (AAFA), some cities are particularly problematic for those managing asthma. Based on the latest data, here are the five worst cities to live in for asthma sufferers.

1. Detroit, Michigan

Detroit ranks as the most challenging city for individuals with asthma. Poor air quality, driven by high levels of ozone and particle pollution, makes it tough for residents with asthma to breathe easy. A large part of the pollution comes from heavy traffic and the region’s manufacturing industry. Unfortunately, Detroit also ranks high for asthma cases and related deaths, further complicating health management. The high poverty rates and limited access to care make it even harder for many residents to get the treatment they need.

2. Cleveland, Ohio

Cleveland, Ohio, is another city that presents significant challenges for asthma sufferers. With high rates of asthma diagnoses, emergency room visits, and asthma-related deaths, this city has earned its place on the list. The ozone pollution in the area worsens asthma symptoms, and the prevalence of quick-relief inhaler use highlights how often residents need emergency care for their condition.

3. Allentown, Pennsylvania

Allentown, Pennsylvania, takes the third spot. The city not only has a high asthma prevalence but also records a troubling number of emergency room visits related to asthma. Pollen levels are high during certain seasons, and other pollutants in the area further exacerbate breathing difficulties. This combination makes Allentown one of the hardest places to live for those dealing with asthma.

4. Lakeland, Florida

In Lakeland, Florida, asthma cases are also widespread, and many residents need quick-relief treatments more frequently than those in other cities. The area struggles with a shortage of asthma specialists and a significant portion of the population lacks insurance, making it difficult to access proper medical care. The limited healthcare options and financial barriers increase the risk of asthma attacks that require emergency treatment.

5. Fresno, California

Fresno, California, rounds out the top five. The city suffers from high pollution and ozone levels, which significantly worsen asthma symptoms. Additionally, there are fewer asthma specialists available, and the area has high rates of poverty, further limiting access to effective care. The number of asthma-related emergency room visits in Fresno remains high, making it one of the worst cities to live in for asthma sufferers.

If you suffer from asthma, it's essential to consider environmental and healthcare factors before deciding where to live. Poor air quality and limited medical resources can make managing asthma symptoms far more difficult, leading to an increased need for emergency care.