Where one chooses to call home can have substantial impacts on overall health and, in turn, quality of life. This is especially true for those living with chronic conditions that, with proper care and attention, are often manageable but still require thoughtful planning when deciding to move to a new part of the country. Climate, geography, and access to health care providers are all key considerations for those with a chronic health condition.
Asthma is long-term inflammation of the lungs’ airways thought to be brought on by genetic, environmental, and in some cases, behavioral factors. According to the Centers for Disease Control, if affects some 25 million Americans of all ages, making it one of the more common chronic diseases.
While there's no cure for the condition, careful management of lifestyle and environmental factors can help reduce the symptoms, which include a feeling of breathlessness, tightness in the chest, and wheezing.
It's generally agreed upon that air quality, both indoor and outdoor, has a major impact on the frequency and intensity of symptoms for people living with asthma. Tobacco smoke, whether directly inhaled or in the form of second-hand smoke, is a major contributor to symptoms and should be avoided as much as possible. Thankfully for those with asthma, smoking indoors is largely a thing of the past in many parts of the country due to regulations enacted in recent decades.
Similarly, pet-dander and strong perfumes can trigger often trigger symptoms and, like tobacco smoke, are relatively easy to avoid. While it was once customary to be bombarded with spritzes of perfume when entering a department store, most retailers now have discontinued their practice to ensure the comfort of their customers. Also, modern advances in vacuums cleaners, particularly those with HEPA filters, have made it much easier to effectively clean pet hair and dander from carpets and upholstered furniture.
The Bigger Picture
Indoor air quality is relatively easy to control and usually a matter of personal choice. Vacuuming regularly and asking smoking visitors to step outside before lighting up usually does the job. What about outdoors though? It's true some areas of the country are likely to be much more comfortable than others for those with asthma.
Here are some general considerations to help guide travel and real estate decisions:
Air Pollution: This is the most obvious and, in some cases, visible cause of discomfort for those suffering chronic breathing conditions. The Clean Air Act of 1963 and its later amendments have helped reduce air pollution over the years, but it's still very much an issue to be mindful of.
There are a variety of different types, but the two that have the greatest impact on asthma sufferers are particulate pollution and ozone. Particulate pollution is easy to see—think the dirty exhaust from a diesel motor or coal power plant. Ozone pollution is often associated with hot days and car exhaust which provide the right conditions for those ozone action days you may have heard about during a weather report.
Geography and Weather: These two go hand-in-hand in their effects on air quality and, in turn, the quality of life for those living with asthma. Generally speaking, cities near bodies of water have a bit more wind which helps move the air, blowing out particulate pollution and pollen. Topography can have a big impact too. Anyone who’s ever lived in a river valley can tell you that air tends to settle, especially on hot, muggy days.
Weather and climate are, of course, affected by geography. Some people with asthma find extreme weather, think the heat of Southern Texas or the bitter cold of Northern Minnesota, can have a “shock” effect on their lungs while some are relatively undisturbed by this. Those who are impacted often find cities with milder, more consistent weather are more comfortable for them.
The Best Cities for Those With Asthma
Now that we understand some of the factors that contribute or detract from the comfort of people with asthma, we’ll get into some specific cities generally considered the best for those with asthma. Keep in mind, this is not intended to be a definitive guide, and if you or a loved one is living with asthma, you and your doctor should discuss specific risk factors when making travel or homebuying decisions.
This beautiful and historic coastal North Carolina city is ranked by the American Lung Association as one of the best cities in the country for outdoor air quality. It had zero ozone or particulate pollution warning days in the previous year. Residents of Wilmington enjoy mild winters and, despite an average July high of 90 degrees Fahrenheit, the area's ocean breezes keep pollutants to a minimum. As of 2009, restaurants and bars in the state are also smoke-free, allowing diners to enjoy clean air inside as well.
One of the “it” cities in recent years, people are attracted to the clean mountain air and active lifestyle the city promotes. A 46-mile greenbelt encourages active transportation, with many residents choosing to commute on foot, bicycle, or other non-motorized means. Healthcare options are considered quite good in Boise. Air quality is usually excellent, but it can be adversely affected during wildfire season which may bring in heavy smoke and particulate pollution. These effects can be mitigated by staying indoors during wildfires and investing in good air filtration systems.
Cape Coral is a popular destination for seasonal residents looking to escape cold, northern winters. The denizens of this city instead spend their time soaking up rays with an average of 265 sunny days a year. With its near-constant ocean breezes and very mild winters, it's easy to see the appeal. It shares the honor of being the cleanest metropolitan area as determined by the American Lung Association. Though smoking is allowed in certain places (most commonly in bars), a new law has been proposed to ban smoking on beaches which is a positive sign for those looking to avoid tobacco smoke in public.
Another coastal city on our list shares many of the same benefits of other seaside communities. Freezing weather and heatwaves are exceptionally rare; so much so that many homes, especially older ones, don't have a central air conditioner. Seattle is well-known for its rain which can cause higher levels of mold and affect some people with asthma. Smoking of both tobacco and newly legal cannabis is banned in all public areas and workplaces. The city has also, in large part, transitioned from heavy industry and shipping to a tech economy, leading to very low ozone and particulate pollution—all the better to take in the stunning mountain views.
As an outdoors-lovers’ delight, Minneapolis enjoys excellent air quality year-round, owing to both their mild summers and windy winters. Stringent state environmental regulations keep the air and water clean, something Minnesotans pride themselves on. The region is also home to some of the best healthcare providers in the country, including the renowned Mayo Clinic in nearby Rochester. This makes it easy for those with asthma or other chronic conditions to access expert medical care. However, it's no mystery that the region’s winters are intense, so it's best to keep that in mind if cold is an aggravating factor.
While many cities stand out for their excellent air quality, these are among the best and most diverse in the country. As you can see, there's no “perfect” city for people living with asthma, and it's best to weigh your own specific health needs against what these cities offer. Whether you’re a tourist or looking to settle down more permanently, asthma doesn’t have to limit your options. Instead, it can lead you to some places that are as lively and captivating as they are beautiful.