What Are the Best and Worst Cities for People With Allergies?

Reviewed by: HU Medical Review Board | Last reviewed: April 2023

Most people do not think about allergies when looking for a new place to live. Usually, things like location, jobs, and schools are more important. But if you have severe allergies, where you live can impact your allergies.1

Where are the best places in the US for people with allergies to live?

Every year, the Asthma and Allergy Foundation of America (AAFA) puts together a list of 100 cities where people are most affected by seasonal allergies. The report looks at the largest cities in the United States. It uses 3 factors in its decision-making:1

  • Pollen counts in spring and fall. Higher tree, grass, and weed pollen counts make allergies and a city’s rank worse.
  • Sales of over-the-counter allergy medicines. Higher sales of medicine make a city’s rank worse.
  • Number of board-certified allergists in the area. Fewer doctors makes a city’s rank worse.

In 2023, the worst cities to live for people with allergies were:1

  1. Wichita, Kansas
  2. Dallas, Texas
  3. Scranton, Pennsylvania
  4. Oklahoma City, Oklahoma
  5. Tulsa, Oklahoma
  6. Sarasota, Florida
  7. Cape Coral, Florida
  8. Orlando, Florida
  9. Des Moines, Iowa
  10. Greenville, South Carolina

The AAFA found that best cities for people with allergies were:1

  1. Buffalo, New York
  2. Seattle, Washington
  3. Cleveland, Ohio
  4. Austin, Texas
  5. Akron, Ohio
  6. Washington, District of Columbia
  7. Detroit, Michigan
  8. Albuquerque, New Mexico
  9. Columbus, Ohio
  10. Salt Lake City, Utah

Why does location impact allergies?

Geographical location can impact seasonal allergies in many ways. Location impacts the climate. This influences which plants grow and the length of allergy season.1,2

Southern cities are warmer for more of the year. This means the plants have more time to grow and can produce pollen for longer. This can make conditions worse for people with allergies. For example, 7 of AAFA's 20 worst allergy cities are in Florida.1,2

Pollen counts can also be impacted by the type and amount of plants. Cities with more vegetation will usually have higher pollen counts. But some types of plants produce less pollen. Regions with these plants will have less pollen.1,2

However, pollen is not the only issue. Very large cities can also have more air pollution. This can be harmful for people with allergies.1,2

How does climate change impact allergies?

Climate change has also led to longer and worse allergy seasons in many places. Climate change has led to warmer weather. For example, across the US, the freeze-free season grew by about 20 days between 1990 and 2018. The freeze-free season is the part of the year when plants can grow.3,4

This means a longer allergy season. The US allergy season now produces about one-fifth more pollen than it used to.3,4

Some regions are more impacted by climate change than others. For example, in Reno, Nevada, the freeze-free season increased by 99 days. The average increase across the western US was 27 days. But in the southeast, northeast, and central regions, the increase was closer to 14 days. Unfortunately, as climate change continues, it is likely that allergy seasons will continue to get longer and more extreme.2-4

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