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

You may not think of allergies when looking for a new place to live. More often, things like location, jobs, schools, and close family are key factors. However, if you have severe allergies, you may want to reconsider where you live to help control your allergies.

The Asthma and Allergy Foundation of America (AAFA) compiles an annual list of 100 cities where people are most affected by spring and fall allergies. The report looks at the largest cities in the United States and uses 3 factors in its decision-making:¹

• Pollen counts in spring and fall
• Sales of over-the-counter allergy medicines
• Number of board-certified allergists in the area

This information can help the 50 million people in the United States living with nasal and seasonal allergies.¹

Top 10 most challenging cities

In 2021, the top 10 out of 100 cities that were most difficult for people living with seasonal allergies were:¹

1. Scranton, Pennsylvania
2. Richmond, Virginia
3. Wichita, Kansas
4. McAllen, Texas
5. Pittsburgh, Pennsylvania
6. Hartford, Connecticut
7. Springfield, Massachusetts
8. New Haven, Connecticut
9. Oklahoma City, Oklahoma
10. Bridgeport, Connecticut

The AAFA reports that climate change means many cities have their last freeze earlier in the year. This means spring starts earlier and plants have more time to grow and release pollen. Plus, fall seasons are 2.5 degrees warmer, which means pollen counts stay high for longer.¹

10 least challenging cities

In 2021, the 10 least troublesome cities for people living with seasonal allergies were:¹

91. Denver, Colorado
92. Fresno, California
93. Portland, Oregon
94. Milwaukee, Wisconsin
95. Stockton, California
96. San Jose, California
97. Salt Lake City, Utah
98. Provo, Utah
99. Seattle, Washington
100. Durham, North Carolina

How the largest cities rank

The largest cities in the United States and how they rank for seasonal allergy conditions include:^1,2

1. New York City, New York (Allergy rank: 58)
2. Los Angeles, California (Allergy rank: 56)
3. Chicago, Illinois (Allergy rank: 64)
4. Houston, Texas (Allergy rank: 50)
5. Phoenix, Arizona (Allergy rank: 74)
6. Philadelphia, Pennsylvania (Allergy rank: 28)
7. San Antonio, Texas (Allergy rank: 14)
8. San Diego, California (Allergy rank: 89)
9. Dallas, Texas (Allergy rank: 19)
10. San Jose, California (Allergy rank: 96)

Remember: In this rating, a higher number means people with seasonal allergies find it easier to live in these cities. A lower number means the city is likely more challenging.

Seasons and allergies

What you are allergic to can also affect which cities may be most challenging for you to live in. In the spring, trees usually release pollen first, followed by grasses. Grasses can release pollen into summer. In late summer and early fall, weeds, especially ragweed, can be widespread. Mold tends to be higher in the fall as leaves fall and rot.¹

Cities that are the most challenging for spring allergies are:¹

1. Richmond, Virginia
2. Scranton, Pennsylvania
3. Wichita, Kansas
4. Virginia Beach, Virginia
5. Pittsburgh, Pennsylvania
6. Hartford, Connecticut
7. Oklahoma City, Oklahoma
8. McAllen, Texas
9. Las Vegas, Nevada
10. Springfield, Massachusetts

Cities that ranked the worst for fall allergies were slightly different:¹

1. Scranton, Pennsylvania
2. Richmond, Virginia
3. Wichita, Kansas
4. McAllen, Texas
5. Pittsburgh, Pennsylvania
6. Buffalo, New York
7. Hartford, Connecticut
8. Springfield, Massachusetts
9. New Haven, Connecticut
10. Albany, New York