Every year, the Asthma and Allergy Foundation of America (AAFA) evaluates conditions in the 100 largest cities in America and ranks them based on the quality of life in each city for people living with asthma. Researchers at AAFA review 12 factors that impact the quality of life for people with asthma, including: the estimated prevalence of adult and pediatric asthma; the crude death rate for asthma; risk factors, such as air pollution, pollen counts and public smoking; and medical factors, such as the number of asthma medications used per patient and the number of asthma specialists in the area. Below is a list of the cities that rank best in quality of life for people with asthma in 2009.

This year’s top 10 best cities in the U.S. to live in if you have asthma are:

1. Cape Coral, FL
2. Seattle, WA
3. Minneapolis, MN
4. Colorado Springs, CO
5. Portland, OR
6. Palm Bay, FL
7. Daytona Beach, FL
8. San Francisco, CA
9. Portland, ME
10. Boise City, ID

No matter where you live, having uncontrolled asthma significantly impact your life and lead to missed school or work, emergency room visits, hospitalization, and even death. If your asthma is poorly controlled, talk to your doctor about making changes to your asthma action plan include adjustments in your current asthma prevention medications. Not sure if your asthma is well controlled? Take the Asthma Quiz Challenge and find out how much you know about uncontrolled asthma symptoms. Learn more by reading the Healia Health Guide to Uncontrolled Asthma.

<sub>Source: Allergy and Asthma Foundation of America, Asthma Capitals 2009, Jan 2009. http://www.aafa.org/pdfs/2009ACPublicList.PDF 

Photo: pink_Fish13, Flickr, Creative Commons</sub>

Deaths due to cigarette smoking have declined since the 1960s thanks to a parallel decline in smoking rates. When the Surgeon General first reported that smoking may be hazardous to your health in 1964, about 42 percent of American adults smoked. The most recent data available show that this rate has now dropped below twenty percent (19.8%) for the first time on record. The Centers for Disease Control and Prevention’s Smoking-Attributable Mortality, Morbidity, and Economic Costs report shows that overall death rates from smoking declined in all but one state (Oklahoma) between 1996-1999 and 2000-2004. Below is a list of the states with the lowest rates of smoking-related deaths, followed in parentheses by the smoking-attributable death rate per 100,000 residents and the percent change in that death rate between 1996-1999 and 2000-2004.

The top 10 states with the lowest rates of smoking-related deaths for 2000-2004 are:

1. Utah (138.3 deaths per 100,000 residents, -11.0% change)
2. Hawaii (167.6, -28.0%)
3. Minnesota (215.1, -14.4%)
4. North Dakota (225.6, -10.9%)
5. New Mexico (234, -21.1%)
6. California (235, -37.8%)
7. Nebraska (235.8, -25.9%)
8. Idaho (237.4, -21.5%)
9. Colorado (237.6, -24.3%)
10. Connecticut (238.3, -18.4%)

To find out more about lung diseases related to smoking, visit the Healia Health Community for Lung Diseases. Find help and support to quit smoking at the Healia Health Community for Smoking.

_{Source: Adhikari B et al "State-specific smoking-attributable mortality and years of potential life lost-United States 2000-2004" MMWR 2009; 58:29-33. http://www.cdc.gov/MMWR/preview/mmwrhtml/mm5802a2.htm}

Photo: Paraflyer, Flickr, Creative Commons

For the past six years, the Asthma and Allergy Foundation of America (AAFA) has evaluated conditions in the 100 largest cities in America and ranked them based on the quality of life each affords for people with asthma. Researchers at AAFA review 12 factors that impact the quality of life for people with asthma, including: the crude death rate for asthma; the estimated prevalence of adult and pediatric asthma; risk factors, such as air pollution, pollen counts and public smoking; and medical factors, such as the number of asthma medications used per patient and the number of asthma specialists in the area. Below is a list of the cities that rank worst in quality of life for people with asthma in 2009.

This year’s top 10 worst cities in the U.S. to live in if you have asthma are:

1. St. Louis, MO. This Midwest city tops the list this year after coming in ninth last year, due to a variety of factors, including poor air quality and a rise in the percentage of uninsured residents.
   
   
2. Milwaukee, WI. Climbing up one spot from last year, Milwaukee has rates of self-reported asthma and estimated asthma prevalence that are higher than average, poor air quality, and only below average use of asthma control medications.
   
   
3. Birmingham, AL. Jumping all the way up from number 13 on the list last year, Birmingham saw an increase in estimated asthma prevalence and ranks poorly in air quality and public smoke free laws. In fact, all of the cities that make the top 10 lack public smoking bans.
   
   
4. Chattanooga, TN. Rising twelve spots from last year, this Appalachian city saw an increase in the crude asthma death rate and a decline in the use of rescue medications from last year. Chattanooga also ranks below average in air quality.
   
   
5. Charlotte, NC. While this Southern city has an above average rate of estimated asthma prevalence, Charlotte saw a jump in its annual pollen score, which accounts for its rise from last years position in the number seven spot.
   
   
6. Memphis, TN. A small bright spot on the list, Memphis improved in self-reported asthma incidence, annual pollen score, and uninsured rate from last year, causing it to drop one spot from last year’s list. High crude death rates from asthma and poor air quality still negatively impact people living with asthma in Memphis.
   
   
7. Knoxville, TN. Home to the University of Tennessee, Knoxville improved its ranking considerably over last year when it held the top spot. Knoxville improved because both the estimated and self-reported prevalence of asthma decreased, and reported pollen levels were lower than the national average. However, poor air quality and low adherence to asthma medications keep Knoxville in the top 10.
   
   
8. McAllen, TX. Perhaps not a household name, this border town near Brownsville jumps all the way up from number 26 last year. While the air quality ranking actually improved from last year, increases in the estimated and self-reported asthma prevalence and the annual pollen score are responsible for the precipitous rise.
   
   
9. Atlanta, GA. The "Jewel of the South" improved its ranking from last year, moving down from the number four spot thanks to improvements in crude asthma death rate, poverty rate, rate of uninsured people, and use of quick-relief asthma medications. Below average air quality and low numbers of asthma specialists are still a problem in Atlanta.
   
   
10. Little Rock, AK. Rounding out the top 10, Little Rock rose 12 spots from last year to just make the list. Increases in the annual pollen score, air pollution levels, and self-reported asthma rates offset a nice improvement in crude asthma death rate.

No matter where you live, having asthma that is uncontrolled can significantly impact your life and lead to missed school or work, emergency room visits, hospitalization, and even death. If your asthma is poorly controlled, talk to your doctor about making changes to your asthma action plan include adjustments in your current asthma prevention medications. Not sure if your asthma is well controlled? Take the Asthma Quiz Challenge and find out how much you know about uncontrolled asthma symptoms. Learn more by reading the Healia Health Guide to Uncontrolled Asthma.

_{Source: Allergy and Asthma Foundation of America, Asthma Capitals 2009, Jan 2009. http://www.aafa.org/pdfs/2009ACPublicList.PDF}

The State of the Air report is an annual publication of the American Lung Association (ALA) that ranks cities and counties based on their levels of air pollution. The following is a list of the cleanest cities for air pollution from that report, based on the annual PM2.5 concentration, a measure of the yearly concentration of particles in the air that are less than 2.5 micrometers in size (PM2.5), which are thought to be the most harmful to human health. The ALA used the Environmental Protection Agency’s database to obtain the data, calculated the concentration of a pollutant, and ranked cities based on the EPA’s determination of the number of days that violated the national ambient air quality standard for annual PM2.5 of 15 µg/m³. The list below represents the cities with the best annual PM2.5 measures over the years 2004-2006 followed in parentheses by the total population that inhabits each area. Note that mostly small and medium-sized cities make the list.

The top 10 cities with the cleanest air in the U.S. are:

1. Cheyenne, WY (85,384)
2. Santa Fe-Espanola, NM (183,356)
3. Honolulu, HI (909,863)
4. Great Falls, MT (79,385)
5. Farmington, NM 126,473
6. Tucson, AZ (946,362)
7. Bismarck, ND (101,138)
8. Flagstaff, AZ 124,953
9. Anchorage, AK (359,180)
10. Salinas, CA (410,206)

To find out more about diseases caused by air pollution, join the Healia Health Community for Lung Diseases or the Healia Health Community for Heart Diseases.

Related blog posts: Study Finds Cleaner Air Lengthens American Lives by Nearly Five Months

        The Top 10 Most Polluted Cities in America

_{Source: American Lung Association, State of the Air 2008, Table 2. http://www.stateoftheair.org/2008/key-findings/SOTA08_Table2.pdf}

Smoking rates—and smoking-related deaths—have declined pretty steadily in the United States since a 1964 Surgeon General’s report that suggested smoking may be hazardous to your health. At that time, around 42 percent of American adults smoked. The latest data from the Centers for Disease Control and Prevention (CDC) show that for the first time on record, the smoking rate among U.S. adults has dropped below twenty percent (19.8%). In the CDC's Smoking-Attributable Mortality, Morbidity, and Economic Costs report, the agency reports that overall deaths rates from smoking declined in all but one state between 1996-1999 and 2000-2004. However, the smoking death rate actually increased for women in several states, and many states still have relatively high rates of smoking-related deaths. Below is a list of the states with the highest rates, followed in parenthesis by the smoking-attributable death rate per 100,000 residents and the percent change in that death rate between 1996-1999 and 2000-2004.

The top 10 states with the highest rates of smoking-related deaths for 2000-2004 are:

1. Kentucky (370.6 deaths per 100,000 residents, -13.3% change)
2. West Virginia (344.3, -21.5%)
3. Nevada (343.7, -44.4%)
4. Mississippi (333.6, -9.4%)
5. Oklahoma (332.1 +26.9%)
6. Tennessee (325, -12.4%)
7. Arkansas (323.7, -9.8%)
8. Alabama (317.5 -5.9%)
9. Indiana (308.9, -14.4%)
10. Missouri (307.8, -27.3%)

To find out more about lung diseases related to smoking, visit the Healia Health Community for Lung Diseases. Find help and support to quit smoking at the Healia Health Community for Smoking.

_{Source: Adhikari B et al "State-specific smoking-attributable mortality and years of potential life lost-United States 2000-2004" MMWR 2009; 58:29-33. http://www.cdc.gov/MMWR/preview/mmwrhtml/mm5802a2.htm}

_{Photo: Saudi..., Flickr, Creative Commons}

The American Lung Association (ALA) recently released its annual State of the Air report for 2008, which ranks cities and counties based on their levels of air pollution. The following is a list of the worst cities for air pollution based on the 24-hour PM2.5 concentration. This measure is the maximum daily value of the concentration of particles in the air that are less than 2.5 micrometers in size (PM2.5), which are thought to be the most harmful to human health. The ALA used the Environmental Protection Agency’s database to obtain the data and ranked cities based on the number of days that the 24-hour PM2.5 was rated in the categories unhealthy for sensitive groups, unhealthy, very unhealthy, or hazardous. The list below represents the cities (and surrounding areas) with the worst 24-hour PM2.5 measures over the years 2004-2006 followed in parentheses by the total population that inhabits each area. Note that cities both small and large make the list.

The top 10 most polluted cities in the U.S. are:

1. Pittsburgh-New Castle, PA (2,462,571)
2. Los Angeles-Long Beach-Riverside, CA (17,775,984)
3. Fresno-Madera, CA (1,038,101)
4. Bakersfield, CA (780,117)
5. Birmingham-Hoover-Cullman, AL (1,180,206)
6. Logan, UT-ID (111,156)
7. Salt Lake City-Ogden-Clearfield, UT (1,632,814)
8. Sacramento-Arden-Arcade-Yuba City, CA-NV (2,373,596)
9. Detroit-Warren-Flint, MI (5,410,014)
10. Washington-Baltimore-Northern Virginia, DC-MD-VA (8,211,213)

To find out more about diseases caused by air pollution, join the Healia Health Community for Lung Diseases or the Healia Health Community for Heart Diseases.

Related blog post: Study Finds Cleaner Air Lengthens American Lives by Nearly Five Months

_{Source: American Lung Association, State of the Air 2008, Table 2. http://www.stateoftheair.org/2008/key-findings/SOTA08_Table2.pdf}

_{Photo: saeru, Flickr, Creative Commons}

Food allergies are relatively common in the United States and are reported to be on the rise. Up to 8% of children and 2% of adults in the United States are estimated to have food allergies. Food allergies occur when the immune system mistakes an element of food for a foreign invader and mounts an immune response against it. This can lead to symptoms such as an itching sensation in your mouth, vomiting, diarrhea, throat tightness, trouble breathing, and in rare cases, a potentially deadly reaction called anaphylaxis.

Not all foods can cause food allergies. For unknown reasons a short list of only eight foods is responsible for more than 90% of all food allergies in the U.S. Food allergies are related to how common a particular food is in the diet and as a result, tend to be cultural: rice allergies are common in Japan and codfish appears on the list in Scandinavia. Below is a list of the most common foods that cause food allergies, along with a discussion of their prevalence in adults and children.

The top foods that cause food allergies are:

• Cow’s Milk
  The most common food allergy in children, milk allergy affects 2-3% of infants in developed countries. Up to 90% of these children grow out of the allergy by the time they reach 4 years of age. Note that an allergy to cow’s milk is not the same thing as lactose intolerance. The former is a true allergy and causes symptoms such as hives and breathing problems as well as stomach problems, while the latter is not an allergy but a food “intolerance” and causes only digestive problems.


• Eggs
  Eggs are another very common food allergy among children and this allergy persists into adulthood for some. Most kids will outgrow an egg allergy by age 5. Something to be aware of if you or your child has egg allergies is that some vaccines, including the flu vaccine, contain egg proteins which may provoke a serious reaction in allergic individuals.


• Peanuts
  Peanut allergies are common in both children and adults with about 1% of each group affected. Only about one-quarter of children with peanut allergies outgrow them. Peanut proteins in seem especially adept at provoking the immune system into a lethal attack on the body, and indeed peanut allergies are the leading cause of food-related death. However, these deaths are still quite rare.


• Tree nuts
  Tree nut allergies are more common in children than adults but a fair amount of adults are affected as well. Tree nuts include most familiar nuts except peanuts, including almonds, walnuts, cashews, Brazil nuts, pecans, macadamia nuts, and others.


• Wheat
  Wheat allergies are quite common in adults, accounting for as much as one-quarter of all food allergies. Many children also have wheat allergies. There is a related problem called celiac disease, in which the immune system attacks the small intestine whenever the protein gluten is ingested. Gluten is present is large amount in wheat, rye, and barley. For people with either celiac disease or wheat allergies, a wheat-free diet is essential.


• Soy
  Soy allergies are more common in children than adults. Think babies don’t eat soy? Actually, many infant formulas contain soy protein and soy allergy often starts with a reaction to a soy-based infant formula. Although most children outgrow soy allergy by age 3, soy allergy may persist and is becoming more common in adults. Other foods that contain soy include tofu and many bread products, which may contain soy flour.


• Fish
  Seafood allergies, which include allergies to fish and shellfish, are the most common cause of food allergy. Seafood can be a powerful allergen for certain people, causing life-threatening reactions. Seafood allergies are life-long, but don’t affect children as much as adults because kids don’t eat as much seafood. Most people who are allergic to fish are not allergic to shellfish and vice versa, but it is not a good idea to test that for yourself unless under the supervision of a doctor.


• Shellfish (i.e. crustaceans and mollusks)
  As with fish, shellfish allergies are very common, especially among adults. Interestingly, people tend to be allergic to either crustaceans (e.g. crabs, lobsters, and shrimp) or mollusks (e.g. squid, clams, mussels, oysters, and scallops); only 14% of seafood allergy sufferers are allergic to both.

For more information about food allergies, see the Healia Health Guide on Allergies. To share stories and tips about how to live with a food allergy, join the Healia Health Community for Food Allergy

_{Sources: Ameican Academy of Allergy, Asthma, and Immunology, TIps to Remember: Food Allergy. http://www.aaaai.org/patients/publicedmat/tips/foodallergy.stm; Seafood Allergy, Allergy and Asthma Advocate, Winter 2006. http://www.aaaai.org/patients/advocate/2006/winter/seafood.asp}

_{Photo: wEnDaLicious, Flickr, Creative Commons}

Parents always worry about their kids – especially boys – getting sick or being injured, but what are the real reasons that parents bring their boys into the emergency room? Every year, the CDC publishes an annual report called the National Hospital Ambulatory Medical Care Survey, one of its National Health Statistics Reports. The data in this report include information on emergency room (ER) visits based on age and gender. The following is a list of the top 10 reasons that boys aged 14 and under visited the ER in the year 2006, the year for which the most recent data are available. After each reason, the number of visits appears in parentheses followed by the percentage that number represents out of all ER visits by this age group.

Boys under 15 make up more than half of the ER visits for this age group: overall, males aged 14 and under made 11,548,000 visits to the ER in 2006, representing 52.8% of all ER visits for this age group. For the 15 and older age group, ER visits by females vastly outnumber those by men.

The top 10 reasons for ER visits among boys under 15 for 2006 are:

1. Fever (1,659,000 visits, 7.6%)
2. Cough (828,000 visits, 3.8%)
3. Vomiting (611,000 visits, 2.8%)
4. Unspecified injuries to the head, neck, and face (368,000 visits, 1.7%)
5. Facial area symptoms (352,000 visits, 1.6%)
6. Ear ache or ear infection (347,000 visits, 1.6%)
8. Stomach and abdominal pain or cramps (277,000 visits, 1.35)
9. Throat symptoms (239,000 visits, 1.1%)
10. Difficulty breathing (dyspnea; 203,000 visits, 0.9%)

For more information on children’ health, join the Healia Health Community for Child Health.

Related blog posts:

  - Top 10 Reasons for ER Visits Among Males 15 and Older

  - Top 10 Reasons for ER Visits Among Females 15 and Older

_{Source: Centers for Disease Control and Prevention, DHHS Publication No. (PHS) 2008–1250, August 2008. National Hospital Ambulatory Medical Care Survey: 2006 Emergency Department Summary, National Health Statistics Report No. 7}

_{Photo: Matthew Oliphant, Flickr, Creative Commons}

Every year, the CDC publishes an annual report called the National Hospital Ambulatory Medical Care Survey, one of its National Health Statistics Reports. The data in this report include information on emergency room (ER) visits based on age and gender. The following is a list of the top 10 reasons patients visited the emergency room for adult females 15 years and older for 2006, the year for which the most recent data are available. After each reason, the number of visits appears in parentheses followed by the percentage that number represents out of all ER visits by people of this age group.

Previously, we posted the top 10 reasons for ER visits for males aged 15 and older. As you will see, the top reasons that older teen and adult females end up in the ER over are somewhat different than the reasons for males. Females also make more ER visits: overall, females aged 15 and older made 54,633,000 visits to the ER in 2006, representing 56.1 % of all ER visits for this age group.

The top 10 reasons for ER visits among males aged 15 and older for 2006 are:

1. Stomach and abdominal pain or cramp (5,062,000 visits, 5.2%)
2. Chest pain and related symptoms (3,212,000 visits, 3.3%)
3. Headache or other head pain (1,923,000 visits, 2.0%)
4. Back symptoms (1,692,000 visits, 1.7%)
5. Shortness of breath (1,583,000 visits, 1.6%)
6. Pain, non-specific or poorly localized (1,303,000 visits, 1.3%)
7. Throat symptoms (1,148,000 visits, 1.2%)
8. Nausea (1,065,000 visits, 1.1%)
9. Cough (966,000 visits, 1.0%)
10. Dizziness or vertigo (952,000 visits, 1.0%)

For more information on women’s health, join the Healia Health Community for Women’s Health.

Related blog post: Top 10 Reasons for ER Visits Among Males 15 and Older

_{Source: Centers for Disease Control and Prevention, DHHS Publication No. (PHS) 2008–1250, August 2008. National Hospital Ambulatory Medical Care Survey: 2006 Emergency Department Summary, National Health Statistics Report No. 7}

_{Photo: Mark Coggins, Flickr, Creative Commons}

Each year, the Centers for Disease Control and Prevention (CDC) tracks all reported births and deaths in the United States, including teen birth rates, and releases that information part of the National Vital Statistics Reports. The just-released report for the year 2006 shows that the birth rate for teenagers aged 15–19 years increased, up 3 percent from 2005 after declining for the previous 14 years. Teen birth rates increased significantly in 26 states between 2005 and 2006, representing nearly every region of the country. But not every state was affected; some states have teen birth rates that are less than half of the national average. Below is a list of the states with the lowest teen birth rates in 2006. The rates per 1,000 females aged 15-19 are listed in parentheses.

The top 10 states with the lowest teen birth rates for 2006 are:

1. New Hampshire (18.7 births per 1,000 females aged 15-19). Virtually unchanged from a year ago, New Hampshire has the lowest teen birthrate in the nation, as it did in 2005.
2. Vermont (20.8). New Hampshire’s Northeastern neighbor was also second on the list last year and saw little change in the teen pregnancy rate in 2006.
3. Massachusetts (21.3). Another New England state, Massachusetts also had no change in its teen birth rate from last year and is less than half of the national average.
4. Connecticut (23.5). This densely populated state had a similar teen birth rate in 2006 as in 2005, but this represents a decrease of 42 percent since 1991.      
5. New Jersey (24.9). The Garden State actually saw a six percent increase in teen births from 2005, but remains in the fifth spot.
6. New York (25.7). The Nation’s second largest state saw a three percent decline in teen birth rate from 2005 to 2006, climbing two spots on the list.
7. Maine (25.8). Maine’s teen birth rate stayed about the same in 2006 but the state dropped one spot after being passed up by New York.
8. North Dakota (26.5). This Northern state saw only modest declines in the teen birth rate form the years 1991 to 2005: 16 percent was the smallest decline in the country. But they are making up for that now, with the teen birth rate declining 11 percent in the last year alone.
9. Rhode Island (27.8). With a decline of 11 percent over the 2005 teen birth rate, the Nation’s smallest state moved up four spots and into the top ten.
10. Minnesota (27.9). A seven percent increase in teen birth rate dropped Minnesota down three spots to number ten on the list.

If you have questions about teenage pregnancy, join the Healia Health Community for Teen Health or the Healia Health Community for Pregnancy, or ask the experts at Healia Health Communities.

Related blog post: The Top 10 States with the Highest Teen Birth Rates

_{Source: CDC, Births: Final data for 2006. National vital statistics reports; vol 57 no 7. Hyattsville, MD: National Center for Health Statistics. 2009. http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_07.pdf}

_{Photo: LabGP&SigOther, Flickr, Creative Commons}