Staff Reporter
Three Pennsylvania cities have made headlines for the wrong reasons. Allentown, Philadelphia, and Harrisburg are ranked among the nation’s toughest places to live for people with asthma, according to the Asthma and Allergy Foundation of America’s 2025 U.S. Asthma Capitals report.
Story Highlights:
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Allentown ranks No. 3, Philadelphia No. 4, and Harrisburg No. 15 in the 2025 Asthma Capitals report.
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High asthma rates linked to poor air quality, mold, poverty, and lack of affordable medication.
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Inhalers and long-term medications remain costly and often inaccessible for uninsured residents.
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Seasonal allergens and aging infrastructure worsen conditions, especially for children.
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Experts call for policy reforms, affordable treatment access, and environmental improvements.
The report, released earlier this month, identifies cities where asthma prevalence, emergency room visits, and asthma-related deaths are alarmingly high. Pennsylvania cities, in particular, continue to face challenges in reducing environmental triggers and ensuring access to life-saving treatments.
“There’s a number of things that are not going well in the asthma ecosystem,” said Ana Santos Rutschman, health law professor at Villanova University. “It is one of the major public health problems we face nationally and more pronounced in regions including Philadelphia.”
Experts point to a combination of factors behind the high asthma rates in these Pennsylvania cities. Poor indoor and outdoor air quality, aging buildings, mold exposure, and seasonal allergens contribute to worsening conditions. Coupled with poverty and insurance gaps, many residents struggle to manage asthma effectively.
“Towns and cities named as ‘asthma capitals’ often have higher rates of poorer air quality, more people living in poverty, and many residents who are uninsured or underinsured,” Rutschman said. “All of these are risk factors that make it difficult for people to manage asthma.”
Medication Access Remains a Critical Challenge
Long-term medications can help keep asthma under control, reducing attacks and emergency visits. But access is uneven. Many treatments require specialist prescriptions, which are not always available depending on one’s location or health insurance status.
Rescue inhalers, vital for immediate relief during attacks, also come with high costs. “Even that ends up with a price tag that many parents just cannot afford,” Rutschman noted. Brand-name inhalers can cost several hundred dollars without insurance, while generics may still exceed $200.
“It has been puzzling because these are older medications with expired patents. There’s nothing about them that should cost so much,” Rutschman added.
Even when medications are available, environmental triggers can make asthma management extremely difficult. Exposure to polluted outdoor air, cigarette or vape smoke, and indoor mold remains common. Children, especially, are vulnerable in older school buildings where mold and air quality issues are more prevalent. Seasonal allergens, particularly in September, further increase asthma attacks and emergency room visits in the tri-state area.
Experts Advocate for Affordable Medications and Environmental Reforms
Increasing access to asthma medications and inhalers is crucial, experts say. Making treatments more affordable could significantly reduce emergency room visits and long-term healthcare costs. Some pharmaceutical companies recently capped inhaler costs at $35 per month, but only for fully insured patients under private health plans, leaving those on public programs like Medicaid or Medicare still at risk.
“Price caps can be helpful, but without federal or state laws mandating them, companies can change policies at any time,” Rutschman explained.
Websites like GoodRx can help patients find discounted prices at local pharmacies, providing some relief in the absence of universal price caps.
At the same time, experts emphasize reducing environmental triggers. Avoiding smoke, improving outdoor air quality, and encouraging mold remediation in older buildings can all help reduce asthma attacks. “States and cities could create incentive programs for mold removal and improving indoor air conditions, which would especially help children,” Rutschman said.
The findings of the 2025 Asthma Capitals report highlight the urgent need for comprehensive action in Pennsylvania asthma cities. Addressing both the medical and environmental aspects of asthma can improve quality of life and reduce preventable emergency visits, offering hope for residents who have long struggled with this chronic condition.
Addressing the asthma crisis in Pennsylvania cities requires urgent action. Reducing environmental triggers, improving access to affordable medications, and supporting public health initiatives can help residents breathe easier. Without comprehensive solutions, Allentown, Philadelphia, and Harrisburg will continue to face high asthma rates, emergency visits, and preventable health risks.
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