If you have asthma, you’ll have to fight the disease no matter where you live, but in some cities, the breathing disorder is harder to control. In 2014, the 10 worst cities for asthma sufferers, as ranked by the Asthma and Allergy Foundation’s annual list, are:

—Richmond, Virginia, skyrocketed from No. 23 last year to the number one spot because of poverty and high levels of year-round pollen.

—Memphis, Tennessee, stays near the top of the AAF’s list. This is attributed to year-round pollen, weak anti-smoking laws and low use of daily medications.

—The biggest problem asthma sufferers face in McAllen, Texas, is a lack of access to care. Many people without insurance don’t have daily medications to prevent asthma. And Texas is one of the states that didn’t accept Medicaid expansion, leaving too many of its citizens uninsured.

—Smoking is a big contributor to Oklahoma City’s asthma problem. A third of folks with asthma who live here are also smokers.

—Poor air quality and unhealthy ozone days make Philadelphia a rough city for asthma sufferers. For black asthmatics, it’s a particularly bad place; asthma deaths are four times more common among us in the City of Brotherly Love.

—Though asthma rates are lower than the national average in Chattanooga, Tennessee, asthma-induced ER visits are higher than average.

—More than 1 in 5 children who live in Fresno, California, have asthma, which is enough to place this California city in the top 10 worst cities for asthma sufferers.

—Fall is particularly difficult for folks who have asthma and live in Tulsa, Oklahoma. That’s peak ragweed season, and ragweed can trigger attacks.

—Black folks in the Chicago are five times as likely as their white counterparts to die from asthma.

—Detroit has been making the news for all the wrong reasons lately, including coming in at No. 10 on this year’s asthma list. Poverty and lack of access to care make asthma a major concern here.

Read more about the worst cities for asthma at BlackHealthMatters.Com.

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