In this photo illustration, two asthma inhalers are pictured in a handbag on Feb. 3, 2021. (Photo by Ute Grabowsky/Photothek via Getty Images)
DALLAS - A new report from the Asthma and Allergy Foundation of America (AAFA) has Dallas ranked No. 18 among the 100 most challenging metropolitan areas in the United States for people living with asthma.
Dallas was the only Texas metro area to rank in the top 20 nationally. The report evaluated metropolitan areas based on estimated asthma prevalence, asthma-related emergency department visits and asthma-related death rates.
Dallas ranks No. 18 on the national asthma list
Local perspective:
The AAFA report classified Dallas as worse than average for estimated asthma prevalence and asthma-related emergency department visits. Dallas' Asthma-related death rate was considered average compared with the other metros that were analyzed.
How Texas metros compare across the state
The report analyzed the 100 most populated metropolitan areas in the contiguous United States. Overall, a total of six Texas metropolitan areas appeared in the report:
- Dallas: No. 18
- El Paso: No. 70
- San Antonio: No. 74
- Austin: No. 78
- McAllen: No. 79
- Houston: No. 95
The AAFA stated that asthma remains one of the most common chronic diseases in the country, and that nearly 28 million people in the United States are affected by it.
The report also said an average of 9 to 11 people die from asthma in the United States each day. There were 3,279 asthma-related deaths nationwide in 2024, according to the report.
Texas' asthma risk factors rankings
FILE - GSK is discontinuing the corticosteroid inhaler Flovent HFA (fluticasone propionate inhalation aerosol) on Dec. 31, 2023. The medication is pictured in a provided image. (Credit: American Academy of Pediatrics)
Big picture view:
The organization said asthma outcomes are influenced not only by individual health but also by factors including housing conditions, air quality, access to health care, poverty, insurance coverage, pollen and respiratory infections. Several Texas metropolitan areas ranked among the report's highest-risk communities for individual asthma-related factors.
McAllen had the highest poverty rate among the metropolitan areas included in the report. It also ranked No. 1 for lack of health insurance and No. 5 for the lowest flu and COVID-19 vaccination rates during the 2025-2026 viral season.
El Paso ranked No. 2 for lack of health insurance, while Dallas ranked No. 3. Houston and San Antonio also appeared among the 10 metropolitan areas with the highest number of uninsured residents.
San Antonio was among 18 metropolitan areas that received failing grades for a combination of ozone days and particle pollution, according to data from the American Lung Association's 2026 State of the Air report.
Houston ranked No. 10 among metropolitan areas with the lowest RSV vaccination rates to date.
The AAFA said the risk-factor data was not used to calculate the overall Asthma Capitals ranking. Instead, the factors are intended to help explain why some communities experience higher rates of asthma, emergency department visits or deaths.
How communities can reduce asthma risks
What you can do:
Asthma-related emergency department visits can signal that people are not adequately controlling the condition, the report said. Nationally, asthma accounts for nearly 1 million emergency department visits each year.
The organization said communities can reduce the burden of asthma by improving housing conditions, strengthening air-quality standards, addressing mold and pests, improving ventilation and filtration in homes and schools, and expanding access to medical care.
The Source: Information in this article was provided by Asthma and Allergy Foundation of America's 2026 Asthma Capitals report.