Philadelphia and Allentown have been identified as two of the most challenging cities in the United States for people living with asthma. According to the Asthma and Allergy Foundation of America (AAFA), Philadelphia ranks No. 4 and Allentown No. 3 in its latest report released on September 9, 2025. The ranking highlights the ongoing struggles faced by asthma patients in these cities.
The AAFA, the largest patient advocacy group for asthma and allergy sufferers in the U.S., evaluates cities based on various metrics, including asthma prevalence rates, emergency room visits, and asthma-related fatalities. Notably, Allentown has improved its position from No. 1 in 2024 to No. 3, while Philadelphia has seen a decline, moving from No. 3 to No. 4.
Understanding the Asthma Crisis
As the report points out, the month of September poses significant challenges for asthma patients, marking the peak season for asthma-related issues. This time of the year typically sees a surge in asthma attacks and related hospital visits across the nation. Factors such as heightened pollen levels and poor indoor air quality contribute to this seasonal spike. In Pennsylvania, many school buildings are at risk due to age and deterioration, exacerbating the situation for children with asthma.
A report published in August 2025 indicated that schools in Pennsylvania are rife with asthma triggers, including radon, mold, and lead paint. Alarmingly, less than 4% of schools in the state have implemented indoor air quality plans. This lack of preparedness is particularly concerning in cities like Philadelphia, where many educational facilities are over 70 years old and in dire need of repairs.
Addressing Medication Affordability
For many asthma patients, access to affordable medication is critical for managing their condition. Over the last 15 years, the costs of asthma medications have skyrocketed, making it increasingly difficult for patients to afford their treatments. While some pharmaceutical companies have introduced caps on the prices of asthma inhalers, not all medications are covered, leaving many patients facing substantial expenses.
According to recent changes, some inhalers are now capped at US$35 each. However, other asthma medications, particularly oral treatments, remain prohibitively expensive. Patients can explore resources like GoodRx, an online platform that allows users to compare medication prices across pharmacies, to help alleviate some of the financial burden.
In light of the challenges surrounding affordability, there are calls for state-level interventions. Similar to the federal Medicare price cap on insulin, lawmakers in Pennsylvania could consider legislation imposing price caps on asthma medications. Other states, such as Minnesota, have already taken steps in this direction by capping inhaler prices at US$25 starting January 1, 2025.
Moreover, addressing the broader asthma crisis requires multifaceted strategies. Pennsylvania could provide funding for schools to improve ventilation systems and enhance indoor air quality, which is essential for the well-being of students with asthma.
The insights from this report underscore the urgent need for coordinated efforts among individuals, schools, and policymakers to improve conditions for asthma patients in Pennsylvania. As the challenges persist, proactive measures are essential to ensure a healthier environment for those affected by this chronic condition.
Ana Santos Rutschman, a health law professor and the director of the Health Innovation Lab at Villanova University, emphasizes the importance of these initiatives and remains committed to finding solutions that make asthma medications more accessible and affordable for patients.
