Asthma Capitals 2018: Asthma-Related Emergency Department Visits

In the AAFA's Asthma Capitals 2018 ReportDownload PDF , AAFA ranked cities based on three health outcomes: asthma prevalence, asthma-related emergency department visits and asthma-related mortality rates. The outcomes were not weighted equally.


Proper asthma management may help to reduce trips to the emergency department (ED). These steps can help you reduce your chance of needing to go to the ED:

More than 2 million ED visits each year are due to asthma. If you have an asthma attack that is severe or won’t respond to quick-relief medicines, you may need to go to the ED. Call your asthma care provider right away if you or your child has trouble breathing. If you can’t reach them, call 911.

Unnecessary trips to the emergency room can be costly. On average, every asthma-related trip to the ED costs $1502.1

The Centers for Disease Control and Prevention released its Vital Signs report on pediatric asthma. The CDC’s findings showed that from 2010-2016 the use of asthma action plans increased and the number of hospitalizations decreased. During the past 10 years, asthma-related hospitalizations decreased from 10% to 5%.2

AAFA analyzed the number of asthma-related emergency department visits in the top 100 U.S. cities. This outcome was weighed in the overall ranking of the 2018 Asthma Capitals. 

Asthma Emergency Room Visits by City

Nancy Gomez of Boston, Massachusetts, (overall #11 on Asthma Capitals), knows too well the financial and emotional cost of severe asthma attacks and emergency department visits. Her 10-year-old son, Oziel, has had asthma and allergies since he was a baby and has been to an ED several times. The cost of these visits puts a strain on her finances as a single mother.

Nancy struggles with worry. “I think my main concern is being able to get him to the hospital on time.”

When Oziel has a severe asthma attack, Nancy drives him to the hospital herself. She doesn’t call 911 because it’s another expense and she lives paycheck to paycheck. Her main health insurance is private insurance with copays and deductibles that are hard for her to afford. She wants to avoid getting a bill for $500 for the ambulance.

“Last year one time I thought I wasn’t going to make it to the hospital on time,” Nancy recalls. “He was in the back seat hardly getting any air. He couldn’t sit up straight. We barely made it.”

“There’s times when I don’t know how I manage,” Nancy adds. In addition to asthma, Oziel has environmental allergies to pollen, animals, dust, smoke and more. He also has life-threatening food allergies to peanuts, tree nuts and dairy products. And he is autistic. Managing all of this is a constant challenge for Nancy. “It gets very stressful. Especially since it’s not something acute where a child is really sick and then gets better. You have to be on top of that medical care all the time.”

Talk with your doctor or nurse to make sure you understand how to best manage your or your child’s asthma.




1. Rui, P., & Kang, K. (2014). National Hospital Ambulatory Medical Care Survey: 2014 Emergency Department Summary Tables. Retrieved from /data/ahcd/nhamcs_emergency/2014 _ed_web_tables.pdf

2. Vital Signs. (2018, February 06). Retrieved from