Dallas has been ranked the 18th most challenging metropolitan area in the United States for people living with asthma, according to the Asthma and Allergy Foundation of America’s 2026 Asthma Capitals report.
It was the only Texas city to appear in the national top 20, with the assessment taking account of asthma prevalence, asthma-related emergency department visits and deaths. The study covers the 100 largest metropolitan areas in the contiguous United States. ([aafa.org](https://aafa.org/asthma-allergy-research/our-research/asthma-capitals/?utm_source=openai))
Dallas asthma ranking reflects emergency visits and prevalence
Dallas was judged worse than average for both estimated asthma prevalence and asthma-related emergency visits. Its asthma-related death rate was classed as average when compared with the other metropolitan areas included in the report.
The figures are intended to show the wider burden of asthma rather than suggest that every neighbourhood faces the same conditions. AAFA says the data is based on metropolitan statistical areas, which include surrounding suburbs and, in some cases, nearby rural communities.
The organisation estimated asthma prevalence using claims data from people who sought asthma care during 2025. Emergency department data also came from 2025, while asthma-related death rates were calculated using the most recent available figures covering 2020 to 2024. ([aafa.org](https://aafa.org/asthma-allergy-research/our-research/asthma-capitals/asthma-health-outcomes/?utm_source=openai))
Across Texas, El Paso ranked 70th, followed by San Antonio at 74th, Austin at 78th, McAllen at 79th and Houston at 95th.
AAFA said nearly 28 million people in the United States live with asthma. The condition is linked to almost one million emergency department visits nationally each year, while 3,279 asthma-related deaths were recorded in 2024.
Housing, insurance and air quality add to asthma risks
The report also examined factors that can make asthma more difficult to control, although they were not used to determine the overall ranking. These included housing conditions, air pollution, poverty, health insurance coverage, pollen and respiratory infections.
McAllen recorded the highest poverty rate among the metropolitan areas examined and ranked first for lack of health insurance. El Paso ranked second for the proportion of uninsured residents, with Dallas third. Houston and San Antonio were also among the 10 metropolitan areas with the highest numbers of uninsured people.
AAFA’s figures show that access to healthcare remains a significant issue for several Texas communities. Consistent medical care and access to prescribed medicines can help people manage asthma and reduce the risk of severe attacks.
Air quality was another concern. San Antonio was among 18 metropolitan areas given failing grades for a combination of ozone days and particle pollution in the American Lung Association’s 2026 State of the Air report. The assessment used air-quality data from 2022, 2023 and 2024. ([lung.org](https://www.lung.org/research/sota/city-rankings?utm_source=openai))
The American Lung Association said 44 per cent of Americans – around 152.3 million people – live in areas receiving a failing grade for unhealthy ozone or particle pollution. ([lung.org](https://www.lung.org/research/sota/key-findings?mf_ct_campaign=tribune-synd-feed&utm_source=openai))
AAFA said communities could reduce the impact of asthma by tackling mould and pests, improving ventilation and filtration in homes and schools, strengthening air-quality standards, improving housing and expanding access to healthcare.
The foundation said emergency department visits can be a sign that asthma is not being adequately controlled. It advised communities to focus on prevention and timely treatment to reduce avoidable hospital visits and deaths.
