Top 10 worst US cities to live in if you have allergies

More than 100 million people in the United States live with seasonal pollen allergies. Most of the pollen that triggers allergic reactions comes from trees, grasses and weeds. Pollen can trigger symptoms in people with two common allergic conditions: seasonal allergic rhinitis (also known as "hay fever" or "nasal allergies") and allergic asthma.

Each year, the Asthma and Allergy Foundation of America (AAFA) evaluates the top 100 U.S. cities for seasonal allergies and identifies the 10 most challenging cities for people with pollen allergies.

To determine which cities made its "Allergy Capitals" report, AAFA analyzed data from the 100 most populated U.S. metropolitan areas.

"We use pollen counts, over-the-counter usage and access to allergy specialists. It's those three elements that combine in the rankings, and if you're worse than those, then you're higher up on the scale and have a more challenging place to live in," Kenneth Mendez, president and CEO of the Asthma and Allergy Foundation of America, told AccuWeather.

Top 10 most challenging U.S. cities to enjoy with allergies

This year’s report named Wichita, Kansas, as the top 2025 Allergy Capital for the third year in a row due to worse-than-average tree and grass pollen. New Orleans ranks second despite having a better-than-average number of allergists and immunologists. According to AAFA, it has below-average grass pollen, weed pollen and over-the-counter allergy medicine use. In third place is Oklahoma City, Oklahoma, due to worse-than-average tree and grass pollen and over-the-counter medication use.

"Predominantly, it's the pollen and the trees in the Southeast and then access to specialists. Certainly, Wichita, Kansas, which is number one for the third year in a row, lacks access to specialists...But in general, when you're looking at this map, think about the climate. Think about the trees and the pollen that are around there and what the weather might have been in the previous year. So there's a lot of moisture in the South, and the allergy seasons are getting longer and more intense because of climate change" said Mendez.

Is climate change worsening allergy season?

A 2023 report from Climate Central, a nonprofit focused on climate news and research, analyzed how higher temperatures have affected allergy season in 203 U.S. cities since 1970. It found that, on average, the growing season—the period between the last freeze in spring and the first freeze of fall -- is lasting 16 days longer in the Southeast, 15 days longer in the Northeast and 14 days longer in the South.

In the West, the growing season is 27 days longer on average, Climate Central reported. Reno, Nevada, for example, has experienced an increase of 99 days.

"Because of climate change, we're now seeing an earlier and longer growing season for plants, which, of course, make pollen, which is the enemy of many Americans that suffer from pollen allergies—and mold allergies as well," Lauren Casey, a meteorologist with Climate Central, told CNN. "Pollen can also trigger an asthma attack, which of course is much more serious for people that suffer from asthma."

When plants reproduce, typically during spring, many release tiny pollen grains that are carried by the wind. The pollen grains are small enough to be inhaled, and some people's immune systems react poorly to the tiny particles.

With millions of people suffering from pollen allergies, a longer and earlier start to pollen season could trigger a public health emergency, researchers say. As temperatures rise in the South and drought plagues the Southwest, pollen from plants like ragweed or Poaceae—a plant that typically grows in grasslands or salt marshes—is projected to be higher across those regions than in the North.

Wind-driven pollen, which plays an important role in plant fertilization, is closely tied to temperature and precipitation changes. As spring arrives earlier due to climate change, plants could pollinate much earlier and for a longer period than they do now.

Top tips to mitigate your allergy symptoms

If you suffer from allergies, AAFA President Kenneth Mendez said there are many things you can do to mitigate your reaction to pollen, starting with understanding what triggers your symptoms.

"See an allergy specialist so you know what your triggers are and then start taking your medication, if that provides some relief, before the allergy season starts because sometimes you need to get that in your system," Mendez explained, adding, "And then make sure you avoid being outside during high pollen events...If you have to go outdoors, when you come indoors, leave your coat at the door. If you're walking your dog, wash your dog off, if you can. Have an air purifier indoors. Keep the windows closed. Those are very important things to manage your triggers."

Click here for the full 2025 Allergy Capitals report and be sure to check out AccuWeather's allergy outlook on AccuWeather.com for the latest pollen reports for your area.

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