These Are the Worst U.S. Cities for Spring Allergies

If you suffer from spring allergies, avoid these cities at all costs.

Spring brings beautiful blooms, warm breezes, and longer days. Unfortunately, though, that pleasant air and those fresh flowers can be breeding grounds for irritating allergens. According to the Asthma and Allergy Foundation of America (AAFA), more than 50 million people suffer from seasonal allergies in the United States alone, with symptoms peaking during the fall and spring. And it's not just seasonal differences that make allergies worse. Things like the average amount of pollen in the air, access to allergy medication, and the general environment of an area also make some cities worse for allergy sufferers than others.

Curious as to which cities to avoid this spring to avoid sneezing and a stuffy nose? In their 2019 Spring Allergy capitals report, the AAFA ranked the 100 largest metropolitan areas in the contiguous 48 states from worst to best using metrics like pollen count, medicine utilization per patient, and access to board-certified allergists (with 100 being the worst and 1 being the best). Below, we've highlighted the 20 worst cities for spring allergies based on their data.

Knoxville, Tennessee

Knoxville Tennessee

While Knoxville, Tennessee, has seen some improvements since 2018, they still received an underwhelming score of 68.01 out of 100 from the AAFA. The thing that hurt the city the most was its medicine utilization per patient score, which was worse than average.

Columbia, South Carolina

Columbia SC

With a score of 68.57, Columbia, South Carolina, is one of the few southeastern cities to make an appearance in the bottom 20. Like Knoxville, its downfall was its residents' lack of medication use.

Oklahoma City, Oklahoma

Oklahoma City

In the state "where the wind comes sweeping down the plain," you'll find the 18th worst city for spring allergies: Oklahoma City. Though its medicine utilization and access to allergists are fairly average, the city's pollen score is well below average, with the AAFA giving it a score of 68.64.

El Paso, Texas

El Paso

Though it improved slightly on the AAFA's list since 2018, El Paso, Texas, is still considered one of the worst cities for allergy sufferers with a score of 68.83. The Texas Mulberry tree may be largely to blame; found all over the city, it is considered a severe allergen, according to IMS Health.

Buffalo, New York

Buffalo NY

New York's second most populous city gets blasted with blizzards in the winter and allergies in the spring. Buffalo takes the 16th spot on the AAFA's list with a score of 69.55.

Little Rock, Arkansas

Little Rock

Although the number of allergists available in Little Rock, Arkansas, is considered better than average, the city scored a 70.27 overall, putting it in the 15th spot.

San Antonio, Texas

San Antonio

This Texas city where the famed Battle of the Alamo occurred finds itself in 14th place for the worst cities for spring allergies with a score of 70.32. This is a vast improvement for the southern city, though: In 2018, it was among the bottom five on the AAFA's list.

Dayton, Ohio

Dayton Ohio

With below average pollen and medicine use ratings, Dayton, Ohio, received a score of 70.70 from the AAFA, which is nothing to sneeze at. The city has a high concentration of plants and trees that bloom at the same time, which likely plays a significant role in its high score.

Syracuse, New York


With a score of 71.28, Syracuse, New York, secured the 12th spot on the list of the worst cities for spring allergies. The city's only slight saving grace was its prevalence of board-certified allergists, which was considered to be average.

Toledo, Ohio

Toledo Ohio

This Ohio locale takes 11th place with a score of 71.82 from the AAFA, making it the worst city for spring allergy sufferers in the Midwest.

Richmond, Virginia

Richmond Virgina

Rounding out the bottom 10 is Richmond, Virginia, with a score of 72.45. The city's access to medicine and certified allergists were only considered average, while its pollen count was worse than average.

Baton Rouge, Louisiana

Baton Rouge

Bad news for Baton Rouge residents: The AAFA gave Louisiana's capital city a score of 72.67, even though its pollen count and the number of allergists per patient were both considered average.

Scranton, Pennsylvania

Scranton Pennsylvania

The Electric City popularized by The Office managed to jump from 47th place in 2018 to the bottom 10 in 2019 for the cities with the worst spring allergies with a score of 73.04.

New Orleans, Louisiana

Bourbon Street New Orleans, Louisiana

It seems The Big Easy isn't so easy on allergy sufferers, as evidenced by its AAFA score of 73.56. With a below average medicine utilization per patient score, New Orleans should be called The Big Sneezy instead!

Louisville, Kentucky

Louisville Kentucky

With a score of 78.67, it appears that Louisville gets slugged by allergy season. The city seems to be slowly improving in terms of its status as a spring allergy hot bed, though; it's up four spots from 2018.

Springfield, Massachusetts

Springfield Massachusetts

Springfield, Massachusetts, seems to be accelerating to the top of the AAFA's list of worst cities for spring allergies quite rapidly. In 2016, it ranked 20th; in 2018, it was 11th; and now, it's at 5th place for 2019 with a score of 78.76.

Memphis, Tennessee

Memphis Tennessee

With below average rankings for both pollen and medicine usage, Memphis, Tennessee, earned the 4th spot on the AAFA's list with a score of 78.92.

Providence, Rhode Island

Downtown Providence Rhode Island

Rhode Island's capital city leads us into the bottom three with a score of 80.48. It fared worse than average for pollen count, medicine per patient, and allergists per patient.

Jackson, Mississippi

waterfall in Jackson Tennessee

Though Jackson, Mississippi, was rated better than average for its access to board-certified allergists, it still received a score of 84.74, making it the second worst U.S. city for spring allergy sufferers.

McAllen, Texas

McAllen Texas

They say that everything is bigger in Texas, and that goes for allergy symptoms as well. The city of McAllen comes in first place on the AAFA's list of the worst spring allergy cities, scoring 100 points based on the checklist. The city also came in second-to-last place on the AAFA's list of the most challenging places to live with asthma.

Additional reporting by Sarah Crow.

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