Worse than Average Average Better than Average

2013 Fall Rank 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34

Rank Last Year 2 4 3 1 8 5 10 6 11 7 13 9 22 16 19 12 18 26 28 24 17 23 15 36 21 42 32 25 27 37 20 33 31 34

The Most Challenging Places to Live with Fall Allergies

Subtotal: Pollen Score* (Avg. 300 grains/cubic meter air daily) l l l l l l l l l l l l l l l l l l l l l l l

www.AllergyCapitals.com 2013 Asthma and Allergy Foundation of America (Factors are not weighted equally)
Subtotal: Board Certified Allergists per Patient (Avg. 1.05 Board Certified Allergists Per 10,000 Est. Patients) l l l l l l l
1

Overall

Metropolitan Area

Total Score (Avg. 62.87) 100.00 96.44 94.32 89.12 88.72 88.37 87.87 86.91 85.76 85.65 84.54 83.67 82.64 80.02 77.50 77.10 76.88 76.63 76.27 75.59 74.54 73.86 73.53 72.37 72.35 70.96 70.71 70.15 70.08 69.63 69.47 68.95 68.12 67.82

Subtotal: Medicine Utilization per Patient (Avg. 0.78 Medications Per Est. Patient) l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l

l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l

Wichita, KS Jackson, MS Knoxville, TN Louisville, KY Memphis, TN McAllen, TX Baton Rouge, LA Dayton, OH Chattanooga, TN Oklahoma City, OK New Orleans, LA Madison, WI Omaha, NE Little Rock, AR Tulsa, OK Buffalo, NY Grand Rapids, MI Dallas, TX Detroit, MI Toledo, OH Birmingham, AL Des Moines, IA San Antonio, TX Nashville, TN Syracuse, NY Charleston, SC Augusta, GA Providence, RI St. Louis, MO Greenville, SC Youngstown, OH Houston, TX Columbia, SC Virginia Beach, VA

Worse than Average Average Better than Average

2013 Fall Rank 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68

Rank Last Year

14 30 44 38 43 41 35 40 53 51 47 29 39 50 46 45 54 48 55 52 63 56 71 57 59 58 72 49 68 70 62 61 60 65

The Most Challenging Places to Live with Fall Allergies

Subtotal: Pollen Score* (Avg. 300 grains/cubic meter air daily) l l l l l l l l l l l l l

www.AllergyCapitals.com 2013 Asthma and Allergy Foundation of America (Factors are not weighted equally)
Subtotal: Board Certified Allergists per Patient (Avg. 1.05 Board Certified Allergists Per 10,000 Est. Patients) l l l l l l l l l
2

Overall

Metropolitan Area

Total Score (Avg. 62.87) 67.67 67.33 66.99 66.80 66.32 65.52 65.06 64.98 64.86 64.73 64.45 64.37 63.48 62.40 61.99 61.80 60.04 59.84 59.21 59.09 58.73
58.71 58.27 58.25 58.18 58.16 58.00 57.64 56.79 56.40 56.38 56.32 55.55 55.48

Subtotal: Medicine Utilization per Patient (Avg. 0.78 Medications Per Est. Patient) l l l l l

Rochester, NY Akron, OH Minneapolis, MN Kansas City, MO Portland, ME Columbus, OH Cleveland, OH Philadelphia, PA Milwaukee, WI Charlotte, NC Austin, TX Pittsburgh, PA Riverside, CA Albany, NY Greensboro, NC Indianapolis, IN Scranton, PA El Paso, TX Hartford, CT Poughkeepsie, NY Cincinnati, OH New York, NY Richmond, VA Chicago, IL Jacksonville, FL Allentown, PA Springfield, MA New Haven, CT Lakeland, FL Fresno, CA Cape Coral, FL Bridgeport, CT Miami, FL Harrisburg, PA

Worse than Average Average Better than Average

2013 Fall Rank 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100

Rank Last Year 79 69 73 75 77 78 83 67 74 66 76 64 86 87 82 91 88 92 85 96 84 80 90 81 89 95 94 97 93 98 100 99

The Most Challenging Places to Live with Fall Allergies

Subtotal: Pollen Score* (Avg. 300 grains/cubic meter air daily)

www.AllergyCapitals.com 2013 Asthma and Allergy Foundation of America (Factors are not weighted equally)
Subtotal: Board Certified Allergists per Patient (Avg. 1.05 Board Certified Allergists Per 10,000 Est. Patients) l l l l l l l l l l l l l

Overall

Metropolitan Area

Total Score (Avg. 62.87) 55.25 55.22 54.22 54.06 53.96 53.67 52.88 52.28 51.92 51.89 51.33 50.57 48.62 48.62 48.06 47.05 47.00 46.55 46.28 45.74 45.64 45.26 44.36 43.16 43.11 42.97 42.78 41.60 40.86 40.08 37.95 37.87

Subtotal: Medicine Utilization per Patient (Avg. 0.78 Medications Per Est. Patient)

Worcester, MA Las Vegas, NV Tampa, FL Phoenix, AZ Tucson, AZ Atlanta, GA Boston, MA Los Angeles, CA Lancaster, PA Bakersfield, CA Orlando, FL Ogden, UT Baltimore, MD Albuquerque, NM Washington, DC Seattle, WA Raleigh, NC Sarasota, FL Modesto, CA San Francisco, CA Palm Bay, FL Oxnard, CA San Diego, CA Salt Lake City, UT Boise, ID Denver, CO San Jose, CA Daytona Beach, FL Colorado Springs, CO Stockton, CA Sacramento, CA Portland, OR

The Most Challenging Places to Live with Fall Allergies

2013 Rank - Rankings for the Allergy Capitals are based on analysis of data from factors including: Prevalence Data, Seasonal Pollen, Allergy Medicine Utilization per Patient, and the number of Board Certified Allergists per patient. Weights were applied to each factor and a composite final score was calculated for each Metropolitan Statistical Area (MSA). Total Score - Final total scores and subtotals were rescaled assigning 100 points to the largest score and presenting all other scores as a percentage of the largest. The metro area with a total score of 100 points did not necessarily have the most severe score for all factors, but, rather, the highest total weighted final score overall. Pollen Score* - Quantitative data analysis of average recorded pollen/mold spore levels and predicted prevalence for certain types of pollens/molds over the most recent spring season and the duration of the peak season for the most allergenic pollen types; this score also takes into consideration local prevalence statistics for people affected by allergies to pollen. (Regarding daily pollen counts: previous studies have shown that daily pollen concentrations of 150+ grains per cubic meter of airborne allergenic pollen is a sufficiently high concentration which can trigger allergy symptoms in a large percentage of the allergic population.) Medicine Utilization per Patient Score - Quantitative data analysis of recorded per capita utilization of recorded pharmacy data for prescription (RX) allergy medicines in each metro area during the most recent spring season. Also includes over-the-counter (OTC) and behind-the-counter (BTC) allergy medication sales at the pharmacy counter. Board Certified Allergists per Patient Score - Quantitative data analysis for the most recent spring season of the number of Board Certified allergy and immunology specialists per 10,000 estimated patients. GOVERNMENTAL SOURCES: National Institute of Allergy and Infectious Diseases, National Institutes of Health, Allergic Rhinitis Information (2012) U.S. Deparlent of Commerce, Bureau of the Census, U.S. Census 2000, 2011 Updates U.S. Deparlent of Commerce, National Oceanic and Alospheric Administration, Air Resources Laboratory (ARL), Air Stagnation Climatology for the U.S. (2012) U.S. Environmental Protection Agency, Status and Trends, Latest Findings on National Air Quality (2012) NON-GOVERNMENTAL SOURCES: Asthma and Allergy Foundation of America, Asthma and Allergy Answers (2013) American Board of Medical Specialties, Specialist Database (2012) INDUSTRY SOURCES: IMS/SDI Pollen.com Database (2012) IMS Medication Database (2012) AAFA is solely responsible for the contents of this report. AAFA, Founded in 1953, is the leading national advocacy organization for the allergy community in the U.S. AAFA provides education, promotes advocacy and funds research.