LAKELAND, Fla. (WFLA) — Bay area doctors said they are surprised to see Lakeland top the list of most challenging cities in the south to live with asthma.

The Asthma and Allergy Foundation of America (AAFA) releases the report every year, and this year, Lakeland is number four of the top 100 metropolitan areas in the country.

It follows Detroit, MI, Cleveland, OH, and Allentown, PA to make it the number one worst city for asthma in the south.

“To be quite honest, I was surprised and also not surprised because I think asthma is under-recognized in this region,” said Dr. Kathryn Convers, from Lakeland Allergy, Asthma and Immunology.

Her office has a three-month wait for new patients.

“Every day I am diagnosing new patients with asthma who are not being referred here for asthma,” said Dr. Convers. “They’re being referred for other things and in the conversation and obtaining the history, we identify those red flags.”

Dr. Convers said she is trying to expand her practice and hire a new physician or practitioner.

“On the AAFA study, Lakeland rated #10 in terms of lowest access to asthma specialists, so specifically allergists, immunologists like myself, and pulmonologists,” Dr. Convers said.

The study uses three main criteria: prevalence of asthma, asthma-related deaths, and asthma-related emergency room visits.

Lakeland ranked fourth for prevalence and 10th for emergency room visits.

Data provided by Lakeland Regional Health showed 4,000 – 6,500 visits to its emergency room with asthma as either the principal or other diagnosis each year for the last five years.

Lakeland is not ranked in the top 10 cities when it comes to asthma-related mortality.

“Asthma is not a benign disease. It can kill you. It does kill quite a number of people throughout the year,” said Dr. Lionel Bonini, allergist and immunologist at Watson Clinic.

Dr. Bonini pointed out that given Lakeland’s smaller size, mild winters, and relative lack of pollution, he was not expecting Lakeland’s ranking.

“We do have seasonal pollen counts that are quite high but I would have been surprised that Lakeland would score so high,” said Dr. Bonini.

“We really don’t want it to be, like, a really grim outlook if you do manage to be at the top of this list. This is really meant to be more of a tool of empowerment and advocacy,” said Hannah Jaffee, research analyst at AAFA.

Notably, Lakeland went from 72 on the list last year to fourth in 2022 — a leap in the wrong direction.

“Lakeland did make a huge jump. One of the reasons for that is we actually did change data sources this year,” Jaffee said.

According to Jaffee, AAFA used insurance claim data instead of self-reporting surveys.

Tampa ranked 33 on the list.

Ragweed and mold counts peak in September, leading to issues for children and adults with asthma.

Doctors recommend keeping track of symptoms, including wheezing and a prolonged cough after a cold.

“If they ever have nighttime respiratory symptoms like a cough that might wake them up from their sleep, that should ideally never happen but if it happens twice a month or more that’s a specific red flag for possible asthma,” said Dr. Convers.

To view the report, visit