Worst Cities for People With Fall Allergies Louisville, Ky., is once again the toughest place to live if you have fall allergies, says a 2014 list from the Asthma and Allergy Foundation of America. Louisville has topped the rankings of the country's top 100 metro areas for four years in a row.

The rankings are based on several factors:

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• airborne pollen counts from grass, trees, weeds, and mold spores
• number of people affected by pollen allergies
• the number of allergymedications used per person
• the number of allergy specialists per 10,000 patients

Louisville’s score was 100. The city that’s best for people with fall allergies, Greeneville, S.Car., had a score of 30.60.

The top five allergy capitals for fall 2014 and their scores are:

Louisville, Ky. 100.00

Wichita, Kan. 95.76

Oklahoma City, Okla. 92.00

Dayton, Ohio 91.58

McAllen, Texas 90.37

The five cities with the lowest scores, meaning the cities that are best for people with fall allergies, are:

Greeneville, S. Car. 30.60

Spokane, Wash. 34.49

Portland, Ore. 36.53

Sacramento, Calif. 37.16

Provo, Utah 401.13