Best Cities for COPD Patients

Discover the cleanest air for COPD based on comprehensive air quality data.

The metric that matters for people with COPD

EPA's AQI turns "Unhealthy for Sensitive Groups" at 100 — the point at which people with COPD are advised to shorten or ease outdoor exertion. So the useful ranking is not the most Good days, it is the fewest days above AQI 100. On that measure the best-placed metro area EPA published a full 2025 record for is Santa Rosa, CA, with 0 days above AQI 100 all year (0 above 150) and a median AQI of 9.

US cities ranked from EPA annual AQI summaries for 2025
#City (EPA area)Good days (2025)Median AQIDays over 100Days over 150Main pollutantAQI now
1Santa Rosa, CASanta Rosa, CA365 / 365 (100%)900coarse dust (PM10)32
2Honolulu, HIUrban Honolulu, HI355 / 365 (97.3%)2900ground-level ozone32
3Billings, MTBillings, MT315 / 365 (86.3%)3800ground-level ozone34
4Charleston, WVCharleston, WV281 / 365 (77%)3900fine particulate matter (PM2.5)11
5San Jose, CASan Jose-Sunnyvale-Santa Clara, CA334 / 365 (91.5%)3900ground-level ozone57
6Amarillo, TXAmarillo, TX286 / 365 (78.4%)4200ground-level ozone47
7Greensboro, NCGreensboro-High Point, NC272 / 365 (74.5%)4200fine particulate matter (PM2.5)21
8Lexington, KYLexington-Fayette, KY268 / 365 (73.4%)4200fine particulate matter (PM2.5)22
9Durham, NCDurham-Chapel Hill, NC261 / 365 (71.5%)4300fine particulate matter (PM2.5)19
10Montgomery, ALMontgomery, AL229 / 359 (63.8%)4400fine particulate matter (PM2.5)
11Raleigh, NCRaleigh, NC242 / 365 (66.3%)4400fine particulate matter (PM2.5)19
12Santa Fe, NMSanta Fe, NM286 / 365 (78.4%)4400ground-level ozone30
13Colorado Springs, COColorado Springs, CO249 / 365 (68.2%)4600ground-level ozone31
14Stockton, CAStockton-Lodi, CA219 / 365 (60%)4600fine particulate matter (PM2.5)55
15Columbia, SCColumbia, SC212 / 365 (58.1%)4700fine particulate matter (PM2.5)28
16Sarasota, FLNorth Port-Sarasota-Bradenton, FL230 / 365 (63%)4700fine particulate matter (PM2.5)32
17Savannah, GASavannah, GA214 / 365 (58.6%)4700fine particulate matter (PM2.5)32
18Charlotte, NCCharlotte-Concord-Gastonia, NC-SC168 / 365 (46%)5200fine particulate matter (PM2.5)16
19Jackson, MSJackson, MS167 / 365 (45.8%)5200fine particulate matter (PM2.5)46
20Winston-Salem, NCWinston-Salem, NC152 / 365 (41.6%)5200fine particulate matter (PM2.5)21
21Erie, PAErie, PA280 / 365 (76.7%)3410fine particulate matter (PM2.5)21
22Atlantic City, NJAtlantic City-Hammonton, NJ300 / 365 (82.2%)3610ground-level ozone41
23Worcester, MAWorcester, MA-CT296 / 365 (81.1%)3910ground-level ozone19
24Norfolk, VAVirginia Beach-Norfolk-Newport News, VA-NC285 / 365 (78.1%)4110fine particulate matter (PM2.5)61
25Virginia Beach, VAVirginia Beach-Norfolk-Newport News, VA-NC285 / 365 (78.1%)4110fine particulate matter (PM2.5)61

Figures are EPA's published annual AQI summaries by metropolitan area (Annual AQI by CBSA, 2019–2025), retrieved 2026-09-07. The daily AQI EPA summarises is the highest value any monitor in the area reported that day, so these are metro-area readings, not statewide or rural ones. Only cities with at least 300 reported days in 2025 are ranked — a partial year cannot be compared fairly against a full one — and cities in areas EPA publishes no summary for are left out rather than given an estimated value. "AQI now" is the latest AirNow observation at build time and is blank where AirNow has none. Ordering is by days above AQI 100, then days above AQI 150, then median AQI.

Using this list honestly

A low annual count of AQI-100 days does not mean a city never has a bad day, and the days it does have are the ones that matter to people with COPD. Check the "days over 150" column as well as the headline number, and look at when those days fall: many cities concentrate them in one season, which the per-city month and season pages break out.

These are metro-area monitor readings, not an assessment of any individual address, and nothing here is medical advice. Indoor air matters at least as much for a sensitive group; see the indoor air quality guide and the room-size calculator.

Why Air Quality Matters

For people with respiratory conditions, air quality is crucial for managing symptoms and maintaining quality of life. These cities offer the cleanest air to help you breathe easier.

Selection Criteria

Cities are ranked based on AQI levels, dominant pollutants, seasonal patterns, and specific factors relevant to this category.