April is nearly upon us, which means a pollen-filled spring of irritated eyes and throats is also upon us. Spring allergies affect even the best of us, but whether the city or town you live in is equipped to help you treat those allergies could be just as vital to your overall health.

Some cities may have few people with severe allergies, yet have even fewer allergists than another city with more allergic people. If you ask the Asthma and Allergy Foundation of America, which recently released its 2014 list for the 50 worst cities for allergies, that fact could seriously hurt a city’s overall score. It could also help it, as the industry-heavy New York and Los Angeles both fall out of the top 10.

The AAFA formed its list based on three criteria: pollen scores (airborne grass/tree/weed pollen and mold spores), number of allergy medications used per person, and number of allergy specialists per person. With roughly 45 million Americans living with nasal allergies, the AAFA reports, covering for all three of these factors ensures a city can adequately protect its at-risk inhabitants.

10. McAllen, Texas

10mcallen McAllen, Texas, improved from last year's 4th place but still fails in its overall pollen score and people using medication. Photo by Alex Wathen. Alex Wathen

9. Birmingham, Ala.

9birmingham Birmingham scored average on both pollen score and number of allergists, but failed to offer adequate medication. Photo by Andre Natta. Andre Natta

8. Richmond, Va.

8richmond Richmond, Va., has loads of pollen with few people taking medication for it. It falls in the middle of the pack in allergist headcount. Photo by Ron Cogswell. Ron Cogswell

7. Dallas, Texas

shutterstock_183302669 Surprisingly, while ranked 7th, Dallas is the only city inside the top 10 to score "worse than average" on all three categories. Photo by Shutterstock. Shutterstock

6. Chattanooga, Tenn.

6chattanooga So few people in Chattanooga use medication that the city falls in 6th place despite a better-than-average number of allergists and average pollen score. Photo by Andre Natta. Andre Natta

5. Jackson, Miss.

5jackson Jackson, Miss., has a lot of pollen and few people medicating themselves, even though it has plenty of allergists at its disposal. Photo by Ken Lund. Ken Lund

4. Oklahoma City, Okla.

4oklahomacity Oklahoma City starts the streak of cities that is heavy in pollen and poor in medication rates, while being average in certified allergists. Photo by Matthew Rigdon. Matthew Rigdon

3. Baton Rouge, La.

3batonrouge Last year's 10th-worst city for spring allergies, Baton Rouge has moved to third with a score of 91.93 out of 100. Photo by Sean Davis. Sean Davis

2. Memphis, Tenn.

2memphis The former 8 spot in 2013, Memphis falls to second place with a near-perfect (imperfect?) score of 97.10. Photo by Noel Pennington. Noel Pennington

1. Louisville, Ky.

1louisville Louisville, Ky., is this year's worst city for allergies, down from 5th in 2013, with high pollen, low medication, and the maximum score of 100.00. Photo by Dan Previte. Dan Previte