Dallas. Home of Ross Perot, the Dallas Mavericks, the original Neiman Marcus. For all the advantages that come with living in this city, there’s a downside. Too many dinners at your favorite Mexican restaurant and endless hours stuck on the freeway can equal a health disaster. We’ve asked the experts for insights into the top health risks for those who dwell in Dallas, and what can be done to reduce their effects.

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ASTHMA AND ALLERGY: We can thank high pollen counts almost year-round for our allergy and asthma woes, says Jane Lee, M.D., director of the Texas Allergy Center in Dallas.

“About 80 percent of people with asthma have underlying allergies,” Lee says. “These allergies are often seasonally triggered. In Dallas, we have a high cedar count in the winter, high tree pollens carried by strong winds in the spring, and ragweed in the fall. This means we can potentially suffer from allergies and asthma all year. Mold also triggers allergies, and Dallas has an elevated mold count due to warm temperatures and high humidity.”

Dallas is also affected by environmental threats, such as the thinning of the ozone layer. According to Lee, pollen counts elevate as the ozone layer diminishes. “Studies indicate that allergies will double or even triple during the next 20 years due to poor environmental factors,” she says.

When temperatures rise in Dallas, so do dangerous ozone levels. Most ozone alerts are color-coded from green to purple (good to bad). Predictors include how sunny it will be and the level of traffic on any given day. On a high ozone alert day, people should be concerned about the level of pollution in the air. To keep asthma and allergies from flaring up, stay indoors as much as possible, limit outdoor exercise or playtime, and keep asthma medications handy.

“Seasonal allergy sufferers usually respond well to over-the-counter medications as needed,” Lee says. “If it’s more serious, an evaluation will sort out the specific allergy triggers that will help determine the best treatment. Allergy shots can make you immune from what you’re allergic to so that, over time, you become less sensitive to it.”

TRAFFIC ACCIDENTS: Although new downtown and Uptown developments have made Dallas more pedestrian-friendly in recent years, there’s no doubt Dallas is a city designed for driving. The average daily commute to work, one way, is about 25 minutes. And with hundreds of people moving to the Dallas area each week, there are more cars than ever on the roads.

On average, there are more than 6 million car accidents in the United States each year. In the United States alone, one person dies because of a car accident every 12 minutes and, every 14 seconds, a car accident results in a serious injury. From accidents at congested intersections to crashes on busy freeways, traffic accidents pose a real threat to anyone living here.

The majority of car accidents could be avoided by driving more responsibly, which includes forgoing other activities while driving, such as talking on a cellphone, texting, and eating. Approximately 40 percent of car accident fatalities occur because of a drunk driver. About 30 percent are attributed to driving above the speed limit, and 33 percent because of reckless driving.

But perhaps the best advice for staying safe on the road is not a surprise—wear your seat belt. In more than half of all car accident fatalities, the victims were not wearing their seat belts at the time of the crash, even though seat belt laws have long been in effect. “Wearing a seat belt shows you are making a conscious decision to take care of your well-being,” says Danelle Parker, R.N., B.S.N., manager of community outreach prevention and education for Texas Health Presbyterian Hospital Plano and coordinator of the Safe Kids Collin County Chapter. “Seat belts protect you from being ejected from the car, which is what causes the most serious injuries in the majority of car accidents.”

HYPERTENSION/HIGH BLOOD PRESSURE: Stress can negatively affect even the healthiest adults, but for those with hypertension, or high blood pressure, it can be life-threatening.

Hypertension has been identified as a major risk factor for coronary heart disease, the leading cause of death in the country. It’s also the most treatable form of cardiovascular disease. If left untreated, hypertension can result in stroke, kidney failure, and blindness. Nearly one-third of adults with hypertension are unaware of it.

Rafic Berbarie, M.D., a cardiologist with the HeartPlace cardiology group at Baylor Hamilton Heart and Vascular Hospital, says most people with hypertension don’t have symptoms and find out about it at a regular checkup. In many cases, medication can control hypertension before it leads to a more serious cardiovascular problem and other health issues. When Berbarie diagnoses a patient with hypertension, he counsels them about lifestyle changes that will lower blood pressure. “Stress plays a powerful role in the severity of hypertension,” he says. “It naturally causes your blood pressure to elevate, and this is especially dangerous if you already have high blood pressure. I tell patients to find ways to reduce the stress in their life, such as exercising.”

In many cases, those who suffer from hypertension are also overweight and have related health issues, including obesity, high cholesterol, and diabetes. Berbarie says living in a major city presents another health risk when it comes to cardiovascular disease: restaurants. “We are inundated with so many opportunities to eat out, whether it’s drive-through spots or sit-down restaurants,” he says. “The choices are overwhelming, and the portion sizes are extremely large. People tend to cheat or forget about their diets when they eat out. My best advice here is to follow a heart-healthy diet at home as much as possible and eat in moderation at restaurants.”

METABOLIC SYNDROME/SYNDROME X: Janna Massar, M.D., a board-certified internist at Texas Health Presbyterian Hospital Plano, says a rising health threat in North Texas is metabolic syndrome, previously referred to as Syndrome X. “The public isn’t generally aware of this, but physicians are talking about it behind closed doors more and more,” Massar says.

People are considered metabolic syndrome patients when they present with three or more abnormalities in the following health conditions: abdominal obesity (more than 40 inches for men and 35 inches for women), triglycerides greater than 150, low HDL (good) cholesterol, and blood pressure greater than 130/85 or an elevated level of fasting blood sugar.

More than 40 percent of the population age 60 and older have metabolic syndrome, which increases the risk of weight gain, hypertension, diabetes, heart attack, and stroke. Lifestyle factors, such as an unhealthy diet and lack of exercise, contribute to metabolic syndrome, but genetic risk is the largest predictor. “If you have a primary family member with heart disease, diabetes, or high blood pressure, consider yourself genetically different,” Massar says. “If you are genetically at risk for these health issues, you can’t eat processed foods or foods high in cholesterol and fat and not expect it to negatively impact your health. Studies show that just a 7 percent decrease in weight reduces your risk of diabetes by 58 percent.”

Exercising three to five times per week, dietary intervention, a decreased intake of concentrated sweets, decreased portion sizes, and avoiding processed foods with fiber removed are some of the steps you can take to decrease your risk of being diagnosed with metabolic syndrome. Talk to your doctor about appropriate screenings and intervention methods if you think you are at risk.

SKIN CANCER: In Dallas, tans are a fashion accessory of sorts, especially in the skin-baring summer months. Tans can also be an indication that your skin is damaged, says Tanya Rodgers, M.D., a dermatologist with Texas Health Presbyterian Hospital Allen.

“Recent statistics show that one in three Texans have some form of skin cancer,” Rodgers says. “Nationally, more than 1 million cases of skin cancer are reported each year, including melanoma, the deadliest form of skin cancer.”

Clay Cockerell, M.D., managing director of Dermpath Diagnostics Cockerell & Associates in Dallas and clinical professor of dermatology and pathology at UT Southwestern, says the risk of skin cancer is considerable in this part of the country because the sun is more intense. Plus, many Dallasites do love the tanning salon. Repeated exposure to UVA rays in tanning beds has been associated with skin cancer and melanoma. If caught early, however, most skin cancers can be treated and cured.

The best way to detect skin cancer is to be proactive in regular skin checks, Rodgers says. Look for moles that have changed shape or color. Dermatologists use the “ABCDE” rule for detection—asymmetry, borders, color, diameter, and elevation. “If you notice any significant changes in these elements, see a dermatologist right away,” Rodgers says. “It’s critical to report anything suspicious.”

Cockerell offers the following tips to stay safe in the hot Texas sun. Use sunscreen (at least SPF 15) every day, especially if you’ll be outdoors for an extended amount of time, and reapply every two to three hours. Try to schedule outdoor activities in the early or later parts of the day as the sun is most intense from 11 am to 2 pm. Also, wearing protective clothing and a broad-brimmed hat will provide further sun protection.

SMOKING: Smoking is a bad habit no matter where you live. Amit Khera, M.D., a cardiologist with UT Southwestern, is co-chair of the Texas State Advocacy Committee for the American Heart

Association, which assisted the City of Dallas with its new smoking ordinance. The ordinance essentially states that there will be no more designated smoking areas in public work places, restaurants, and bars. Smokers have to go outdoors to light up.

“I consider this a huge win,” Khera says. “The ordinance wasn’t designed to take away people’s rights. It’s an ordinance to protect workers’ rights in these places. You have to look at it in a broader perspective. The health risks of secondhand smoke are proven and definitive. Smoking is linked to pulmonary disease, cardiovascular disease, and chronic lung illnesses. These diseases are costly to treat, so ultimately we all pay as a society for the damage that smoking and secondhand smoke causes.”

Smoking is the No. 1 preventable cause of death in the United States, yet it kills more than 450,000 people per year. People who are exposed to second-hand smoke have a 30 percent increased chance of heart disease and cancer. Smokers have an almost 80 percent increased risk of heart disease. “These anti-smoking ordinances are a national trend statewide; Dallas was a bit behind the curve,” Khera says. “There is actually a bill under consideration now that will mandate a similar statewide smoking ordinance. Other states that have adopted public smoking bans have reported a decline in smoking-related deaths and illnesses.”

Khera treats cardiac patients every day who have managed to stop smoking or who are in the process of kicking the habit. “There is a general trend to quit right now, which is encouraging,” he says. “But it’s very hard. Less than 10 percent of people who quit cold turkey are successful, and 30 to 40 percent of people who use medicine or other stop-smoking remedies are successful. I have patients who have tried to quit three times or more. Eventually they do. The key is to want to quit and have a support network.”