Data / Rankings / Uninsured rate, ages 18 to 64 (US model-based estimate) / Counties in Alabama

Counties in Alabama by uninsured rate, ages 18 to 64 (US model-based estimate)

DeKalb County had the highest uninsured rate, ages 18 to 64 (US model-based estimate) of 67 counties in 2018, at 24.5%. Shelby County had the lowest, at 10.4%. The median was 15.8% and the figure for Alabama was 15.1%. Source: the U.S. Census Bureau.

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Highest24.5DeKalb County
Lowest10.4Shelby County
Median15.867 counties
Alabama15.1History

Map of counties, 2018

Autauga County: 13 %Baldwin County: 16.8 %Barbour County: 17.7 %Bibb County: 13.4 %Blount County: 17.9 %Bullock County: 15.8 %Butler County: 15.3 %Calhoun County: 14.1 %Chambers County: 14.7 %Cherokee County: 16.8 %Chilton County: 21.1 %Choctaw County: 16.8 %Clarke County: 16.1 %Clay County: 19.8 %Cleburne County: 17.4 %Coffee County: 16.2 %Colbert County: 14.3 %Conecuh County: 15.8 %Coosa County: 14.9 %Covington County: 15.5 %Crenshaw County: 16 %Cullman County: 17.7 %Dale County: 14.2 %Dallas County: 14.9 %DeKalb County: 24.5 %Elmore County: 12.6 %Escambia County: 19.5 %Etowah County: 15.9 %Fayette County: 15.6 %Franklin County: 21 %Geneva County: 18.2 %Greene County: 14.9 %Hale County: 14.6 %Henry County: 17.5 %Houston County: 16.7 %Jackson County: 16.7 %Jefferson County: 14.2 %Lamar County: 14.9 %Lauderdale County: 14.6 %Lawrence County: 17.5 %Lee County: 13 %Limestone County: 13.8 %Lowndes County: 15.1 %Macon County: 14.3 %Madison County: 11.8 %Marengo County: 13.6 %Marion County: 16.6 %Marshall County: 18.9 %Mobile County: 17.1 %Monroe County: 17.5 %Montgomery County: 15.8 %Morgan County: 16.9 %Perry County: 15.2 %Pickens County: 15.2 %Pike County: 17.4 %Randolph County: 16.7 %Russell County: 15.6 %St. Clair County: 14.7 %Shelby County: 10.4 %Sumter County: 16.6 %Talladega County: 15.3 %Tallapoosa County: 14.8 %Tuscaloosa County: 12.6 %Walker County: 16.6 %Washington County: 17.3 %Wilcox County: 14.5 %Winston County: 18.5 %
  • Under 14
  • 14 to 15
  • 15 to 16
  • 16 to 17
  • 17 to 18
  • 18 and over
%, 2018. Source: U.S. Census Bureau, Small Area Health Insurance Estimates (SAHIE): percent uninsured, ages 18 to 64, all races, both sexes, all income levels, states and counties. Boundaries: U.S. Census Bureau cartographic boundary files.

Top 40 counties, 2018

DeKalb County: 24.5 %DeKalb County24.5Chilton County: 21.1 %Chilton County21.1Franklin County: 21 %Franklin County21Clay County: 19.8 %Clay County19.8Escambia County: 19.5 %Escambia County19.5Marshall County: 18.9 %Marshall County18.9Winston County: 18.5 %Winston County18.5Geneva County: 18.2 %Geneva County18.2Blount County: 17.9 %Blount County17.9Barbour County: 17.7 %Barbour County17.7Cullman County: 17.7 %Cullman County17.7Henry County: 17.5 %Henry County17.5Lawrence County: 17.5 %Lawrence County17.5Monroe County: 17.5 %Monroe County17.5Cleburne County: 17.4 %Cleburne County17.4Pike County: 17.4 %Pike County17.4Washington County: 17.3 %Washington County17.3Mobile County: 17.1 %Mobile County17.1Morgan County: 16.9 %Morgan County16.9Baldwin County: 16.8 %Baldwin County16.8Cherokee County: 16.8 %Cherokee County16.8Choctaw County: 16.8 %Choctaw County16.8Houston County: 16.7 %Houston County16.7Jackson County: 16.7 %Jackson County16.7Randolph County: 16.7 %Randolph County16.7Marion County: 16.6 %Marion County16.6Sumter County: 16.6 %Sumter County16.6Walker County: 16.6 %Walker County16.6Coffee County: 16.2 %Coffee County16.2Clarke County: 16.1 %Clarke County16.1Crenshaw County: 16 %Crenshaw County16Etowah County: 15.9 %Etowah County15.9Bullock County: 15.8 %Bullock County15.8Conecuh County: 15.8 %Conecuh County15.8Montgomery County: 15.8 %Montgomery County15.8Fayette County: 15.6 %Fayette County15.6Russell County: 15.6 %Russell County15.6Covington County: 15.5 %Covington County15.5Butler County: 15.3 %Butler County15.3Talladega County: 15.3 %Talladega County15.3DeKalb County: 24.5 %DeKalb County24.5Chilton County: 21.1 %Chilton County21.1Franklin County: 21 %Franklin County21Clay County: 19.8 %Clay County19.8Escambia County: 19.5 %Escambia County19.5Marshall County: 18.9 %Marshall County18.9Winston County: 18.5 %Winston County18.5Geneva County: 18.2 %Geneva County18.2Blount County: 17.9 %Blount County17.9Barbour County: 17.7 %Barbour County17.7Cullman County: 17.7 %Cullman County17.7Henry County: 17.5 %Henry County17.5Lawrence County: 17.5 %Lawrence County17.5Monroe County: 17.5 %Monroe County17.5Cleburne County: 17.4 %Cleburne County17.4Pike County: 17.4 %Pike County17.4Washington County: 17.3 %Washington County17.3Mobile County: 17.1 %Mobile County17.1Morgan County: 16.9 %Morgan County16.9Baldwin County: 16.8 %Baldwin County16.8Cherokee County: 16.8 %Cherokee County16.8Choctaw County: 16.8 %Choctaw County16.8Houston County: 16.7 %Houston County16.7Jackson County: 16.7 %Jackson County16.7Randolph County: 16.7 %Randolph County16.7Marion County: 16.6 %Marion County16.6Sumter County: 16.6 %Sumter County16.6Walker County: 16.6 %Walker County16.6Coffee County: 16.2 %Coffee County16.2Clarke County: 16.1 %Clarke County16.1Crenshaw County: 16 %Crenshaw County16Etowah County: 15.9 %Etowah County15.9Bullock County: 15.8 %Bullock County15.8Conecuh County: 15.8 %Conecuh County15.8Montgomery County: 15.8 %Montgomery County15.8Fayette County: 15.6 %Fayette County15.6Russell County: 15.6 %Russell County15.6Covington County: 15.5 %Covington County15.5Butler County: 15.3 %Butler County15.3Talladega County: 15.3 %Talladega County15.3
%. Source: U.S. Census Bureau, Small Area Health Insurance Estimates (SAHIE): percent uninsured, ages 18 to 64, all races, both sexes, all income levels, states and counties. Retrieved 2026-10-12.

Full ranking

RankCounties2018 (%)Change on 2017
1DeKalb County24.5+1.7 pts
2Chilton County21.1+3.6 pts
3Franklin County21+1.1 pts
4Clay County19.8+2.6 pts
5Escambia County19.5+0.6 pts
6Marshall County18.9-1.9 pts
7Winston County18.5+2.5 pts
8Geneva County18.2+0.1 pts
9Blount County17.9+0.8 pts
10Barbour County17.7+1.6 pts
10Cullman County17.7+1.5 pts
12Henry County17.5+2.2 pts
12Lawrence County17.50 pts
12Monroe County17.5+1.2 pts
15Cleburne County17.4+0.6 pts
15Pike County17.4+1.4 pts
17Washington County17.3-0.2 pts
18Mobile County17.1+1.9 pts
19Morgan County16.9+2 pts
20Baldwin County16.8+2.5 pts
20Cherokee County16.8+2.9 pts
20Choctaw County16.8+2.7 pts
23Houston County16.7+2.3 pts
23Jackson County16.7+0.2 pts
23Randolph County16.7-0.1 pts
26Marion County16.6+2.1 pts
26Sumter County16.6+2.6 pts
26Walker County16.6+1.6 pts
29Coffee County16.2+0.9 pts
30Clarke County16.1+0.8 pts
31Crenshaw County16+0.4 pts
32Etowah County15.9-0.1 pts
33Bullock County15.8+0.6 pts
33Conecuh County15.8+0.5 pts
33Montgomery County15.8+1.5 pts
36Fayette County15.6+1.1 pts
36Russell County15.6+0.7 pts
38Covington County15.5+0.2 pts
39Butler County15.3+0.8 pts
39Talladega County15.3+2.2 pts
41Perry County15.2+0.1 pts
41Pickens County15.2+0.6 pts
43Lowndes County15.1+1.3 pts
44Coosa County14.9-0.6 pts
44Dallas County14.9+1.2 pts
44Greene County14.9+0.2 pts
44Lamar County14.9+0.4 pts
48Tallapoosa County14.8-0.3 pts
49Chambers County14.7-0.5 pts
49St. Clair County14.7+1.8 pts
51Hale County14.6+0.9 pts
51Lauderdale County14.6+0.5 pts
53Wilcox County14.5+0.8 pts
54Colbert County14.3+2.2 pts
54Macon County14.3+1.2 pts
56Dale County14.2+1.7 pts
56Jefferson County14.2+1.5 pts
58Calhoun County14.1-1.3 pts
59Limestone County13.8-0.3 pts
60Marengo County13.6+1 pts
61Bibb County13.4+0.4 pts
62Autauga County13+1.9 pts
62Lee County13+0.2 pts
64Elmore County12.6+1.6 pts
64Tuscaloosa County12.6+0.9 pts
66Madison County11.80 pts
67Shelby County10.4+0.5 pts

Other periods

About this ranking

People aged 18 to 64 without health insurance coverage of any kind, as a percentage of all people aged 18 to 64. United States: Census Bureau Small Area Health Insurance Estimates (SAHIE) for states and counties, all races, both sexes and all income levels.

A model-based single-year estimate that combines the American Community Survey with administrative records and population estimates, so every county gets a figure. Covers states and counties only, because the SAHIE dataset files have no national row. The Census Bureau advises comparing years from 2008 on only; 2013 is the updated release. Working-age adults; the rate for everyone under 65 is uninsured_rate_under_65.

Every value in the ranking comes from the same publisher and the same period, so the counties are compared on one definition. Equal values share a rank.

How to cite

U.S. Census Bureau. Small Area Health Insurance Estimates (SAHIE): percent uninsured, ages 18 to 64, all races, both sexes, all income levels, states and counties. https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2018-csv.zip. Retrieved 2026-10-12.

Citation styles

The publisher is the author. Invokely is named only as the place the figures were read, where a style asks for it.

APA 7

U.S. Census Bureau. (2026). Small Area Health Insurance Estimates (SAHIE): percent uninsured, ages 18 to 64, all races, both sexes, all income levels, states and counties (Counties in Alabama by uninsured rate, ages 18 to 64 (US model-based estimate), 2018) [Data set]. Retrieved October 12, 2026, from https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2018-csv.zip

MLA 9

Small Area Health Insurance Estimates (SAHIE): percent uninsured, ages 18 to 64, all races, both sexes, all income levels, states and counties, Counties in Alabama by uninsured rate, ages 18 to 64 (US model-based estimate), 2018. U.S. Census Bureau, 6 Aug. 2026, https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2018-csv.zip. Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/alabama-counties?period=2018. Accessed 12 Oct. 2026.

Chicago (author-date)

U.S. Census Bureau. 2026. Small Area Health Insurance Estimates (SAHIE): percent uninsured, ages 18 to 64, all races, both sexes, all income levels, states and counties. Counties in Alabama by uninsured rate, ages 18 to 64 (US model-based estimate), 2018. Dataset. Accessed October 12, 2026. https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2018-csv.zip. Also distributed by Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/alabama-counties?period=2018.

Harvard

U.S. Census Bureau (2026) Small Area Health Insurance Estimates (SAHIE): percent uninsured, ages 18 to 64, all races, both sexes, all income levels, states and counties, Counties in Alabama by uninsured rate, ages 18 to 64 (US model-based estimate), 2018 [Dataset]. Available at: https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2018-csv.zip, via Invokely: https://invokely.ai/rankings/uninsured-rate-ages-18-64/alabama-counties?period=2018 (Accessed: 12 October 2026).

BibTeX
@misc{census_counties_in_alabama_by_2018,
  author = {{U.S. Census Bureau}},
  title = {{Small Area Health Insurance Estimates (SAHIE): percent uninsured, ages 18 to 64, all races, both sexes, all income levels, states and counties: Counties in Alabama by uninsured rate, ages 18 to 64 (US model-based estimate), 2018}},
  year = {2026},
  howpublished = {Data set},
  url = {https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2018-csv.zip},
  urldate = {2026-10-12},
  note = {Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/alabama-counties?period=2018. Publisher attribution: U.S. Census Bureau. Small Area Health Insurance Estimates (SAHIE): percent uninsured, ages 18 to 64, all races, both sexes, all income levels, states and counties. https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2018-csv.zip. Retrieved 2026-10-12.},
}
RIS
TY  - DATA
AU  - U.S. Census Bureau
TI  - Small Area Health Insurance Estimates (SAHIE): percent uninsured, ages 18 to 64, all races, both sexes, all income levels, states and counties: Counties in Alabama by uninsured rate, ages 18 to 64 (US model-based estimate), 2018
PY  - 2026
DA  - 2026/08/06
PB  - U.S. Census Bureau
DB  - Invokely
UR  - https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2018-csv.zip
L2  - https://invokely.ai/rankings/uninsured-rate-ages-18-64/alabama-counties?period=2018
Y2  - 2026/10/12
N1  - Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/alabama-counties?period=2018.
N1  - Publisher attribution: U.S. Census Bureau. Small Area Health Insurance Estimates (SAHIE): percent uninsured, ages 18 to 64, all races, both sexes, all income levels, states and counties. https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2018-csv.zip. Retrieved 2026-10-12.
ER  -
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Questions

Which county has the highest uninsured rate, ages 18 to 64 (US model-based estimate)?

DeKalb County, with 24.5% in 2018, according to the U.S. Census Bureau.

Which county has the lowest uninsured rate, ages 18 to 64 (US model-based estimate)?

Shelby County, with 10.4% in 2018.

Where does this ranking come from?

Every value comes from one source and one period, so the places are comparable: U.S. Census Bureau, Small Area Health Insurance Estimates (SAHIE): percent uninsured, ages 18 to 64, all races, both sexes, all income levels, states and counties. Retrieved 2026-10-12.

Uninsured rate, ages 18 to 64 (US model-based estimate): other rankings

Counties in Alabama: more rankings