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 2019, at 24.3%. Shelby County had the lowest, at 11.1%. The median was 15.4% and the figure for Alabama was 14.7%. Source: the U.S. Census Bureau.

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Highest24.3DeKalb County
Lowest11.1Shelby County
Median15.467 counties
Alabama14.7History

Map of counties, 2019

Autauga County: 12 %Baldwin County: 13.8 %Barbour County: 16.8 %Bibb County: 13.9 %Blount County: 18.1 %Bullock County: 14.8 %Butler County: 14.7 %Calhoun County: 15.1 %Chambers County: 15.4 %Cherokee County: 16 %Chilton County: 17.6 %Choctaw County: 14.9 %Clarke County: 15.1 %Clay County: 17.8 %Cleburne County: 16 %Coffee County: 16.8 %Colbert County: 13.5 %Conecuh County: 15.4 %Coosa County: 13.4 %Covington County: 16 %Crenshaw County: 16.9 %Cullman County: 17.2 %Dale County: 15.4 %Dallas County: 14.4 %DeKalb County: 24.3 %Elmore County: 11.2 %Escambia County: 18.6 %Etowah County: 16 %Fayette County: 15.1 %Franklin County: 19.9 %Geneva County: 18.8 %Greene County: 14.8 %Hale County: 14.9 %Henry County: 15.6 %Houston County: 17.2 %Jackson County: 17.4 %Jefferson County: 13.7 %Lamar County: 14.9 %Lauderdale County: 14.8 %Lawrence County: 18.5 %Lee County: 13.1 %Limestone County: 14.6 %Lowndes County: 13.6 %Macon County: 13.2 %Madison County: 11.4 %Marengo County: 14.1 %Marion County: 15.6 %Marshall County: 20.6 %Mobile County: 16.6 %Monroe County: 16.4 %Montgomery County: 15.1 %Morgan County: 16.2 %Perry County: 15.6 %Pickens County: 15.4 %Pike County: 16.5 %Randolph County: 15.6 %Russell County: 14.7 %St. Clair County: 13 %Shelby County: 11.1 %Sumter County: 16.2 %Talladega County: 14.2 %Tallapoosa County: 15.2 %Tuscaloosa County: 12.4 %Walker County: 16.6 %Washington County: 17 %Wilcox County: 14.9 %Winston County: 16.3 %
  • Under 14
  • 14 to 15
  • 15 to 16
  • 16 to 17
  • 17 and over
%, 2019. 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, 2019

DeKalb County: 24.3 %DeKalb County24.3Marshall County: 20.6 %Marshall County20.6Franklin County: 19.9 %Franklin County19.9Geneva County: 18.8 %Geneva County18.8Escambia County: 18.6 %Escambia County18.6Lawrence County: 18.5 %Lawrence County18.5Blount County: 18.1 %Blount County18.1Clay County: 17.8 %Clay County17.8Chilton County: 17.6 %Chilton County17.6Jackson County: 17.4 %Jackson County17.4Cullman County: 17.2 %Cullman County17.2Houston County: 17.2 %Houston County17.2Washington County: 17 %Washington County17Crenshaw County: 16.9 %Crenshaw County16.9Barbour County: 16.8 %Barbour County16.8Coffee County: 16.8 %Coffee County16.8Mobile County: 16.6 %Mobile County16.6Walker County: 16.6 %Walker County16.6Pike County: 16.5 %Pike County16.5Monroe County: 16.4 %Monroe County16.4Winston County: 16.3 %Winston County16.3Morgan County: 16.2 %Morgan County16.2Sumter County: 16.2 %Sumter County16.2Cherokee County: 16 %Cherokee County16Cleburne County: 16 %Cleburne County16Covington County: 16 %Covington County16Etowah County: 16 %Etowah County16Henry County: 15.6 %Henry County15.6Marion County: 15.6 %Marion County15.6Perry County: 15.6 %Perry County15.6Randolph County: 15.6 %Randolph County15.6Chambers County: 15.4 %Chambers County15.4Conecuh County: 15.4 %Conecuh County15.4Dale County: 15.4 %Dale County15.4Pickens County: 15.4 %Pickens County15.4Tallapoosa County: 15.2 %Tallapoosa County15.2Calhoun County: 15.1 %Calhoun County15.1Clarke County: 15.1 %Clarke County15.1Fayette County: 15.1 %Fayette County15.1Montgomery County: 15.1 %Montgomery County15.1DeKalb County: 24.3 %DeKalb County24.3Marshall County: 20.6 %Marshall County20.6Franklin County: 19.9 %Franklin County19.9Geneva County: 18.8 %Geneva County18.8Escambia County: 18.6 %Escambia County18.6Lawrence County: 18.5 %Lawrence County18.5Blount County: 18.1 %Blount County18.1Clay County: 17.8 %Clay County17.8Chilton County: 17.6 %Chilton County17.6Jackson County: 17.4 %Jackson County17.4Cullman County: 17.2 %Cullman County17.2Houston County: 17.2 %Houston County17.2Washington County: 17 %Washington County17Crenshaw County: 16.9 %Crenshaw County16.9Barbour County: 16.8 %Barbour County16.8Coffee County: 16.8 %Coffee County16.8Mobile County: 16.6 %Mobile County16.6Walker County: 16.6 %Walker County16.6Pike County: 16.5 %Pike County16.5Monroe County: 16.4 %Monroe County16.4Winston County: 16.3 %Winston County16.3Morgan County: 16.2 %Morgan County16.2Sumter County: 16.2 %Sumter County16.2Cherokee County: 16 %Cherokee County16Cleburne County: 16 %Cleburne County16Covington County: 16 %Covington County16Etowah County: 16 %Etowah County16Henry County: 15.6 %Henry County15.6Marion County: 15.6 %Marion County15.6Perry County: 15.6 %Perry County15.6Randolph County: 15.6 %Randolph County15.6Chambers County: 15.4 %Chambers County15.4Conecuh County: 15.4 %Conecuh County15.4Dale County: 15.4 %Dale County15.4Pickens County: 15.4 %Pickens County15.4Tallapoosa County: 15.2 %Tallapoosa County15.2Calhoun County: 15.1 %Calhoun County15.1Clarke County: 15.1 %Clarke County15.1Fayette County: 15.1 %Fayette County15.1Montgomery County: 15.1 %Montgomery County15.1
%. 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

RankCounties2019 (%)Change on 2018
1DeKalb County24.3-0.2 pts
2Marshall County20.6+1.7 pts
3Franklin County19.9-1.1 pts
4Geneva County18.8+0.6 pts
5Escambia County18.6-0.9 pts
6Lawrence County18.5+1 pts
7Blount County18.1+0.2 pts
8Clay County17.8-2 pts
9Chilton County17.6-3.5 pts
10Jackson County17.4+0.7 pts
11Cullman County17.2-0.5 pts
11Houston County17.2+0.5 pts
13Washington County17-0.3 pts
14Crenshaw County16.9+0.9 pts
15Barbour County16.8-0.9 pts
15Coffee County16.8+0.6 pts
17Mobile County16.6-0.5 pts
17Walker County16.60 pts
19Pike County16.5-0.9 pts
20Monroe County16.4-1.1 pts
21Winston County16.3-2.2 pts
22Morgan County16.2-0.7 pts
22Sumter County16.2-0.4 pts
24Cherokee County16-0.8 pts
24Cleburne County16-1.4 pts
24Covington County16+0.5 pts
24Etowah County16+0.1 pts
28Henry County15.6-1.9 pts
28Marion County15.6-1 pts
28Perry County15.6+0.4 pts
28Randolph County15.6-1.1 pts
32Chambers County15.4+0.7 pts
32Conecuh County15.4-0.4 pts
32Dale County15.4+1.2 pts
32Pickens County15.4+0.2 pts
36Tallapoosa County15.2+0.4 pts
37Calhoun County15.1+1 pts
37Clarke County15.1-1 pts
37Fayette County15.1-0.5 pts
37Montgomery County15.1-0.7 pts
41Choctaw County14.9-1.9 pts
41Hale County14.9+0.3 pts
41Lamar County14.90 pts
41Wilcox County14.9+0.4 pts
45Bullock County14.8-1 pts
45Greene County14.8-0.1 pts
45Lauderdale County14.8+0.2 pts
48Butler County14.7-0.6 pts
48Russell County14.7-0.9 pts
50Limestone County14.6+0.8 pts
51Dallas County14.4-0.5 pts
52Talladega County14.2-1.1 pts
53Marengo County14.1+0.5 pts
54Bibb County13.9+0.5 pts
55Baldwin County13.8-3 pts
56Jefferson County13.7-0.5 pts
57Lowndes County13.6-1.5 pts
58Colbert County13.5-0.8 pts
59Coosa County13.4-1.5 pts
60Macon County13.2-1.1 pts
61Lee County13.1+0.1 pts
62St. Clair County13-1.7 pts
63Tuscaloosa County12.4-0.2 pts
64Autauga County12-1 pts
65Madison County11.4-0.4 pts
66Elmore County11.2-1.4 pts
67Shelby County11.1+0.7 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-2019-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), 2019) [Data set]. Retrieved October 12, 2026, from https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2019-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), 2019. U.S. Census Bureau, 6 Aug. 2026, https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2019-csv.zip. Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/alabama-counties?period=2019. 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), 2019. Dataset. Accessed October 12, 2026. https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2019-csv.zip. Also distributed by Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/alabama-counties?period=2019.

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), 2019 [Dataset]. Available at: https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2019-csv.zip, via Invokely: https://invokely.ai/rankings/uninsured-rate-ages-18-64/alabama-counties?period=2019 (Accessed: 12 October 2026).

BibTeX
@misc{census_counties_in_alabama_by_2019,
  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), 2019}},
  year = {2026},
  howpublished = {Data set},
  url = {https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2019-csv.zip},
  urldate = {2026-10-12},
  note = {Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/alabama-counties?period=2019. 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-2019-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), 2019
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-2019-csv.zip
L2  - https://invokely.ai/rankings/uninsured-rate-ages-18-64/alabama-counties?period=2019
Y2  - 2026/10/12
N1  - Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/alabama-counties?period=2019.
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-2019-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 24.3% in 2019, 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 11.1% in 2019.

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