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 2020, at 24.4%. Shelby County had the lowest, at 11.6%. The median was 15.7% and the figure for Alabama was 14.9%. Source: the U.S. Census Bureau.

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Highest24.4DeKalb County
Lowest11.6Shelby County
Median15.767 counties
Alabama14.9History

Map of counties, 2020

Autauga County: 13.2 %Baldwin County: 13.6 %Barbour County: 18.7 %Bibb County: 16.3 %Blount County: 16.7 %Bullock County: 16.4 %Butler County: 17.2 %Calhoun County: 16.5 %Chambers County: 16.3 %Cherokee County: 15.7 %Chilton County: 19.5 %Choctaw County: 15.5 %Clarke County: 17.1 %Clay County: 17.5 %Cleburne County: 17 %Coffee County: 17.1 %Colbert County: 13 %Conecuh County: 14.2 %Coosa County: 13.7 %Covington County: 15.4 %Crenshaw County: 16 %Cullman County: 17.6 %Dale County: 17.8 %Dallas County: 14.8 %DeKalb County: 24.4 %Elmore County: 13.7 %Escambia County: 18.7 %Etowah County: 17.5 %Fayette County: 17.4 %Franklin County: 20.4 %Geneva County: 19.2 %Greene County: 14.4 %Hale County: 14.3 %Henry County: 14.8 %Houston County: 17.2 %Jackson County: 15.7 %Jefferson County: 12.6 %Lamar County: 14.9 %Lauderdale County: 14.5 %Lawrence County: 18.6 %Lee County: 13 %Limestone County: 15.1 %Lowndes County: 14.5 %Macon County: 16.3 %Madison County: 12.4 %Marengo County: 13.9 %Marion County: 15.5 %Marshall County: 20.1 %Mobile County: 15.6 %Monroe County: 16.7 %Montgomery County: 15.8 %Morgan County: 18.4 %Perry County: 15.4 %Pickens County: 15.4 %Pike County: 15.2 %Randolph County: 16.2 %Russell County: 15.5 %St. Clair County: 14.6 %Shelby County: 11.6 %Sumter County: 14.9 %Talladega County: 14.4 %Tallapoosa County: 16.8 %Tuscaloosa County: 12.8 %Walker County: 14.6 %Washington County: 17.4 %Wilcox County: 15.4 %Winston County: 16.7 %
  • Under 14
  • 14 to 15
  • 15 to 16
  • 16 to 17
  • 17 to 18
  • 18 and over
%, 2020. 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, 2020

DeKalb County: 24.4 %DeKalb County24.4Franklin County: 20.4 %Franklin County20.4Marshall County: 20.1 %Marshall County20.1Chilton County: 19.5 %Chilton County19.5Geneva County: 19.2 %Geneva County19.2Barbour County: 18.7 %Barbour County18.7Escambia County: 18.7 %Escambia County18.7Lawrence County: 18.6 %Lawrence County18.6Morgan County: 18.4 %Morgan County18.4Dale County: 17.8 %Dale County17.8Cullman County: 17.6 %Cullman County17.6Clay County: 17.5 %Clay County17.5Etowah County: 17.5 %Etowah County17.5Fayette County: 17.4 %Fayette County17.4Washington County: 17.4 %Washington County17.4Butler County: 17.2 %Butler County17.2Houston County: 17.2 %Houston County17.2Clarke County: 17.1 %Clarke County17.1Coffee County: 17.1 %Coffee County17.1Cleburne County: 17 %Cleburne County17Tallapoosa County: 16.8 %Tallapoosa County16.8Blount County: 16.7 %Blount County16.7Monroe County: 16.7 %Monroe County16.7Winston County: 16.7 %Winston County16.7Calhoun County: 16.5 %Calhoun County16.5Bullock County: 16.4 %Bullock County16.4Bibb County: 16.3 %Bibb County16.3Chambers County: 16.3 %Chambers County16.3Macon County: 16.3 %Macon County16.3Randolph County: 16.2 %Randolph County16.2Crenshaw County: 16 %Crenshaw County16Montgomery County: 15.8 %Montgomery County15.8Cherokee County: 15.7 %Cherokee County15.7Jackson County: 15.7 %Jackson County15.7Mobile County: 15.6 %Mobile County15.6Choctaw County: 15.5 %Choctaw County15.5Marion County: 15.5 %Marion County15.5Russell County: 15.5 %Russell County15.5Covington County: 15.4 %Covington County15.4Perry County: 15.4 %Perry County15.4DeKalb County: 24.4 %DeKalb County24.4Franklin County: 20.4 %Franklin County20.4Marshall County: 20.1 %Marshall County20.1Chilton County: 19.5 %Chilton County19.5Geneva County: 19.2 %Geneva County19.2Barbour County: 18.7 %Barbour County18.7Escambia County: 18.7 %Escambia County18.7Lawrence County: 18.6 %Lawrence County18.6Morgan County: 18.4 %Morgan County18.4Dale County: 17.8 %Dale County17.8Cullman County: 17.6 %Cullman County17.6Clay County: 17.5 %Clay County17.5Etowah County: 17.5 %Etowah County17.5Fayette County: 17.4 %Fayette County17.4Washington County: 17.4 %Washington County17.4Butler County: 17.2 %Butler County17.2Houston County: 17.2 %Houston County17.2Clarke County: 17.1 %Clarke County17.1Coffee County: 17.1 %Coffee County17.1Cleburne County: 17 %Cleburne County17Tallapoosa County: 16.8 %Tallapoosa County16.8Blount County: 16.7 %Blount County16.7Monroe County: 16.7 %Monroe County16.7Winston County: 16.7 %Winston County16.7Calhoun County: 16.5 %Calhoun County16.5Bullock County: 16.4 %Bullock County16.4Bibb County: 16.3 %Bibb County16.3Chambers County: 16.3 %Chambers County16.3Macon County: 16.3 %Macon County16.3Randolph County: 16.2 %Randolph County16.2Crenshaw County: 16 %Crenshaw County16Montgomery County: 15.8 %Montgomery County15.8Cherokee County: 15.7 %Cherokee County15.7Jackson County: 15.7 %Jackson County15.7Mobile County: 15.6 %Mobile County15.6Choctaw County: 15.5 %Choctaw County15.5Marion County: 15.5 %Marion County15.5Russell County: 15.5 %Russell County15.5Covington County: 15.4 %Covington County15.4Perry County: 15.4 %Perry County15.4
%. 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

RankCounties2020 (%)Change on 2019
1DeKalb County24.4+0.1 pts
2Franklin County20.4+0.5 pts
3Marshall County20.1-0.5 pts
4Chilton County19.5+1.9 pts
5Geneva County19.2+0.4 pts
6Barbour County18.7+1.9 pts
6Escambia County18.7+0.1 pts
8Lawrence County18.6+0.1 pts
9Morgan County18.4+2.2 pts
10Dale County17.8+2.4 pts
11Cullman County17.6+0.4 pts
12Clay County17.5-0.3 pts
12Etowah County17.5+1.5 pts
14Fayette County17.4+2.3 pts
14Washington County17.4+0.4 pts
16Butler County17.2+2.5 pts
16Houston County17.20 pts
18Clarke County17.1+2 pts
18Coffee County17.1+0.3 pts
20Cleburne County17+1 pts
21Tallapoosa County16.8+1.6 pts
22Blount County16.7-1.4 pts
22Monroe County16.7+0.3 pts
22Winston County16.7+0.4 pts
25Calhoun County16.5+1.4 pts
26Bullock County16.4+1.6 pts
27Bibb County16.3+2.4 pts
27Chambers County16.3+0.9 pts
27Macon County16.3+3.1 pts
30Randolph County16.2+0.6 pts
31Crenshaw County16-0.9 pts
32Montgomery County15.8+0.7 pts
33Cherokee County15.7-0.3 pts
33Jackson County15.7-1.7 pts
35Mobile County15.6-1 pts
36Choctaw County15.5+0.6 pts
36Marion County15.5-0.1 pts
36Russell County15.5+0.8 pts
39Covington County15.4-0.6 pts
39Perry County15.4-0.2 pts
39Pickens County15.40 pts
39Wilcox County15.4+0.5 pts
43Pike County15.2-1.3 pts
44Limestone County15.1+0.5 pts
45Lamar County14.90 pts
45Sumter County14.9-1.3 pts
47Dallas County14.8+0.4 pts
47Henry County14.8-0.8 pts
49St. Clair County14.6+1.6 pts
49Walker County14.6-2 pts
51Lauderdale County14.5-0.3 pts
51Lowndes County14.5+0.9 pts
53Greene County14.4-0.4 pts
53Talladega County14.4+0.2 pts
55Hale County14.3-0.6 pts
56Conecuh County14.2-1.2 pts
57Marengo County13.9-0.2 pts
58Coosa County13.7+0.3 pts
58Elmore County13.7+2.5 pts
60Baldwin County13.6-0.2 pts
61Autauga County13.2+1.2 pts
62Colbert County13-0.5 pts
62Lee County13-0.1 pts
64Tuscaloosa County12.8+0.4 pts
65Jefferson County12.6-1.1 pts
66Madison County12.4+1 pts
67Shelby County11.6+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-2020-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), 2020) [Data set]. Retrieved October 12, 2026, from https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2020-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), 2020. U.S. Census Bureau, 6 Aug. 2026, https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2020-csv.zip. Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/alabama-counties?period=2020. 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), 2020. Dataset. Accessed October 12, 2026. https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2020-csv.zip. Also distributed by Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/alabama-counties?period=2020.

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), 2020 [Dataset]. Available at: https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2020-csv.zip, via Invokely: https://invokely.ai/rankings/uninsured-rate-ages-18-64/alabama-counties?period=2020 (Accessed: 12 October 2026).

BibTeX
@misc{census_counties_in_alabama_by_2020,
  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), 2020}},
  year = {2026},
  howpublished = {Data set},
  url = {https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2020-csv.zip},
  urldate = {2026-10-12},
  note = {Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/alabama-counties?period=2020. 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-2020-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), 2020
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-2020-csv.zip
L2  - https://invokely.ai/rankings/uninsured-rate-ages-18-64/alabama-counties?period=2020
Y2  - 2026/10/12
N1  - Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/alabama-counties?period=2020.
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-2020-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 24.4% in 2020, 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 11.6% in 2020.

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