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 2021, at 25.1%. Shelby County had the lowest, at 9.8%. The median was 15.2% and the figure for Alabama was 14.6%. Source: the U.S. Census Bureau.

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Highest25.1DeKalb County
Lowest9.8Shelby County
Median15.267 counties
Alabama14.6History

Map of counties, 2021

Autauga County: 12.4 %Baldwin County: 13.4 %Barbour County: 16.3 %Bibb County: 14.1 %Blount County: 16.1 %Bullock County: 16.4 %Butler County: 15.1 %Calhoun County: 16.6 %Chambers County: 15.7 %Cherokee County: 15.8 %Chilton County: 18.2 %Choctaw County: 15.5 %Clarke County: 15.2 %Clay County: 16.1 %Cleburne County: 15.1 %Coffee County: 15.4 %Colbert County: 13.2 %Conecuh County: 14.2 %Coosa County: 13.4 %Covington County: 16.4 %Crenshaw County: 16.8 %Cullman County: 15 %Dale County: 14.6 %Dallas County: 13.7 %DeKalb County: 25.1 %Elmore County: 14.7 %Escambia County: 17.3 %Etowah County: 16.5 %Fayette County: 15.1 %Franklin County: 18.6 %Geneva County: 17.2 %Greene County: 14.4 %Hale County: 15.7 %Henry County: 14.6 %Houston County: 15.9 %Jackson County: 17.1 %Jefferson County: 13 %Lamar County: 14.7 %Lauderdale County: 15.6 %Lawrence County: 18.6 %Lee County: 14.4 %Limestone County: 13.9 %Lowndes County: 13.5 %Macon County: 14.5 %Madison County: 11.2 %Marengo County: 14 %Marion County: 16.9 %Marshall County: 19.3 %Mobile County: 17.4 %Monroe County: 15.6 %Montgomery County: 15.7 %Morgan County: 17.4 %Perry County: 15.8 %Pickens County: 14.6 %Pike County: 14.5 %Randolph County: 15.6 %Russell County: 14.5 %St. Clair County: 13.2 %Shelby County: 9.8 %Sumter County: 14.9 %Talladega County: 14.3 %Tallapoosa County: 16 %Tuscaloosa County: 12.2 %Walker County: 15.7 %Washington County: 14.7 %Wilcox County: 14.7 %Winston County: 16.9 %
  • Under 14
  • 14 to 15
  • 15 to 16
  • 16 to 17
  • 17 and over
%, 2021. 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, 2021

DeKalb County: 25.1 %DeKalb County25.1Marshall County: 19.3 %Marshall County19.3Franklin County: 18.6 %Franklin County18.6Lawrence County: 18.6 %Lawrence County18.6Chilton County: 18.2 %Chilton County18.2Mobile County: 17.4 %Mobile County17.4Morgan County: 17.4 %Morgan County17.4Escambia County: 17.3 %Escambia County17.3Geneva County: 17.2 %Geneva County17.2Jackson County: 17.1 %Jackson County17.1Marion County: 16.9 %Marion County16.9Winston County: 16.9 %Winston County16.9Crenshaw County: 16.8 %Crenshaw County16.8Calhoun County: 16.6 %Calhoun County16.6Etowah County: 16.5 %Etowah County16.5Bullock County: 16.4 %Bullock County16.4Covington County: 16.4 %Covington County16.4Barbour County: 16.3 %Barbour County16.3Blount County: 16.1 %Blount County16.1Clay County: 16.1 %Clay County16.1Tallapoosa County: 16 %Tallapoosa County16Houston County: 15.9 %Houston County15.9Cherokee County: 15.8 %Cherokee County15.8Perry County: 15.8 %Perry County15.8Chambers County: 15.7 %Chambers County15.7Hale County: 15.7 %Hale County15.7Montgomery County: 15.7 %Montgomery County15.7Walker County: 15.7 %Walker County15.7Lauderdale County: 15.6 %Lauderdale County15.6Monroe County: 15.6 %Monroe County15.6Randolph County: 15.6 %Randolph County15.6Choctaw County: 15.5 %Choctaw County15.5Coffee County: 15.4 %Coffee County15.4Clarke County: 15.2 %Clarke County15.2Butler County: 15.1 %Butler County15.1Cleburne County: 15.1 %Cleburne County15.1Fayette County: 15.1 %Fayette County15.1Cullman County: 15 %Cullman County15Sumter County: 14.9 %Sumter County14.9Elmore County: 14.7 %Elmore County14.7DeKalb County: 25.1 %DeKalb County25.1Marshall County: 19.3 %Marshall County19.3Franklin County: 18.6 %Franklin County18.6Lawrence County: 18.6 %Lawrence County18.6Chilton County: 18.2 %Chilton County18.2Mobile County: 17.4 %Mobile County17.4Morgan County: 17.4 %Morgan County17.4Escambia County: 17.3 %Escambia County17.3Geneva County: 17.2 %Geneva County17.2Jackson County: 17.1 %Jackson County17.1Marion County: 16.9 %Marion County16.9Winston County: 16.9 %Winston County16.9Crenshaw County: 16.8 %Crenshaw County16.8Calhoun County: 16.6 %Calhoun County16.6Etowah County: 16.5 %Etowah County16.5Bullock County: 16.4 %Bullock County16.4Covington County: 16.4 %Covington County16.4Barbour County: 16.3 %Barbour County16.3Blount County: 16.1 %Blount County16.1Clay County: 16.1 %Clay County16.1Tallapoosa County: 16 %Tallapoosa County16Houston County: 15.9 %Houston County15.9Cherokee County: 15.8 %Cherokee County15.8Perry County: 15.8 %Perry County15.8Chambers County: 15.7 %Chambers County15.7Hale County: 15.7 %Hale County15.7Montgomery County: 15.7 %Montgomery County15.7Walker County: 15.7 %Walker County15.7Lauderdale County: 15.6 %Lauderdale County15.6Monroe County: 15.6 %Monroe County15.6Randolph County: 15.6 %Randolph County15.6Choctaw County: 15.5 %Choctaw County15.5Coffee County: 15.4 %Coffee County15.4Clarke County: 15.2 %Clarke County15.2Butler County: 15.1 %Butler County15.1Cleburne County: 15.1 %Cleburne County15.1Fayette County: 15.1 %Fayette County15.1Cullman County: 15 %Cullman County15Sumter County: 14.9 %Sumter County14.9Elmore County: 14.7 %Elmore County14.7
%. 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

RankCounties2021 (%)Change on 2020
1DeKalb County25.1+0.7 pts
2Marshall County19.3-0.8 pts
3Franklin County18.6-1.8 pts
3Lawrence County18.60 pts
5Chilton County18.2-1.3 pts
6Mobile County17.4+1.8 pts
6Morgan County17.4-1 pts
8Escambia County17.3-1.4 pts
9Geneva County17.2-2 pts
10Jackson County17.1+1.4 pts
11Marion County16.9+1.4 pts
11Winston County16.9+0.2 pts
13Crenshaw County16.8+0.8 pts
14Calhoun County16.6+0.1 pts
15Etowah County16.5-1 pts
16Bullock County16.40 pts
16Covington County16.4+1 pts
18Barbour County16.3-2.4 pts
19Blount County16.1-0.6 pts
19Clay County16.1-1.4 pts
21Tallapoosa County16-0.8 pts
22Houston County15.9-1.3 pts
23Cherokee County15.8+0.1 pts
23Perry County15.8+0.4 pts
25Chambers County15.7-0.6 pts
25Hale County15.7+1.4 pts
25Montgomery County15.7-0.1 pts
25Walker County15.7+1.1 pts
29Lauderdale County15.6+1.1 pts
29Monroe County15.6-1.1 pts
29Randolph County15.6-0.6 pts
32Choctaw County15.50 pts
33Coffee County15.4-1.7 pts
34Clarke County15.2-1.9 pts
35Butler County15.1-2.1 pts
35Cleburne County15.1-1.9 pts
35Fayette County15.1-2.3 pts
38Cullman County15-2.6 pts
39Sumter County14.90 pts
40Elmore County14.7+1 pts
40Lamar County14.7-0.2 pts
40Washington County14.7-2.7 pts
40Wilcox County14.7-0.7 pts
44Dale County14.6-3.2 pts
44Henry County14.6-0.2 pts
44Pickens County14.6-0.8 pts
47Macon County14.5-1.8 pts
47Pike County14.5-0.7 pts
47Russell County14.5-1 pts
50Greene County14.40 pts
50Lee County14.4+1.4 pts
52Talladega County14.3-0.1 pts
53Conecuh County14.20 pts
54Bibb County14.1-2.2 pts
55Marengo County14+0.1 pts
56Limestone County13.9-1.2 pts
57Dallas County13.7-1.1 pts
58Lowndes County13.5-1 pts
59Baldwin County13.4-0.2 pts
59Coosa County13.4-0.3 pts
61Colbert County13.2+0.2 pts
61St. Clair County13.2-1.4 pts
63Jefferson County13+0.4 pts
64Autauga County12.4-0.8 pts
65Tuscaloosa County12.2-0.6 pts
66Madison County11.2-1.2 pts
67Shelby County9.8-1.8 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-2021-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), 2021) [Data set]. Retrieved October 12, 2026, from https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2021-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), 2021. U.S. Census Bureau, 6 Aug. 2026, https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2021-csv.zip. Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/alabama-counties?period=2021. 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), 2021. Dataset. Accessed October 12, 2026. https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2021-csv.zip. Also distributed by Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/alabama-counties?period=2021.

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), 2021 [Dataset]. Available at: https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2021-csv.zip, via Invokely: https://invokely.ai/rankings/uninsured-rate-ages-18-64/alabama-counties?period=2021 (Accessed: 12 October 2026).

BibTeX
@misc{census_counties_in_alabama_by_2021,
  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), 2021}},
  year = {2026},
  howpublished = {Data set},
  url = {https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2021-csv.zip},
  urldate = {2026-10-12},
  note = {Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/alabama-counties?period=2021. 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-2021-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), 2021
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-2021-csv.zip
L2  - https://invokely.ai/rankings/uninsured-rate-ages-18-64/alabama-counties?period=2021
Y2  - 2026/10/12
N1  - Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/alabama-counties?period=2021.
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-2021-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 25.1% in 2021, 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 9.8% in 2021.

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