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 2023, at 19.4%. Shelby County had the lowest, at 8.7%. The median was 13.6% and the figure for Alabama was 12.7%. Source: the U.S. Census Bureau.

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Highest19.4DeKalb County
Lowest8.7Shelby County
Median13.667 counties
Alabama12.7History

Map of counties, 2023

Autauga County: 10.2 %Baldwin County: 11.4 %Barbour County: 15.6 %Bibb County: 15.1 %Blount County: 16.6 %Bullock County: 18.3 %Butler County: 13.4 %Calhoun County: 13.9 %Chambers County: 12.9 %Cherokee County: 14.2 %Chilton County: 15.1 %Choctaw County: 13.7 %Clarke County: 13.3 %Clay County: 13.7 %Cleburne County: 14.6 %Coffee County: 13.1 %Colbert County: 12.5 %Conecuh County: 13.1 %Coosa County: 12.1 %Covington County: 13.7 %Crenshaw County: 15.1 %Cullman County: 14.9 %Dale County: 14.6 %Dallas County: 11.8 %DeKalb County: 19.4 %Elmore County: 11 %Escambia County: 14.2 %Etowah County: 14.2 %Fayette County: 13.3 %Franklin County: 15.7 %Geneva County: 16.2 %Greene County: 11.7 %Hale County: 13.6 %Henry County: 14.3 %Houston County: 13.9 %Jackson County: 14.8 %Jefferson County: 12.7 %Lamar County: 12.8 %Lauderdale County: 11.7 %Lawrence County: 14.5 %Lee County: 11.8 %Limestone County: 10.1 %Lowndes County: 12.1 %Macon County: 12.8 %Madison County: 10.1 %Marengo County: 10.9 %Marion County: 14.5 %Marshall County: 14.4 %Mobile County: 14.1 %Monroe County: 13.3 %Montgomery County: 13.8 %Morgan County: 14.6 %Perry County: 11.7 %Pickens County: 12.1 %Pike County: 12.9 %Randolph County: 14.9 %Russell County: 13.7 %St. Clair County: 11 %Shelby County: 8.7 %Sumter County: 12.6 %Talladega County: 11.8 %Tallapoosa County: 12.8 %Tuscaloosa County: 10.6 %Walker County: 14 %Washington County: 10.2 %Wilcox County: 13.9 %Winston County: 14.6 %
  • Under 12
  • 12 to 13
  • 13 to 14
  • 14 to 15
  • 15 and over
%, 2023. 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, 2023

DeKalb County: 19.4 %DeKalb County19.4Bullock County: 18.3 %Bullock County18.3Blount County: 16.6 %Blount County16.6Geneva County: 16.2 %Geneva County16.2Franklin County: 15.7 %Franklin County15.7Barbour County: 15.6 %Barbour County15.6Bibb County: 15.1 %Bibb County15.1Chilton County: 15.1 %Chilton County15.1Crenshaw County: 15.1 %Crenshaw County15.1Cullman County: 14.9 %Cullman County14.9Randolph County: 14.9 %Randolph County14.9Jackson County: 14.8 %Jackson County14.8Cleburne County: 14.6 %Cleburne County14.6Dale County: 14.6 %Dale County14.6Morgan County: 14.6 %Morgan County14.6Winston County: 14.6 %Winston County14.6Lawrence County: 14.5 %Lawrence County14.5Marion County: 14.5 %Marion County14.5Marshall County: 14.4 %Marshall County14.4Henry County: 14.3 %Henry County14.3Cherokee County: 14.2 %Cherokee County14.2Escambia County: 14.2 %Escambia County14.2Etowah County: 14.2 %Etowah County14.2Mobile County: 14.1 %Mobile County14.1Walker County: 14 %Walker County14Calhoun County: 13.9 %Calhoun County13.9Houston County: 13.9 %Houston County13.9Wilcox County: 13.9 %Wilcox County13.9Montgomery County: 13.8 %Montgomery County13.8Choctaw County: 13.7 %Choctaw County13.7Clay County: 13.7 %Clay County13.7Covington County: 13.7 %Covington County13.7Russell County: 13.7 %Russell County13.7Hale County: 13.6 %Hale County13.6Butler County: 13.4 %Butler County13.4Clarke County: 13.3 %Clarke County13.3Fayette County: 13.3 %Fayette County13.3Monroe County: 13.3 %Monroe County13.3Coffee County: 13.1 %Coffee County13.1Conecuh County: 13.1 %Conecuh County13.1DeKalb County: 19.4 %DeKalb County19.4Bullock County: 18.3 %Bullock County18.3Blount County: 16.6 %Blount County16.6Geneva County: 16.2 %Geneva County16.2Franklin County: 15.7 %Franklin County15.7Barbour County: 15.6 %Barbour County15.6Bibb County: 15.1 %Bibb County15.1Chilton County: 15.1 %Chilton County15.1Crenshaw County: 15.1 %Crenshaw County15.1Cullman County: 14.9 %Cullman County14.9Randolph County: 14.9 %Randolph County14.9Jackson County: 14.8 %Jackson County14.8Cleburne County: 14.6 %Cleburne County14.6Dale County: 14.6 %Dale County14.6Morgan County: 14.6 %Morgan County14.6Winston County: 14.6 %Winston County14.6Lawrence County: 14.5 %Lawrence County14.5Marion County: 14.5 %Marion County14.5Marshall County: 14.4 %Marshall County14.4Henry County: 14.3 %Henry County14.3Cherokee County: 14.2 %Cherokee County14.2Escambia County: 14.2 %Escambia County14.2Etowah County: 14.2 %Etowah County14.2Mobile County: 14.1 %Mobile County14.1Walker County: 14 %Walker County14Calhoun County: 13.9 %Calhoun County13.9Houston County: 13.9 %Houston County13.9Wilcox County: 13.9 %Wilcox County13.9Montgomery County: 13.8 %Montgomery County13.8Choctaw County: 13.7 %Choctaw County13.7Clay County: 13.7 %Clay County13.7Covington County: 13.7 %Covington County13.7Russell County: 13.7 %Russell County13.7Hale County: 13.6 %Hale County13.6Butler County: 13.4 %Butler County13.4Clarke County: 13.3 %Clarke County13.3Fayette County: 13.3 %Fayette County13.3Monroe County: 13.3 %Monroe County13.3Coffee County: 13.1 %Coffee County13.1Conecuh County: 13.1 %Conecuh County13.1
%. 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

RankCounties2023 (%)Change on 2022
1DeKalb County19.4-0.7 pts
2Bullock County18.3+3.2 pts
3Blount County16.6+0.5 pts
4Geneva County16.2+0.7 pts
5Franklin County15.7-2 pts
6Barbour County15.6-0.2 pts
7Bibb County15.1+1.6 pts
7Chilton County15.1-1.8 pts
7Crenshaw County15.1-1.6 pts
10Cullman County14.9+0.1 pts
10Randolph County14.9-1.1 pts
12Jackson County14.8-1.6 pts
13Cleburne County14.6-1.2 pts
13Dale County14.6+1.1 pts
13Morgan County14.6-1.2 pts
13Winston County14.6+0.1 pts
17Lawrence County14.5-0.9 pts
17Marion County14.5+0.5 pts
19Marshall County14.4-1.9 pts
20Henry County14.3+0.4 pts
21Cherokee County14.2-2.3 pts
21Escambia County14.2-2.1 pts
21Etowah County14.2-0.1 pts
24Mobile County14.1-1.1 pts
25Walker County14-1.7 pts
26Calhoun County13.9-0.9 pts
26Houston County13.9-1.2 pts
26Wilcox County13.9-1.6 pts
29Montgomery County13.8-0.8 pts
30Choctaw County13.7-0.1 pts
30Clay County13.7+0.5 pts
30Covington County13.7-0.3 pts
30Russell County13.7-1.5 pts
34Hale County13.6-0.9 pts
35Butler County13.4+0.1 pts
36Clarke County13.3-1.1 pts
36Fayette County13.3-1.3 pts
36Monroe County13.3-1.3 pts
39Coffee County13.1-1.8 pts
39Conecuh County13.1-0.1 pts
41Chambers County12.9-3.2 pts
41Pike County12.9-0.1 pts
43Lamar County12.8-1.3 pts
43Macon County12.8+0.9 pts
43Tallapoosa County12.8-2.2 pts
46Jefferson County12.7+0.4 pts
47Sumter County12.6+1 pts
48Colbert County12.5-0.8 pts
49Coosa County12.1+0.7 pts
49Lowndes County12.1+0.5 pts
49Pickens County12.1-0.9 pts
52Dallas County11.8-0.7 pts
52Lee County11.8-0.5 pts
52Talladega County11.8-1.3 pts
55Greene County11.7-0.1 pts
55Lauderdale County11.7-1.5 pts
55Perry County11.7-1.2 pts
58Baldwin County11.4-1.3 pts
59Elmore County11-0.3 pts
59St. Clair County11-0.9 pts
61Marengo County10.9-2 pts
62Tuscaloosa County10.6-0.3 pts
63Autauga County10.2-0.1 pts
63Washington County10.2-2.4 pts
65Limestone County10.1-1.3 pts
65Madison County10.10 pts
67Shelby County8.7-0.8 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-2023-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), 2023) [Data set]. Retrieved October 12, 2026, from https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2023-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), 2023. U.S. Census Bureau, 6 Aug. 2026, https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2023-csv.zip. Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/alabama-counties?period=2023. 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), 2023. Dataset. Accessed October 12, 2026. https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2023-csv.zip. Also distributed by Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/alabama-counties?period=2023.

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), 2023 [Dataset]. Available at: https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2023-csv.zip, via Invokely: https://invokely.ai/rankings/uninsured-rate-ages-18-64/alabama-counties?period=2023 (Accessed: 12 October 2026).

BibTeX
@misc{census_counties_in_alabama_by_2023,
  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), 2023}},
  year = {2026},
  howpublished = {Data set},
  url = {https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2023-csv.zip},
  urldate = {2026-10-12},
  note = {Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/alabama-counties?period=2023. 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-2023-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), 2023
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-2023-csv.zip
L2  - https://invokely.ai/rankings/uninsured-rate-ages-18-64/alabama-counties?period=2023
Y2  - 2026/10/12
N1  - Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/alabama-counties?period=2023.
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-2023-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 19.4% in 2023, 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 8.7% in 2023.

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