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

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

Buffalo County had the highest uninsured rate, ages 18 to 64 (US model-based estimate) of 66 counties in 2021, at 25.7%. Sully County had the lowest, at 7.8%. The median was 13.3% and the figure for South Dakota was 13.2%. Source: the U.S. Census Bureau.

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Highest25.7Buffalo County
Lowest7.8Sully County
Median13.366 counties
South Dakota13.2History

Map of counties, 2021

Aurora County: 14.8 %Beadle County: 16.9 %Bennett County: 23.5 %Bon Homme County: 13.1 %Brookings County: 9.5 %Brown County: 12.4 %Brule County: 15.1 %Buffalo County: 25.7 %Butte County: 15.5 %Campbell County: 10.5 %Charles Mix County: 20.7 %Clark County: 13.6 %Clay County: 15 %Codington County: 12.1 %Corson County: 21.2 %Custer County: 14.2 %Davison County: 11.8 %Day County: 16.6 %Deuel County: 11.2 %Dewey County: 24.6 %Douglas County: 14.3 %Edmunds County: 10.7 %Fall River County: 13.9 %Faulk County: 13.3 %Grant County: 13.6 %Gregory County: 17.4 %Haakon County: 12.1 %Hamlin County: 15 %Hand County: 9.1 %Hanson County: 12.5 %Harding County: 14.2 %Hughes County: 10 %Hutchinson County: 13.1 %Hyde County: 12.5 %Jackson County: 24.3 %Jerauld County: 11 %Jones County: 11.9 %Kingsbury County: 12.7 %Lake County: 11.5 %Lawrence County: 13.7 %Lincoln County: 9.1 %Lyman County: 18.7 %McCook County: 13.9 %McPherson County: 10.7 %Marshall County: 13.3 %Meade County: 10.9 %Mellette County: 22.2 %Miner County: 12.3 %Minnehaha County: 13.1 %Moody County: 14.8 %Oglala Lakota County: 24.5 %Pennington County: 14.2 %Perkins County: 12.8 %Potter County: 10.2 %Roberts County: 20.4 %Sanborn County: 12.5 %Spink County: 13.3 %Stanley County: 11.2 %Sully County: 7.8 %Todd County: 23.9 %Tripp County: 19.1 %Turner County: 11.7 %Union County: 9.1 %Walworth County: 14.7 %Yankton County: 12.6 %Ziebach County: 20.9 %
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%, 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

Buffalo County: 25.7 %Buffalo County25.7Dewey County: 24.6 %Dewey County24.6Oglala Lakota County: 24.5 %Oglala Lakota County24.5Jackson County: 24.3 %Jackson County24.3Todd County: 23.9 %Todd County23.9Bennett County: 23.5 %Bennett County23.5Mellette County: 22.2 %Mellette County22.2Corson County: 21.2 %Corson County21.2Ziebach County: 20.9 %Ziebach County20.9Charles Mix County: 20.7 %Charles Mix County20.7Roberts County: 20.4 %Roberts County20.4Tripp County: 19.1 %Tripp County19.1Lyman County: 18.7 %Lyman County18.7Gregory County: 17.4 %Gregory County17.4Beadle County: 16.9 %Beadle County16.9Day County: 16.6 %Day County16.6Butte County: 15.5 %Butte County15.5Brule County: 15.1 %Brule County15.1Clay County: 15 %Clay County15Hamlin County: 15 %Hamlin County15Aurora County: 14.8 %Aurora County14.8Moody County: 14.8 %Moody County14.8Walworth County: 14.7 %Walworth County14.7Douglas County: 14.3 %Douglas County14.3Custer County: 14.2 %Custer County14.2Harding County: 14.2 %Harding County14.2Pennington County: 14.2 %Pennington County14.2Fall River County: 13.9 %Fall River County13.9McCook County: 13.9 %McCook County13.9Lawrence County: 13.7 %Lawrence County13.7Clark County: 13.6 %Clark County13.6Grant County: 13.6 %Grant County13.6Faulk County: 13.3 %Faulk County13.3Marshall County: 13.3 %Marshall County13.3Spink County: 13.3 %Spink County13.3Bon Homme County: 13.1 %Bon Homme County13.1Hutchinson County: 13.1 %Hutchinson County13.1Minnehaha County: 13.1 %Minnehaha County13.1Perkins County: 12.8 %Perkins County12.8Kingsbury County: 12.7 %Kingsbury County12.7Buffalo County: 25.7 %Buffalo County25.7Dewey County: 24.6 %Dewey County24.6Oglala Lakota County: 24.5 %Oglala Lakota County24.5Jackson County: 24.3 %Jackson County24.3Todd County: 23.9 %Todd County23.9Bennett County: 23.5 %Bennett County23.5Mellette County: 22.2 %Mellette County22.2Corson County: 21.2 %Corson County21.2Ziebach County: 20.9 %Ziebach County20.9Charles Mix County: 20.7 %Charles Mix County20.7Roberts County: 20.4 %Roberts County20.4Tripp County: 19.1 %Tripp County19.1Lyman County: 18.7 %Lyman County18.7Gregory County: 17.4 %Gregory County17.4Beadle County: 16.9 %Beadle County16.9Day County: 16.6 %Day County16.6Butte County: 15.5 %Butte County15.5Brule County: 15.1 %Brule County15.1Clay County: 15 %Clay County15Hamlin County: 15 %Hamlin County15Aurora County: 14.8 %Aurora County14.8Moody County: 14.8 %Moody County14.8Walworth County: 14.7 %Walworth County14.7Douglas County: 14.3 %Douglas County14.3Custer County: 14.2 %Custer County14.2Harding County: 14.2 %Harding County14.2Pennington County: 14.2 %Pennington County14.2Fall River County: 13.9 %Fall River County13.9McCook County: 13.9 %McCook County13.9Lawrence County: 13.7 %Lawrence County13.7Clark County: 13.6 %Clark County13.6Grant County: 13.6 %Grant County13.6Faulk County: 13.3 %Faulk County13.3Marshall County: 13.3 %Marshall County13.3Spink County: 13.3 %Spink County13.3Bon Homme County: 13.1 %Bon Homme County13.1Hutchinson County: 13.1 %Hutchinson County13.1Minnehaha County: 13.1 %Minnehaha County13.1Perkins County: 12.8 %Perkins County12.8Kingsbury County: 12.7 %Kingsbury County12.7
%. 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
1Buffalo County25.7-2.1 pts
2Dewey County24.6-1.1 pts
3Oglala Lakota County24.5-1.7 pts
4Jackson County24.3+1.2 pts
5Todd County23.9+0.5 pts
6Bennett County23.5-2.2 pts
7Mellette County22.2-0.3 pts
8Corson County21.2+3 pts
9Ziebach County20.90 pts
10Charles Mix County20.7-2.2 pts
11Roberts County20.4-2.2 pts
12Tripp County19.1+2.4 pts
13Lyman County18.7+0.1 pts
14Gregory County17.4-0.5 pts
15Beadle County16.9-1.7 pts
16Day County16.6+1.7 pts
17Butte County15.5-1.1 pts
18Brule County15.1-3.2 pts
19Clay County15+0.7 pts
19Hamlin County15+0.6 pts
21Aurora County14.8-0.6 pts
21Moody County14.8-2 pts
23Walworth County14.7-2 pts
24Douglas County14.3+0.8 pts
25Custer County14.2-1.2 pts
25Harding County14.2-2.3 pts
25Pennington County14.2-2.4 pts
28Fall River County13.9-0.2 pts
28McCook County13.9+0.4 pts
30Lawrence County13.7-1.8 pts
31Clark County13.6-0.6 pts
31Grant County13.6-1.6 pts
33Faulk County13.3+3.1 pts
33Marshall County13.3+0.1 pts
33Spink County13.3+0.8 pts
36Bon Homme County13.1-1.5 pts
36Hutchinson County13.1+0.2 pts
36Minnehaha County13.1+2 pts
39Perkins County12.8+2.7 pts
40Kingsbury County12.7+1 pts
41Yankton County12.6-1.9 pts
42Hanson County12.5+1.9 pts
42Hyde County12.5+0.6 pts
42Sanborn County12.5+1 pts
45Brown County12.4-1.2 pts
46Miner County12.3-0.5 pts
47Codington County12.1-1.2 pts
47Haakon County12.1+0.7 pts
49Jones County11.9-3.3 pts
50Davison County11.8-2.3 pts
51Turner County11.7-0.4 pts
52Lake County11.5-0.5 pts
53Deuel County11.2+0.2 pts
53Stanley County11.2-0.1 pts
55Jerauld County11+2.7 pts
56Meade County10.9-1.9 pts
57Edmunds County10.7-0.9 pts
57McPherson County10.7-0.8 pts
59Campbell County10.5+1.8 pts
60Potter County10.2-1.8 pts
61Hughes County10-4.5 pts
62Brookings County9.5-0.8 pts
63Hand County9.1-0.6 pts
63Lincoln County9.1-0.5 pts
63Union County9.1-1 pts
66Sully County7.8-0.5 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-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 South Dakota 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 South Dakota 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/south-dakota-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 South Dakota 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/south-dakota-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 South Dakota 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/south-dakota-counties?period=2021 (Accessed: 12 October 2026).

BibTeX
@misc{census_counties_in_south_dakota_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 South Dakota 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/south-dakota-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 South Dakota 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/south-dakota-counties?period=2021
Y2  - 2026/10/12
N1  - Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/south-dakota-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)?

Buffalo County, with 25.7% in 2021, according to the U.S. Census Bureau.

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

Sully County, with 7.8% 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 South Dakota: more rankings