Data / Rankings / Uninsured rate, under 65 (US model-based estimate) / Counties in Alabama

Counties in Alabama by uninsured rate, under 65 (US model-based estimate)

DeKalb County had the highest uninsured rate, under 65 (US model-based estimate) of 67 counties in 2020, at 19%. Shelby County had the lowest, at 9.3%. The median was 12.5% and the figure for Alabama was 11.8%. Source: the U.S. Census Bureau.

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Highest19DeKalb County
Lowest9.3Shelby County
Median12.567 counties
Alabama11.8History

Map of counties, 2020

Autauga County: 10.6 %Baldwin County: 10.9 %Barbour County: 14.4 %Bibb County: 13 %Blount County: 13.3 %Bullock County: 12.4 %Butler County: 13.5 %Calhoun County: 12.9 %Chambers County: 13.2 %Cherokee County: 12.8 %Chilton County: 15.3 %Choctaw County: 12.7 %Clarke County: 13.7 %Clay County: 14.4 %Cleburne County: 13.5 %Coffee County: 13.7 %Colbert County: 10.5 %Conecuh County: 11.4 %Coosa County: 11.7 %Covington County: 12.1 %Crenshaw County: 12.9 %Cullman County: 14.1 %Dale County: 13.8 %Dallas County: 11.5 %DeKalb County: 19 %Elmore County: 10.9 %Escambia County: 14.4 %Etowah County: 13.8 %Fayette County: 13.8 %Franklin County: 15.9 %Geneva County: 15 %Greene County: 11.6 %Hale County: 11.4 %Henry County: 12 %Houston County: 13.6 %Jackson County: 12.7 %Jefferson County: 10 %Lamar County: 12.1 %Lauderdale County: 11.8 %Lawrence County: 15.1 %Lee County: 10.5 %Limestone County: 12.1 %Lowndes County: 11.7 %Macon County: 13.2 %Madison County: 9.9 %Marengo County: 11.1 %Marion County: 12.4 %Marshall County: 15.2 %Mobile County: 12 %Monroe County: 13.4 %Montgomery County: 12.2 %Morgan County: 14.7 %Perry County: 12.4 %Pickens County: 12.5 %Pike County: 12.5 %Randolph County: 13 %Russell County: 12.1 %St. Clair County: 11.6 %Shelby County: 9.3 %Sumter County: 12.1 %Talladega County: 11.6 %Tallapoosa County: 13.6 %Tuscaloosa County: 10.3 %Walker County: 11.6 %Washington County: 14.3 %Wilcox County: 12.2 %Winston County: 13.6 %
  • Under 11
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  • 14 and over
%, 2020. Source: U.S. Census Bureau, Small Area Health Insurance Estimates (SAHIE): percent uninsured, under 65, all races, both sexes, all income levels, states and counties. Boundaries: U.S. Census Bureau cartographic boundary files.

Top 40 counties, 2020

DeKalb County: 19 %DeKalb County19Franklin County: 15.9 %Franklin County15.9Chilton County: 15.3 %Chilton County15.3Marshall County: 15.2 %Marshall County15.2Lawrence County: 15.1 %Lawrence County15.1Geneva County: 15 %Geneva County15Morgan County: 14.7 %Morgan County14.7Barbour County: 14.4 %Barbour County14.4Clay County: 14.4 %Clay County14.4Escambia County: 14.4 %Escambia County14.4Washington County: 14.3 %Washington County14.3Cullman County: 14.1 %Cullman County14.1Dale County: 13.8 %Dale County13.8Etowah County: 13.8 %Etowah County13.8Fayette County: 13.8 %Fayette County13.8Clarke County: 13.7 %Clarke County13.7Coffee County: 13.7 %Coffee County13.7Houston County: 13.6 %Houston County13.6Tallapoosa County: 13.6 %Tallapoosa County13.6Winston County: 13.6 %Winston County13.6Butler County: 13.5 %Butler County13.5Cleburne County: 13.5 %Cleburne County13.5Monroe County: 13.4 %Monroe County13.4Blount County: 13.3 %Blount County13.3Chambers County: 13.2 %Chambers County13.2Macon County: 13.2 %Macon County13.2Bibb County: 13 %Bibb County13Randolph County: 13 %Randolph County13Calhoun County: 12.9 %Calhoun County12.9Crenshaw County: 12.9 %Crenshaw County12.9Cherokee County: 12.8 %Cherokee County12.8Choctaw County: 12.7 %Choctaw County12.7Jackson County: 12.7 %Jackson County12.7Pickens County: 12.5 %Pickens County12.5Pike County: 12.5 %Pike County12.5Bullock County: 12.4 %Bullock County12.4Marion County: 12.4 %Marion County12.4Perry County: 12.4 %Perry County12.4Montgomery County: 12.2 %Montgomery County12.2Wilcox County: 12.2 %Wilcox County12.2DeKalb County: 19 %DeKalb County19Franklin County: 15.9 %Franklin County15.9Chilton County: 15.3 %Chilton County15.3Marshall County: 15.2 %Marshall County15.2Lawrence County: 15.1 %Lawrence County15.1Geneva County: 15 %Geneva County15Morgan County: 14.7 %Morgan County14.7Barbour County: 14.4 %Barbour County14.4Clay County: 14.4 %Clay County14.4Escambia County: 14.4 %Escambia County14.4Washington County: 14.3 %Washington County14.3Cullman County: 14.1 %Cullman County14.1Dale County: 13.8 %Dale County13.8Etowah County: 13.8 %Etowah County13.8Fayette County: 13.8 %Fayette County13.8Clarke County: 13.7 %Clarke County13.7Coffee County: 13.7 %Coffee County13.7Houston County: 13.6 %Houston County13.6Tallapoosa County: 13.6 %Tallapoosa County13.6Winston County: 13.6 %Winston County13.6Butler County: 13.5 %Butler County13.5Cleburne County: 13.5 %Cleburne County13.5Monroe County: 13.4 %Monroe County13.4Blount County: 13.3 %Blount County13.3Chambers County: 13.2 %Chambers County13.2Macon County: 13.2 %Macon County13.2Bibb County: 13 %Bibb County13Randolph County: 13 %Randolph County13Calhoun County: 12.9 %Calhoun County12.9Crenshaw County: 12.9 %Crenshaw County12.9Cherokee County: 12.8 %Cherokee County12.8Choctaw County: 12.7 %Choctaw County12.7Jackson County: 12.7 %Jackson County12.7Pickens County: 12.5 %Pickens County12.5Pike County: 12.5 %Pike County12.5Bullock County: 12.4 %Bullock County12.4Marion County: 12.4 %Marion County12.4Perry County: 12.4 %Perry County12.4Montgomery County: 12.2 %Montgomery County12.2Wilcox County: 12.2 %Wilcox County12.2
%. Source: U.S. Census Bureau, Small Area Health Insurance Estimates (SAHIE): percent uninsured, under 65, all races, both sexes, all income levels, states and counties. Retrieved 2026-10-12.

Full ranking

RankCounties2020 (%)Change on 2019
1DeKalb County19+0.3 pts
2Franklin County15.9+0.5 pts
3Chilton County15.3+1.6 pts
4Marshall County15.2-0.2 pts
5Lawrence County15.1+0.3 pts
6Geneva County15+0.4 pts
7Morgan County14.7+1.9 pts
8Barbour County14.4+1.4 pts
8Clay County14.40 pts
8Escambia County14.4+0.2 pts
11Washington County14.3+0.5 pts
12Cullman County14.1+0.7 pts
13Dale County13.8+1.8 pts
13Etowah County13.8+1.1 pts
13Fayette County13.8+1.8 pts
16Clarke County13.7+1.7 pts
16Coffee County13.7+0.7 pts
18Houston County13.6+0.3 pts
18Tallapoosa County13.6+1.5 pts
18Winston County13.6+0.6 pts
21Butler County13.5+1.9 pts
21Cleburne County13.5+0.7 pts
23Monroe County13.4+0.5 pts
24Blount County13.3-1 pts
25Chambers County13.2+1 pts
25Macon County13.2+2.5 pts
27Bibb County13+2 pts
27Randolph County13+0.7 pts
29Calhoun County12.9+1 pts
29Crenshaw County12.9-0.5 pts
31Cherokee County12.8-0.2 pts
32Choctaw County12.7+0.5 pts
32Jackson County12.7-1.1 pts
34Pickens County12.5+0.1 pts
34Pike County12.5-1 pts
36Bullock County12.4+1.3 pts
36Marion County12.4+0.1 pts
36Perry County12.4+0.3 pts
39Montgomery County12.2+0.5 pts
39Wilcox County12.2+0.6 pts
41Covington County12.1-0.4 pts
41Lamar County12.1+0.2 pts
41Limestone County12.1+0.5 pts
41Russell County12.1+0.8 pts
41Sumter County12.1-1.1 pts
46Henry County12-0.5 pts
46Mobile County12-0.7 pts
48Lauderdale County11.8-0.1 pts
49Coosa County11.7+0.4 pts
49Lowndes County11.7+0.9 pts
51Greene County11.60 pts
51St. Clair County11.6+1.4 pts
51Talladega County11.6+0.4 pts
51Walker County11.6-1.6 pts
55Dallas County11.5+0.4 pts
56Conecuh County11.4-0.8 pts
56Hale County11.4-0.2 pts
58Marengo County11.10 pts
59Baldwin County10.90 pts
59Elmore County10.9+2 pts
61Autauga County10.6+1.2 pts
62Colbert County10.5-0.3 pts
62Lee County10.5-0.2 pts
64Tuscaloosa County10.3+0.2 pts
65Jefferson County10-0.7 pts
66Madison County9.9+0.7 pts
67Shelby County9.3+0.6 pts

Other periods

About this ranking

People under 65 without health insurance coverage of any kind, as a percentage of all people under 65. 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. People 65 and over are left out because nearly all of them have Medicare.

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, under 65, 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, under 65, all races, both sexes, all income levels, states and counties (Counties in Alabama by uninsured rate, under 65 (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, under 65, all races, both sexes, all income levels, states and counties, Counties in Alabama by uninsured rate, under 65 (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-under-65/alabama-counties?period=2020. Accessed 12 Oct. 2026.

Chicago (author-date)

U.S. Census Bureau. 2026. Small Area Health Insurance Estimates (SAHIE): percent uninsured, under 65, all races, both sexes, all income levels, states and counties. Counties in Alabama by uninsured rate, under 65 (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-under-65/alabama-counties?period=2020.

Harvard

U.S. Census Bureau (2026) Small Area Health Insurance Estimates (SAHIE): percent uninsured, under 65, all races, both sexes, all income levels, states and counties, Counties in Alabama by uninsured rate, under 65 (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-under-65/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, under 65, all races, both sexes, all income levels, states and counties: Counties in Alabama by uninsured rate, under 65 (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-under-65/alabama-counties?period=2020. Publisher attribution: U.S. Census Bureau. Small Area Health Insurance Estimates (SAHIE): percent uninsured, under 65, 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, under 65, all races, both sexes, all income levels, states and counties: Counties in Alabama by uninsured rate, under 65 (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-under-65/alabama-counties?period=2020
Y2  - 2026/10/12
N1  - Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-under-65/alabama-counties?period=2020.
N1  - Publisher attribution: U.S. Census Bureau. Small Area Health Insurance Estimates (SAHIE): percent uninsured, under 65, 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, under 65 (US model-based estimate)?

DeKalb County, with 19% in 2020, according to the U.S. Census Bureau.

Which county has the lowest uninsured rate, under 65 (US model-based estimate)?

Shelby County, with 9.3% 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, under 65, all races, both sexes, all income levels, states and counties. Retrieved 2026-10-12.

Uninsured rate, under 65 (US model-based estimate): other rankings

Counties in Alabama: more rankings