20.6% of working-age adults in Dallas County lack health insurance

Working-age adults in Dallas County are far more likely to lack health insurance than adults in the suburban counties next door. The gap with Collin County is 10.5 percentage points, according to new CDC estimates for 2023.

Dallas County also has higher rates of adult obesity and diagnosed diabetes than Collin, Denton and Rockwall counties. But the coverage gap is the widest of these measures, and survey data show it falls hardest on young adults.

These counties share highways, employers and a job market. Yet the CDC's PLACES estimates show health risks and coverage split at the county line. The figures cover all of Dallas County, not just the city of Dallas.

A wide coverage gap

In Dallas County, 20.6% of working-age adults had no health insurance in 2023, the CDC estimates. That is 10.5 percentage points higher than in Collin County.

The gap with Denton County is 9.4 percentage points. With Rockwall County, it is 9.3 percentage points. Each suburban county sits well below Dallas County on this measure.

For a household, the difference is practical. A working-age adult in Dallas County is more likely to have no coverage when a doctor's bill, a prescription or an emergency room visit comes due.

Dallas County also stands out beyond North Texas. In a comparison of large-metro counties, including its suburban neighbors and counties in peer metros, Dallas County ranked 4th highest for uninsured working-age adults.

Census Bureau survey data point to who is going without. In Dallas County, 30.6% of young adults had no health insurance in the 2020-2024 estimates.

That is above the Texas rate for the same age group, 27.5%. It is far above the U.S. rate of 14.3%.

Middle-aged adults in Dallas County fare little better, at 25.5% uninsured. Among children and teens, the rate is 15.5%.

Seniors are the exception. Just 2.6% of Dallas County residents in the oldest age group lack coverage.

The Census figures come from a different survey and a longer time span than the CDC estimates, so the numbers don't match exactly. They point the same way: the county's coverage gap is concentrated among adults of working age.

Obesity and diabetes run higher, too

Adult obesity in Dallas County stood at 35.7% in 2023, the CDC estimates. That is 3.4 percentage points higher than in Collin County and 2.0 percentage points higher than in Denton County.

Rockwall County comes close. Its obesity rate trails Dallas County's by just 0.6 percentage points, a gap narrow enough that it may fall within the model's uncertainty.

Diagnosed diabetes shows a steadier pattern. The CDC estimates 12.5% of Dallas County adults have been told by a doctor that they have diabetes.

That runs 3.0 percentage points above Collin County, 2.6 percentage points above Denton County and 3.1 percentage points above Rockwall County. Rockwall, nearly even on obesity, shows the widest diabetes gap of the suburban counties.

These numbers show where rates differ, not why. The CDC release does not explain the gaps, and this report does not assign a cause.

Comparing Dallas and Collin counties across every measure in the PLACES release shows how the coverage, obesity and diabetes gaps stack up against other chronic disease and access-to-care measures. The chart below lays them side by side.

What to watch

Open enrollment for health coverage is approaching. These estimates show where the most working-age adults in North Texas lack a plan, and where young adults in particular go without.

The next PLACES release will show whether the county gaps narrow, widen or hold. The Census Bureau's next survey update will refresh coverage rates by age for Dallas County, Texas and the U.S.

How we did this

We used the CDC's PLACES county estimates for 2023 to compare Dallas County with Collin, Denton and Rockwall counties on working-age adults without health insurance, adult obesity and diagnosed diabetes, measuring each gap in percentage points. We also ranked Dallas County against a group of large-metro counties, including its neighbors and peer-metro counties, where it placed 4th highest for uninsured working-age adults. Coverage by age group comes from the Census Bureau's American Community Survey, pooled 2020-2024 estimates, compared with Texas and the U.S.

Percentage points: the simple difference between rates, not a percent change. PLACES: a CDC project that produces local estimates of chronic disease, health risks and access to care. Crude prevalence: the share of adults with a condition, not adjusted for age differences between places. Uninsured (PLACES): working-age adults who report having no current health insurance. Diagnosed diabetes: adults who report a doctor has told them they have diabetes. Obesity: adults whose body mass index, based on reported height and weight, falls in the obese range. Young adults (Census): the youngest adult age group in the Census Bureau's coverage tables; seniors are the oldest group.

Limitations

• PLACES figures are model-based estimates built from survey data, not counts of actual people, and each comes with a range of uncertainty.
• The PLACES rates are crude, meaning they are not adjusted for differences in the age makeup of each county.
• Small gaps, such as the obesity difference between Dallas and Rockwall counties, may fall within the margin of error.
• The Census coverage figures are survey estimates from a different source and a longer time span, so they will not match the CDC numbers exactly.
• Diagnosed diabetes counts only adults who have been told they have it, so it misses people with undiagnosed diabetes.
• County-wide rates can hide large differences between neighborhoods and cities within a county.
• The data show where rates differ, not why they differ.

Sources

• Centers for Disease Control and Prevention, PLACES: Local Data for Better Health: PLACES: Local Data for Better Health, County Data, 2025 release (PLACES 2025 release), latest period 2025; retrieved Oct. 14, 2026. Data
• U.S. Census Bureau, American Community Survey: Types of Health Insurance Coverage by Age (ACS 5-year 2020–2024), latest period 2024; retrieved Oct. 14, 2026. Data