St. Joseph County, MI

County

Add Comparison

Population

60,897

0.0115% 1-year growth

US Senator

Debbie Stabenow

Democratic Party

US Senator

Gary Peters

Democratic Party

Median Age

39.7

Poverty Rate

15.6%

Median Household Income

$50,117

4.72% 1-year growth

Median Property Value

$115,100

3.51% 1-year growth

Number of Employees

28,021

1.51% 1-year growth

About

In 2018, St. Joseph County, MI had a population of 60.9k people with a median age of 39.7 and a median household income of $50,117. Between 2017 and 2018 the population of St. Joseph County, MI grew from 60,890 to 60,897, a 0.0115% increase and its median household income grew from $47,856 to $50,117, a 4.72% increase.

The 5 largest ethnic groups in St. Joseph County, MI are White (Non-Hispanic) (86.6%), White (Hispanic) (4.44%), Two+ (Non-Hispanic) (2.76%), Other (Hispanic) (2.64%), and Black or African American (Non-Hispanic) (2.17%). 0% of the households in St. Joseph County, MI speak a non-English language at home as their primary language, and 97.6% of the residents in St. Joseph County, MI are U.S. citizens.

The largest universities in St. Joseph County, MI are Glen Oaks Community College (200 degrees awarded in 2019).

In 2018, the median property value in St. Joseph County, MI was $115,100, and the homeownership rate was 74.2%. Most people in St. Joseph County, MI drove alone to work, and the average commute time was 20.9 minutes. The average car ownership in St. Joseph County, MI was 2 cars per household.

St. Joseph County, MI borders Elkhart County, IN, LaGrange County, IN, Branch County, MI, Calhoun County, MI, Cass County, MI, Kalamazoo County, MI, and Van Buren County, MI.

United States Michigan Sturgis, MI

COVID-19

Daily New Cases by Date

Showing data at the state level for Michigan. Hospitalization data for some states may be delayed or not reported.

Y-Axis

This chart shows the number of COVID-19 daily new cases by date in Michigan, as a 7-day rolling average, compared with the four states with the most similar number of confirmed cases.

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Unemployment Insurance Claims

Data is only available at the state level. Showing data for Michigan.

This chart shows weekly unemployment insurance claims in Michigan (not-seasonally adjusted) compared with the four states with the most similar impact.

The most recent data point uses Advance State Claims data, which can be revised in subsequent weeks.

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Employment by Industry Sector

Data is only available at the state level. Showing data for Michigan.

Start Year

Y-Axis

-5.78%

Year-over-year decline

Employment change between November 2019 and November 2020

As of November 2020, there are 145M people employed in Michigan. This represents a -5.78% decrease in employment when compared to November 2019.

The following chart shows monthly employment numbers for each industry sector in Michigan.

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Community Mobility

Data is only available at the state level. Showing data for Michigan.

This chart presents movement trends over time in the state of Michigan across different categories of places such as retail and recreation, groceries and pharmacies, parks, transit stations, workplaces, and residential.

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Civics

In the 2016 presidential election, the popular vote in St. Joseph County, MI went to Donald J. Trump with 62.7% of the vote. The runner-up was Hillary Rodham Clinton (31.7%), followed by Other (5.67%). The most partisan county was Missaukee County, MI with 73.6% of the vote going to Donald J. Trump running for the Republican Party.

Debbie Stabenow and Gary Peters are the senators currently representing the state of Michigan. In the United States, senators are elected to 6-year terms with the terms for individual senators staggered.

Michigan is currently represented by 14 members in the U.S. house, and members of the House of Representives are elected to 2-year terms.

Presidential Popular Vote Over Time

Showing data up to the 2016 election. Updated election results are currently being processed, and will be released in the coming months.

2016 Election Results

Donald J. Trump (62.7%)
Republican Party
Hillary Rodham Clinton (31.7%)
Democratic Party
Other (5.67%)
Other Party

In the 2016 presidential election, the popular vote in Michigan went to Donald J. Trump with 62.7% of the vote. The runner-up was Hillary Rodham Clinton (31.7%), followed by Other (5.67%).

The following chart shows the popular vote results in Michigan for each registered party from 1976 to 2016.

Presidential Popular Vote by County

Presidential voting results are only available at the county level. Showing data for the counties inside of Michigan.

Showing data up to the 2016 election. Updated election results are currently being processed, and will be released in the coming months.

Donald J. Trump

Popular Vote for St. Joseph County, MI

62.7% for the Republican Party

Most Partisan Counties in Michigan

Missaukee County, MI
73.6% for Donald J. Trump (Republican Party)
Hillsdale County, MI
70.7% for Donald J. Trump (Republican Party)
Sanilac County, MI
69.9% for Donald J. Trump (Republican Party)

In the 2016 presidential election, the most partisan county in Michigan was Missaukee County, MI with 73.6% of the vote going to Donald J. Trump running for the Republican Party.

The following map shows the counties in Michigan colored by their party leaning.

US Senators from Michigan

Senatorial voting results are only available at the state level. Showing data for Michigan.

Debbie Stabenow

Senator from Michigan

Assumed office on January 3, 2001

Gary Peters

Senator from Michigan

Assumed office on January 3, 2015

Debbie Stabenow and Gary Peters are the senators currently representing Michigan.

In the United States, senators are elected to 6-year terms with the terms for individual senators staggered.

The following chart shows elected senators in Michigan over time, excluding special elections, colored by their political party.

US Representatives from Michigan

Michigan is currently represented by 14 members in the U.S. house.

Members of the House of Representives are elected to 2-year terms, and the following chart shows the how the members for Michigan have changed over time starting in 2008.

Diversity

St. Joseph County, MI is home to a population of 60.9k people, from which 97.6% are citizens. As of 2018, 3.36% of St. Joseph County, MI residents were born outside of the country (2.05k people).

In 2018, there were 19.5 times more White (Non-Hispanic) residents (52.8k people) in St. Joseph County, MI than any other race or ethnicity. There were 2.7k White (Hispanic) and 1.68k Two+ (Non-Hispanic) residents, the second and third most common ethnic groups.

Race and Ethnicity

The 3 largest ethnic groups in St. Joseph County, MI

White (Non-Hispanic)
52.8k ± 15
White (Hispanic)
2.7k ± 478
Two+ (Non-Hispanic)
1.68k ± 184

7.73%

Hispanic Population

4.71k people

7.73% of the people in St. Joseph County, MI are hispanic (4.71k people).

The following chart shows the 7 races represented in St. Joseph County, MI as a share of the total population.

Heritage

Foreign-Born Population

3.36%

2018 Foreign-Born Population

2.05k people

3.5%

2017 Foreign-Born Population

2.13k people

As of 2018, 3.36% of St. Joseph County, MI residents (2.05k people) were born outside of the United States, which is lower than the national average of 13.7%. In 2017, the percentage of foreign-born citizens in St. Joseph County, MI was 3.5%, meaning that the rate has been decreasing.

The following chart shows the percentage of foreign-born residents in St. Joseph County, MI compared to that of it's neighboring and parent geographies.

Age by Nativity

Median Native-Born Age

± 0.4

Median Foreign-Born Age

± 4

In 2018, the median age of all people in St. Joseph County, MI was 39.7. Native-born citizens, with a median age of 40, were generally younger than than foreign-born citizens, with a median age of 43. But people in St. Joseph County, MI are getting getting older. In 2017, the average age of all St. Joseph County, MI residents was 39.

Global Diversity

The PUMS dataset is not available at the County level, so we are showing data for Michigan.

Most Common Origin

Mexico
80,443 ± 6,935 people
India
73,340 ± 6,624 people
Iraq
55,052 ± 5,745 people

In 2019, the most common birthplace for the foreign-born residents of Michigan was Mexico, the natal country of 80,443 Michigan residents, followed by India with 73,340 and Iraq with 55,052.

Citizenship

97.6%

2018 Citizenship

97.6%

2017 Citizenship

As of 2018, 97.6% of St. Joseph County, MI residents were US citizens, which is higher than the national average of 93.2%. In 2017, the percentage of US citizens in St. Joseph County, MI was 97.6%, meaning that the rate of citizenship has been decreasing.

The following chart shows US citizenship percentages in St. Joseph County, MI compared to that of it's neighboring and parent geographies.

Military

Veterans

Most Common Service Period

Vietnam
1,384 ± 144
Gulf War (1990s)
629 ± 134
Gulf War (2001-)
400 ± 95

St. Joseph County, MI has a large population of military personnel who served in Vietnam, 2.2 times greater than any other conflict.

Economy

Median household income in St. Joseph County, MI is $50,117. In 2018, the tract with the highest Median Household Income in St. Joseph County, MI was Census Tract 401 with a value of $66,589, followed by Census Tract 411.02 and Census Tract 409, with respective values of $60,430 and $56,291.

Males in Michigan have an average income that is 1.37 times higher than the average income of females, which is $49,622. The income inequality in Michigan (measured using the Gini index) is 0.475, which is lower than than the national average.

The economy of St. Joseph County, MI employs 28k people. The largest industries in St. Joseph County, MI are Manufacturing (10,908 people), Health Care & Social Assistance (2,960 people), and Retail Trade (2,375 people), and the highest paying industries are Utilities ($62,125), Mining, Quarrying, & Oil & Gas Extraction ($55,000), and Professional, Scientific, & Technical Services ($48,514).

Wages

Median Household Income

$50,117

2018 value

± $1,027

4.72%

1 Year Growth

± 3.53%

Households in St. Joseph County, MI have a median annual income of $50,117, which is less than the median annual income of $61,937 across the entire United States. This is in comparison to a median income of $47,856 in 2017, which represents a 4.72% annual growth.

The following chart shows how the median household income in St. Joseph County, MI compares to that of its neighboring and parent geographies.

Wage by Gender in Common Jobs

The PUMS dataset is not available at the County level, so we are showing data for Michigan.

$67,777

Average Male Salary in Michigan

± $1,173

$49,622

Average Female Salary in Michigan

± $892

In 2019, full-time male employees in Michigan made 1.37 times more than female employees.

This chart shows the gender-based wage disparity in the 5 most common occupations in Michigan by number of full-time employees.

Wage by Race and Ethnicity in Common Jobs

The PUMS dataset is not available at the County level, so we are showing data for Michigan.

Highest Average Salaries by Race & Ethnicity in Michigan

Asian
$66,769 ± $4,515
Native Hawaiian and Other Pacific Islander
$58,569 ± $71,898
White
$51,731 ± $750

In 2019 the highest paid race/ethnicity of Michigan workers was Asian. These workers were paid 1.14 times more than Native Hawaiian and Other Pacific Islander workers, who made the second highest salary of any race/ethnicity in Michigan.

This chart shows the race- and ethnicity-based wage disparities in the 5 most common occupations in Michigan by number of full-time employees.

Wage Distribution

The closest comparable wage GINI for St. Joseph County, MI is from Michigan.

0.475

2019 Wage GINI in Michigan

0.476

2018 Wage GINI in Michigan

In 2019, the income inequality in Michigan was 0.475 according to the GINI calculation of the wage distribution. Income inequality had a 0.169% decline from 2018 to 2019, which means that wage distribution grew somewhat more even. The GINI for Michigan was lower than than the national average of 0.478. In other words, wages are distributed more evenly in Michigan in comparison to the national average.

This chart shows the number of workers in Michigan across various wage buckets compared to the national average.

Income by Location

Use the dropdown to filter by race/ethnicity.

Race/Ethnicity

Highest Median Household Income (Total)

Census Tract 401
Census Tract 411.02
Census Tract 409

In 2018, the tract with the highest Median Household Income (Total) in St. Joseph County, MI was Census Tract 401 with a value of $66,589, followed by Census Tract 411.02 and Census Tract 409, with respective values of $60,430 and $56,291.

The following map shows all of the tracts in St. Joseph County, MI colored by their Median Household Income (Total).

Poverty by Age and Gender

Females 25 - 34

Largest Demographic Living in Poverty

15.6% of the population for whom poverty status is determined in St. Joseph County, MI (9.35k out of 59.8k people) live below the poverty line, a number that is higher than the national average of 13.1%. The largest demographic living in poverty are Females 25 - 34, followed by Males < 5 and then Males 6 - 11.

The Census Bureau uses a set of money income thresholds that vary by family size and composition to determine who classifies as impoverished. If a family's total income is less than the family's threshold than that family and every individual in it is considered to be living in poverty.

Poverty by Race and Ethnicity

Largest Race or Ethnicity Living in Poverty

White
8,213 ± 491
Hispanic
1,841 ± 267
Other
379 ± 176

The most common racial or ethnic group living below the poverty line in St. Joseph County, MI is White, followed by Hispanic and Other.

Occupations

Employment by Occupations

28k

2018 Value

± 821

1.51%

1 Year growth

± 4.25%

From 2017 to 2018, employment in St. Joseph County, MI grew at a rate of 1.51%, from 27.6k employees to 28k employees.

The most common job groups, by number of people living in St. Joseph County, MI, are Production Occupations (6,847 people), Office & Administrative Support Occupations (2,818 people), and Sales & Related Occupations (2,202 people). This chart illustrates the share breakdown of the primary jobs held by residents of St. Joseph County, MI.

Most Common

The most common jobs held by residents of St. Joseph County, MI, by number of employees, are Production Occupations (6,847 people), Office & Administrative Support Occupations (2,818 people), and Sales & Related Occupations (2,202 people).

Most Specialized

Compared to other counties, St. Joseph County, MI has an unusually high number of residents working as Production Occupations (4.26 times higher than expected), Farming, Fishing, & Forestry Occupations (2.04 times), and Material Moving Occupations (1.67 times).

Highest Paid

The highest paid jobs held by residents of St. Joseph County, MI, by median earnings, are Life, Physical, & Social Science Occupations ($71,298), Computer, Engineering, & Science Occupations ($68,214), and Computer & Mathematical Occupations ($67,788).

Industries

Employment by Industries

28k

2018 Value

± 821

1.51%

1 Year growth

± 4.25%

From 2017 to 2018, employment in St. Joseph County, MI grew at a rate of 1.51%, from 27.6k employees to 28k employees.

The most common employment sectors for those who live in St. Joseph County, MI, are Manufacturing (10,908 people), Health Care & Social Assistance (2,960 people), and Retail Trade (2,375 people). This chart shows the share breakdown of the primary industries for residents of St. Joseph County, MI, though some of these residents may live in St. Joseph County, MI and work somewhere else. Census data is tagged to a residential address, not a work address.

Most Common

The most common industries in St. Joseph County, MI, by number of employees, are Manufacturing (10,908 people), Health Care & Social Assistance (2,960 people), and Retail Trade (2,375 people).

Most Specialized

Compared to other counties, St. Joseph County, MI has an unusually high number of Manufacturing (3.86 times higher than expected), Agriculture, Forestry, Fishing & Hunting (2.52 times), and Accommodation & Food Services (0.868 times) industries.

Highest Paying

The highest paying industries in St. Joseph County, MI, by median earnings, are Utilities ($62,125), Mining, Quarrying, & Oil & Gas Extraction ($55,000), and Professional, Scientific, & Technical Services ($48,514).

Domestic Trade

Domestic Production & Consumption

Domestic production and consumption consists of products and services shipped from Michigan to other states, or from other states to Michigan.

Top Domestic Production in Dollars

In 2018, the top outbound Michigan product (by dollars) was Motorized vehicles with $213B, followed by Machinery ($50.8B) and Mixed freight ($37.9B).

The following chart shows the share of these products in relation to all outbound Michigan products.

Domestic Trade Growth

Showing data for Michigan.

$636B

2018 Value in Michigan

$1.17T

Projected 2045 Value in Michigan

83.6% growth

In 2018, total outbound Michigan trade was $636B. This is expected to increase 83.6% to $1.17T by 2045.

The following chart shows how the domestic outbound Michigan trade is projected to change in comparison to its neighboring states.

Interstate Trade

Interstate trade consists of products and services shipped from Michigan to other states, or from other states to Michigan.

Most Common Trade Partners

Ohio
$44B
Indiana
$33.2B
Texas
$30.5B

In 2018, the top outbound Michigan domestic partner for goods and services (by dollars) was Ohio with $44B, followed by Indiana with $33.2B and Texas and $30.5B.

The following map shows the amount of trade that Michigan shares with each state (excluding itself).

Education

In 2019, universities in St. Joseph County, MI awarded 200 degrees. The student population of St. Joseph County, MI is skewed towards women, with 492 male students and 683 female students.

Most students graduating from Universities in St. Joseph County, MI are White (160 and 80%), followed by Hispanic or Latino (21 and 10.5%), Two or More Races (7 and 3.5%), and Black or African American (6 and 3%).

The largest universities in St. Joseph County, MI by number of degrees awarded are Glen Oaks Community College (200 and 100%).

The most popular majors in St. Joseph County, MI are General Studies (70 and 35%), Registered Nursing (19 and 9.5%), and General Business Administration & Management (19 and 9.5%).

The median tuition costs in St. Joseph County, MI are $N/A for private four year colleges, and $N/A and $N/A respectively, for public four year colleges for in-state students and out-of-state students.

Concentrations

Most Common

General Studies
70 degree-majorss awarded
Registered Nursing
19 degree-majorss awarded
General Business Administration & Management
19 degree-majorss awarded

In 2018, the most common concentation for Associates Degree recipients in St. Joseph County, MI was General Studies with 70 degrees awarded.

This visualization illustrates the percentage of students graduating with a Associates Degree from schools in St. Joseph County, MI according to their major.

Universities

Glen Oaks Community College

Largest Universities by degrees awarded

200 degrees awarded

$N/A

Median In-State Public

$N/A

Median Private

In 2019, the St. Joseph County, MI institution with the largest number of graduating students was Glen Oaks Community College with 200 degrees awarded.

Student Gender for Common Institutions

Degrees Awarded to Men

128

Degrees Awarded to Women

In 2019, 72 men were awarded degrees from institutions in St. Joseph County, MI, which is 0.563 times less than the 128 female students who received degrees in the same year.

This chart displays the gender disparity between the institutions in St. Joseph County, MI by degrees awarded.

Student Race and Ethnicity

Most Common Student Race or Ethnicity

White
160 degrees awarded
Hispanic or Latino
21 degrees awarded
Two or More Races
7 degrees awarded

In 2019 the most common race/ethnicity group awarded degrees at institutions in St. Joseph County, MI was White students. These 160 degrees mean that there were 7.62 times more degrees awarded to White students then the next closest race/ethnicity group, Hispanic or Latino, with 21 degrees awarded.

Housing & Living

The median property value in St. Joseph County, MI was $115,100 in 2018, which is 0.501 times smaller than the national average of $229,700. Between 2017 and 2018 the median property value increased from $111,200 to $115,100, a 3.51% increase. The homeownership rate in St. Joseph County, MI is 74.2%, which is higher than the national average of 63.9%. People in St. Joseph County, MI have an average commute time of 20.9 minutes, and they drove alone to work. Car ownership in St. Joseph County, MI is approximately the same as the national average, with an average of 2 cars per household.

Housing

Property Value

$115,100

2018 Median

± $3,250

$111,200

2017 Median

± $3,292

In 2018, the median property value in St. Joseph County, MI grew to to $115,100 from the previous year's value of $111,200.

The following charts display, first, the property values in St. Joseph County, MI compared to it's parent and neighbor geographies and, second, owner-occupied housing units distributed between a series of property value buckets compared to the national averages for each bucket. In St. Joseph County, MI the largest share of households have a property value in the $100k - $125k range.

Household Income

Please note that the buckets used in this visualization were not evenly distributed by ACS when publishing the data.

$50,117

Median Household Income

± $1,027

24k

Number of Households

± 733

In 2018, the median household income of the 24k households in St. Joseph County, MI grew to $50,117 from the previous year's value of $47,856.

The following chart displays the households in St. Joseph County, MI distributed between a series of income buckets compared to the national averages for each bucket. The largest share of households have an income in the $75k - $100k range.

Property Taxes

$800 - $1,499

Average Range

This chart shows the households in St. Joseph County, MI distributed between a series of property tax buckets compared to the national averages for each bucket. In St. Joseph County, MI the largest share of households pay taxes in the $800 - $1,499 range.

Rent vs Own

74.2%

2018 Homeownership

74%

2017 Homeownership

In 2018, 74.2% of the housing units in St. Joseph County, MI were occupied by their owner. This percentage grew from the previous year's rate of 74%.

This percentage of owner-occupation is higher than the national average of 63.9%. This chart shows the ownership percentage in St. Joseph County, MI compared it's parent and neighboring geographies.

Commute Time

20.9 minutes

Average Travel Time

Using averages, employees in St. Joseph County, MI have a shorter commute time (20.9 minutes) than the normal US worker (25.3 minutes). Additionally, 1.64% of the workforce in St. Joseph County, MI have "super commutes" in excess of 90 minutes.

The chart below shows how the median household income in St. Joseph County, MI compares to that of it's neighboring and parent geographies.

Commuter Transportation

Most Common Commute in 2018

Drove Alone (76.5%)
Carpooled (15.4%)
Worked At Home (3.17%)

In 2018, 76.5% of workers in St. Joseph County, MI drove alone to work, followed by those who carpooled to work (15.4%) and those who worked at home (3.17%).

The following chart shows the number of households using each mode of transportation over time, using a logarithmic scale on the y-axis to help better show variations in the smaller means of commuting.

Transportation

Car Ownership

2 cars

Average Number

The following chart displays the households in St. Joseph County, MI distributed between a series of car ownership buckets compared to the national averages for each bucket. The largest share of households in St. Joseph County, MI have 2 cars, followed by 3 cars.

Health

91.9% of the population of St. Joseph County, MI has health coverage, with 45.7% on employee plans, 19.9% on Medicaid, 13.1% on Medicare, 12.1% on non-group plans, and 1.01% on military or VA plans.

Per capita personal health care spending in Michigan was $8,055 in 2014. This is a 4% increase from the previous year ($7,745).

Primary care physicians in St. Joseph County, MI see 3591 patients per year on average, which represents a 6.05% increase from the previous year (3386 patients). Compare this to dentists who see 3048 patients per year, and mental health providers who see 575 patients per year.

Comparing across all counties in the state, Montmorency County has the highest prevalence of diabetes (18.6%). Additionally, Gratiot County has the highest prevalence of adult obesity (45.6%)

Patient to Clinician Ratios

3,591 to 1

Patient to Primary Care Physician Ratio in St. Joseph County, MI

Primary care physicians in St. Joseph County, MI see an average of 3,591 patients per year. This represents a 6.05% increase from the previous year (3,386 patients).

The following chart shows how the number of patients seen by primary care physicians has been changing over time in St. Joseph County, MI in comparison to its neighboring geographies.

Behavioral Health Conditions

Data only available at the state level.

State with the Highest Prevalence

West Virginia
8.26% of the population affected
Arkansas
8.13% of the population affected
New Hampshire
7.98% of the population affected

In 2016, West Virginia had the highest prevalence of adults with major depressive episode, with 8.26% of the population affected. The second highest is Arkansas (8.13%), followed by New Hampshire (7.98%).

The following map shows the percent of individuals with major depressive episode by state over multiple years.

Social Needs

Data only available at the state level.

Most prevalent states

California
35,798 individuals
New York
5,087 individuals
Florida
4,915 individuals

In 2017, California had the highest estimated number of chronically homeless individuals in the nation, at 35,798. New York has the second highest (5,087), followed by Florida (4,915).

The following map shows the estimated number of chronically homeless individuals by state over multiple years.

Access and Quality

Data only available at state level.

Most prevalent states

Mississippi
19.2% of adults
Texas
17.9% of adults
Louisiana
17.6% of adults

In 2016, Mississippi had the highest prevalence of adults who haven't seen a doctor in the past 12 months due to cost, at 19.2%. It is followed by Texas (17.9%) and Louisiana (17.6%).

The following map shows the prevalence of adults who haven't seen a doctor in the past 12 months due to cost by state over multiple years.

Health Care Spending

Data is only available at the state level. Showing data for Michigan.

$8,055

Total Per Capita Spending on Personal Health Care in Michigan

$3,950

Per Enrollee Private Health Insurance Spending on Personal Health Care

$5,915

Per Enrollee Medicaid Spending on Personal Health Care

$11,318

Per Enrollee Medicare Spending on Personal Health Care

Between 2013 and 2014, all personal health care spending per capita in Michigan (including private, Medicare, and Medicaid) grew 4%, from $7,745 to $8,055.

The following chart shows how this spending changed over time in comparison to Medicaid, Medicare, and private insurance spending, per enrollee.

Health Care Coverage

8.14%

Uninsured

45.7%

Employer Coverage

19.9%

Medicaid

13.1%

Medicare

12.1%

Non-Group

1.01%

Military or VA

Between 2017 and 2018, the percent of uninsured citizens in St. Joseph County, MI declined by 10.8% from 9.12% to 8.14%.

The following chart shows how the percent of uninsured individuals in St. Joseph County, MI changed over time compared with the percent of individuals enrolled in various types of health insurance.