Manitowoc & Kewaunee Counties PUMA, WI

Public Use Microdata Area (PUMA)

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2021 Population

101,638

2.28% 1-year growth

US Senator

Ron Johnson

Republican Party

US Senator

Tammy Baldwin

Democratic Party

2021 Median Age

44.7

0.223% 1-year decrease

2021 Poverty Rate

8.99%

5.09% 1-year increase

2021 Median Household Income

$63,506

4.96% 1-year growth

2021 Median Property Value

$147,100

4.4% 1-year growth

2021 Employed Population

50,233

1.88% 1-year growth

About

In 2021, Manitowoc & Kewaunee Counties PUMA, WI had a population of 102k people with a median age of 44.7 and a median household income of $63,506. Between 2020 and 2021 the population of Manitowoc & Kewaunee Counties PUMA, WI grew from 99,375 to 101,638, a 2.28% increase and its median household income grew from $60,507 to $63,506, a 4.96% increase.

The 5 largest ethnic groups in Manitowoc & Kewaunee Counties PUMA, WI are White (Non-Hispanic) (90.2%), White (Hispanic) (2.47%), Asian (Non-Hispanic) (2.17%), Two+ (Non-Hispanic) (1.79%), and Two+ (Hispanic) (1.06%).

5.02% of the households in Manitowoc & Kewaunee Counties PUMA, WI reported speaking a non-English language at home as their primary shared language. This does not consider the potential multi-lingual nature of households, but only the primary self-reported language spoken by all members of the household.

98.7% of the residents in Manitowoc & Kewaunee Counties PUMA, WI are U.S. citizens.

The largest universities in Manitowoc & Kewaunee Counties PUMA, WI are Lakeshore Technical College (1,004 degrees awarded in 2021).

In 2021, the median property value in Manitowoc & Kewaunee Counties PUMA, WI was $147,100, and the homeownership rate was 77%.

Most people in Manitowoc & Kewaunee Counties PUMA, WI drove alone to work, and the average commute time was 19.9 minutes. The average car ownership in Manitowoc & Kewaunee Counties PUMA, WI was 2 cars per household.

Manitowoc & Kewaunee Counties PUMA, WI borders Northwest Lower Peninsula (West) PUMA, MI, Newaygo, Mason, Oceana & Lake Counties PUMA, MI, Outer Green Bay City PUMA, WI, Marinette, Oconto, Door & Florence Counties PUMA, WI, Fond du Lac & Calumet Counties PUMA, WI, and Sheboygan County PUMA, WI.

United States Wisconsin

Population & Diversity

Manitowoc & Kewaunee Counties PUMA, WI is home to a population of 102k people, from which 98.7% are citizens. As of 2021, 2.67% of Manitowoc & Kewaunee Counties PUMA, WI residents were born outside of the country (2.71k people).

In 2021, there were 36.5 times more White (Non-Hispanic) residents (91.7k people) in Manitowoc & Kewaunee Counties PUMA, WI than any other race or ethnicity. There were 2.51k White (Hispanic) and 2.21k Asian (Non-Hispanic) residents, the second and third most common ethnic groups.

The most common non-English languages spoken as the primary langauge in households in Manitowoc & Kewaunee Counties PUMA, WI are Spanish (2,501 households), Hmong (1,118 households), and German (358 households).

Population & Diversity

Residents by Gender and Age

RACE/ETHNICITY

50,223

Women

49.3%

51,575

Men

50.7%

The resident population of United States in 2021 was 101,798 inhabitants, with 50.7% men, and 49.3% women.

The visualization shows the distribution of the residents by gender and age in the United States.

With the upper buttons you can add a filter by race.

Citizenship

98.7%

2021 Citizenship

98.5%

2020 Citizenship

As of 2021, 98.7% of Manitowoc & Kewaunee Counties PUMA, WI residents were US citizens, which is higher than the national average of 93.4%. In 2020, the percentage of US citizens in Manitowoc & Kewaunee Counties PUMA, WI was 98.5%, meaning that the rate of citizenship has been increasing.

The following chart shows US citizenship percentages in Manitowoc & Kewaunee Counties PUMA, WI compared to that of it's neighboring and parent geographies.

Diversity

Race and Ethnicity

The 3 largest ethnic groups in Manitowoc & Kewaunee Counties PUMA, WI

White (Non-Hispanic)
91.7k ± 191
White (Hispanic)
2.51k ± 210
Asian (Non-Hispanic)
2.21k ± 181

4.3%

Hispanic Population

4.37k people

4.3% of the people in Manitowoc & Kewaunee Counties PUMA, WI are hispanic (4.37k people).

The following chart shows the 7 races represented in Manitowoc & Kewaunee Counties PUMA, WI as a share of the total population.

Global Diversity

Most Common Origin

Laos
857 ± 716 people
Mexico
614 ± 607 people
Nicaragua
280 ± 410 people

In 2021, the most common birthplace for the foreign-born residents of Manitowoc & Kewaunee Counties PUMA, WI was Laos, the natal country of 857 Manitowoc & Kewaunee Counties PUMA, WI residents, followed by Mexico with 614 and Nicaragua with 280.

Foreign-Born Population

2.67%

2021 Foreign-Born Population

2.71k people

2.76%

2020 Foreign-Born Population

2.74k people

As of 2021, 2.67% of Manitowoc & Kewaunee Counties PUMA, WI residents (2.71k people) were born outside of the United States, which is lower than the national average of 13.6%. In 2020, the percentage of foreign-born citizens in Manitowoc & Kewaunee Counties PUMA, WI was 2.76%, meaning that the rate has been decreasing.

The following chart shows the percentage of foreign-born residents in Manitowoc & Kewaunee Counties PUMA, WI compared to that of it's neighboring and parent geographies.

Non-English Households

Most Common Non-English Languages

Spanish
2,501 households (2.59%)
Hmong
1,118 households (1.16%)
German
358 households (0.371%)

5.02% of the households in Manitowoc & Kewaunee Counties PUMA, WI reported speaking a non-English language at home as their primary shared language, which is lower than the national average of 21.7%. This does not consider the potential multi-lingual nature of households, but only the primary self-reported language spoken by all members of the household.

In 2021, the most common non-English language spoken in households in Manitowoc & Kewaunee Counties PUMA, WI was Spanish. 2.59% of the households in Manitowoc & Kewaunee Counties PUMA, WI reported speaking Spanish at home as the primary shared language between all members living in the household.

Military

Veterans

Most Common Service Period

Vietnam
2,303 ± 233
Gulf War (2001-)
1,137 ± 181
Gulf War (1990s)
1,058 ± 190

Manitowoc & Kewaunee Counties PUMA, WI has a large population of military personnel who served in Vietnam, 2.03 times greater than any other conflict.

Economy

The economy of Manitowoc & Kewaunee Counties PUMA, WI employs 50.2k people. The largest industries in Manitowoc & Kewaunee Counties PUMA, WI are Construction (3,457 people), Restaurants & Food Services (2,308 people), and Elementary & secondary schools (2,126 people), and the highest paying industries are Electronic shopping and mail-order houses ($119,125), Medical equipment & supplies manufacturing ($101,623), and Securities, commodities, funds, trusts & other financial investments ($100,343).

Males in Manitowoc & Kewaunee Counties PUMA, WI have an average income that is 1.3 times higher than the average income of females, which is $45,725. The income inequality in Manitowoc & Kewaunee Counties PUMA, WI (measured using the Gini index) is 0.4, which is lower than than the national average.

Employment

Workforce Diversity

Measure

RACE/ETHNICITY

22,770

Women

46.2%

26,536

Men

53.8%

The workforce of Manitowoc & Kewaunee Counties PUMA, WI in 2020 was 49,306 people, with 46.2% woman, and 53.8% men.

The visualization shows the distribution of the workforce by gender and age in Manitowoc & Kewaunee Counties PUMA, WI.

With the upper buttons you can see the distribution of the average salary and add a filter by race.

Occupations

50.2k

2021 Value

1.88%

1 Year growth

± 1.88%

From 2020 to 2021, employment in Manitowoc & Kewaunee Counties PUMA, WI grew at a rate of 1.88%, from 49.3k employees to 50.2k employees.

The most common job groups, by number of people living in Manitowoc & Kewaunee Counties PUMA, WI, are Miscellaneous production workers, including semiconductor processors (1,671 people), Driver/sales workers & truck drivers (1,614 people), and Miscellaneous agricultural workers, including animal breeders (1,337 people). This chart illustrates the share breakdown of the primary jobs held by residents of Manitowoc & Kewaunee Counties PUMA, WI.

Unemployment Insurance Claims

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

This chart shows weekly unemployment insurance claims in Wisconsin (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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Industries

Employment by Industries

50.2k

2021 Value

1.88%

1 Year growth

± 1.88%

From 2020 to 2021, employment in Manitowoc & Kewaunee Counties PUMA, WI grew at a rate of 1.88%, from 49.3k employees to 50.2k employees.

The most common employment sectors for those who live in Manitowoc & Kewaunee Counties PUMA, WI, are Construction (3,457 people), Restaurants & Food Services (2,308 people), and Elementary & secondary schools (2,126 people). This chart shows the share breakdown of the primary industries for residents of Manitowoc & Kewaunee Counties PUMA, WI, though some of these residents may live in Manitowoc & Kewaunee Counties PUMA, WI and work somewhere else. Census data is tagged to a residential address, not a work address.

Median Earnings by Industry

$48,051

Median earning men ± $1,365

$32,551

Median earning women ± $951

The industries with the best median earnings for men in 2021 are Finance & Insurance, & Real Estate & Rental & Leasing ($68,792), Transportation & Warehousing, & Utilities ($65,111), and Professional, Scientific, & Management, & Administrative & Waste Management Services ($58,273).

The industries with the best median earnings for women in 2021 are Transportation & Warehousing, & Utilities ($44,375), Finance & Insurance, & Real Estate & Rental & Leasing ($44,032), and Public Administration ($41,895).

Employment by Industry Sector

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

Y-Axis

2.75%

Year-over-year growth

Employment change between February 2022 and February 2023

As of February 2023, there are 155M people employed in Wisconsin. This represents a 2.75% increase in employment when compared to February 2022.

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

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Domestic Trade

Domestic Production & Consumption

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

Top Domestic Production in Dollars

In 2020, the top outbound Wisconsin product (by dollars) was Other foodstuffs with $43.6B, followed by Mixed freight ($37.7B) and Machinery ($34.3B).

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

Domestic Trade Growth

Showing data for Wisconsin.

$348B

2020 Value in Wisconsin

$614B

Projected 2050 Value in Wisconsin

76.2% growth

In 2020, total outbound Wisconsin trade was $348B. This is expected to increase 76.2% to $614B by 2050.

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

Interstate Trade

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

Most Common Trade Partners

Illinois
$35.8B
Minnesota
$17.7B
Michigan
$15.4B

In 2020, the top outbound Wisconsin domestic partner for goods and services (by dollars) was Illinois with $35.8B, followed by Minnesota with $17.7B and Michigan and $15.4B.

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

Civics

In the 2020 presidential election, the popular vote in Wisconsin went to Joseph R Biden Jr. with 49.4% of the vote. The runner-up was Donald J. Trump (48.8%), followed by Jo Jorgensen (1.17%).

Ron Johnson and Tammy Baldwin are the senators currently representing the state of Wisconsin. In the United States, senators are elected to 6-year terms with the terms for individual senators staggered.

Wisconsin is currently represented by 8 members in the U.S. house, and members of the House of Representives are elected to 2-year terms.

Presidential Elections

Presidential Popular Vote Over Time

Voting results are not available for Manitowoc & Kewaunee Counties PUMA, WI. Showing the available data for Wisconsin.

2020 Election Results

Joseph R Biden Jr. (49.4%)
Democratic Party
Donald J. Trump (48.8%)
Republican Party
Jo Jorgensen (1.17%)
Independent Party

In the 2020 presidential election, the popular vote in Wisconsin went to Joseph R Biden Jr. with 49.4% of the vote. The runner-up was Donald J. Trump (48.8%), followed by Jo Jorgensen (1.17%).

The following chart shows the popular vote results in Wisconsin for each registered party from 1976 to 2020.

Senator Elections

US Senators from Wisconsin

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

Ron Johnson

Senator from Wisconsin

Assumed office on January 3, 2011

Tammy Baldwin

Senator from Wisconsin

Assumed office on January 3, 2013

Ron Johnson and Tammy Baldwin are the senators currently representing Wisconsin.

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 Wisconsin over time, excluding special elections, colored by their political party.

US Representative Elections

US Representatives from Wisconsin

Wisconsin is currently represented by 8 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 Wisconsin have changed over time starting in 2008.

Education

In 2021, universities in Manitowoc & Kewaunee Counties PUMA, WI awarded 1,004 degrees. The student population of Manitowoc & Kewaunee Counties PUMA, WI in 2021 is skewed towards women, with 1,139 male students and 1,183 female students.

Most students graduating from Universities in Manitowoc & Kewaunee Counties PUMA, WI are White (822 and 81.9%), followed by Asian (80 and 7.97%), Hispanic or Latino (57 and 5.68%), and Black or African American (17 and 1.69%).

The largest universities in Manitowoc & Kewaunee Counties PUMA, WI by number of degrees awarded are Lakeshore Technical College (1,004 and 100%).

The most popular majors in Manitowoc & Kewaunee Counties PUMA, WI are Nursing Assistant & Patient Care Assistant (133 and 13.2%), General Human Resources Management & Personnel Administration (64 and 6.37%), and Welding Technology (44 and 4.38%).

Admissions & Enrollments

Applicants, Admissions & Enrolled

Measure

In 2019 in Manitowoc & Kewaunee Counties PUMA, WI, the percentage of applicants admitted was 51.1%, while the percentage of admitted who enrolled was 22.6%. The number of students enrolled in 2021 was 2,322 (49.1% men and 50.9% women).

The line chart shows the evolution of the percentage of applicants admitted, admitted who enrolled or the number of students enrolled according to the option selected in the upper button.

Enrollments by Gender and Races

In 2021 there were 2,322 students enrolled in Manitowoc & Kewaunee Counties PUMA, WI, 49.1% men and 50.9% women.

By race, the largest number of students enrolled was concentrated in White with 1,762 records, of which 51% were women and 49% men.

Completions

Concentrations

Most Common

General Business Administration & Management
30 degrees awarded
General Human Resources Management & Personnel Administration
29 degrees awarded
Registered Nursing
33 degrees awarded

In 2021, the most common concentation for Associates Degree recipients in Manitowoc & Kewaunee Counties PUMA, WI was General Business Administration & Management with 30 degrees awarded.

This visualization illustrates the percentage of students graduating with a Associates Degree from schools in Manitowoc & Kewaunee Counties PUMA, WI according to their major.

Universities

Gender

Race

Lakeshore Technical College

Largest Universities by degrees awarded

1,004 degrees awarded

In 2021, the institution with the largest number of graduating students was Lakeshore Technical College with 1,004 degrees awarded.

Student Diversity

In 2021, 402 men were awarded degrees from institutions in Manitowoc & Kewaunee Counties PUMA, WI, which is 0.668 times less than the 602 female students who received degrees in the same year.

In 2021 the most common race/ethnicity group awarded degrees at institutions was White students. These 822 degrees mean that there were 10.3 times more degrees awarded to White students then the next closest race/ethnicity group, Asian, with 80 degrees awarded.

Awarded Degrees over Time

The graph shows the evolution of awarded degrees by degrees. Under the paragraphs, the average number of awarded degrees by university in each degree is shown.

Tuition

Average Net Price by Sector

Public, 2-year ($3,868) is the sector with the highest median state tuition in 2021.

Public, 2-year ($254) is the sector with the highest median state fee in 2021.

Public, 2-year ($1,974) is the sector with the highest average net price of books and supplies.

The graph shows the average net price by sector and year.

Working Population

Educational Pyramid

Measure

In 2021, 1.18% of men over 25 years of age had not completed any academic degree (no schooling), while 0.767% of women were in the same situation.

This visualization shows the gender distribution of the population according to the academic level reached.

Educational Attainment

Race

The most common educational levels obtained by the working population of Manitowoc & Kewaunee Counties PUMA, WI in 2021 were High School or Equivalent (31.1k), Some college (18.8k), and Bachelors Degree (10.8k).

This visualization illustrates the percentage distribution of the population according to the highest educational level reached. You can filter the data by race by using the selector above.

Housing & Living

The median property value in Manitowoc & Kewaunee Counties PUMA, WI was $147,100 in 2021, which is 0.601 times smaller than the national average of $244,900. Between 2020 and 2021 the median property value increased from $140,900 to $147,100, a 4.4% increase. The homeownership rate in Manitowoc & Kewaunee Counties PUMA, WI is 77%, which is approximately the same as the national average of 64.6%.

People in Manitowoc & Kewaunee Counties PUMA, WI have an average commute time of 19.9 minutes, and they drove alone to work. Car ownership in Manitowoc & Kewaunee Counties PUMA, WI is approximately the same as the national average, with an average of 2 cars per household.

Median household income in Manitowoc & Kewaunee Counties PUMA, WI is $63,506. In 2021, the PUMA with the highest Median Household Income in Manitowoc & Kewaunee Counties PUMA, WI was Waukesha County (West) PUMA, WI with a value of $106,632, followed by Waukesha County (East) PUMA, WI and Dane County (West) PUMA, WI, with respective values of $97,138 and $87,583.

Housing

Property

$147,100

Median Property Value 2021

±$3,394

$33,080

Median Property Taxes

±$1,013

The following chart display owner-occupied housing units distributed between a series of property tax buckets compared to the national averages for each bucket. In Manitowoc & Kewaunee Counties PUMA, WI the largest share of households pay taxes in the $3k+ range.

The chart underneath the paragraph shows the property taxes in Manitowoc & Kewaunee Counties PUMA, WI compared to it's parent and neighbor geographies.

Rent vs Own

77%

Homeownership

2021

62.8%

Homeowners with Mortgage

2021

In 2021, 77% of the housing units in Manitowoc & Kewaunee Counties PUMA, WI were occupied by their owner. This percentage grew from the previous year's rate of 76.9%.

This chart shows the percentage of owner in Manitowoc & Kewaunee Counties PUMA, WI compared it's parent and neighboring geographies.

Equity

Income by Location

Use the dropdown to filter by race/ethnicity.

Race/Ethnicity

Highest Median Household Income (Total)

In 2021, the PUMA with the highest Median Household Income (Total) in Manitowoc & Kewaunee Counties PUMA, WI was Waukesha County (West) PUMA, WI with a value of $106,632, followed by Waukesha County (East) PUMA, WI and Dane County (West) PUMA, WI, with respective values of $97,138 and $87,583.

The following map shows all of the PUMAs in Manitowoc & Kewaunee Counties PUMA, WI colored by their Median Household Income (Total).

Household Income

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

$63,506

Median Household Income

± $1,751

42.9k

Number of Households

± 1,270

In 2021, the median household income of the 42.9k households in Manitowoc & Kewaunee Counties PUMA, WI grew to $63,506 from the previous year's value of $60,507.

The following chart displays the households in Manitowoc & Kewaunee Counties PUMA, WI 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.

Wage Distribution

0.4

2021 Wage GINI in Manitowoc & Kewaunee Counties PUMA, WI

0.4

2020 Wage GINI in Manitowoc & Kewaunee Counties PUMA, WI

In 2021, the income inequality in Manitowoc & Kewaunee Counties PUMA, WI was 0.4 according to the GINI calculation of the wage distribution. Income inequality had a 0.117% growth from 2020 to 2021, which means that wage distribution grew somewhat less even. The GINI for Manitowoc & Kewaunee Counties PUMA, WI was lower than than the national average of 0.478. In other words, wages are distributed more evenly in Manitowoc & Kewaunee Counties PUMA, WI in comparison to the national average.

This chart shows the number of workers in Manitowoc & Kewaunee Counties PUMA, WI across various wage buckets compared to the national average.

Transportation

Commuter Transportation

Most Common Commute in 2021

Drove Alone (81.8%)
Carpooled (7%)
Worked At Home (6.94%)

In 2021, 81.8% of workers in Manitowoc & Kewaunee Counties PUMA, WI drove alone to work, followed by those who carpooled to work (7%) and those who worked at home (6.94%).

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.

Commute Time

19.9 minutes

Average Travel Time

Using averages, employees in Manitowoc & Kewaunee Counties PUMA, WI have a shorter commute time (19.9 minutes) than the normal US worker (26.8 minutes). Additionally, 1.27% of the workforce in Manitowoc & Kewaunee Counties PUMA, WI have "super commutes" in excess of 90 minutes.

The chart below shows how the median household income in Manitowoc & Kewaunee Counties PUMA, WI compares to that of it's neighboring and parent geographies.

Car Ownership

2 cars

Average Number

The following chart displays the households in Manitowoc & Kewaunee Counties PUMA, WI distributed between a series of car ownership buckets compared to the national averages for each bucket. The largest share of households in Manitowoc & Kewaunee Counties PUMA, WI have 2 cars.

Poverty

Poverty & Diversity

8.99% of the population for whom poverty status is determined in Manitowoc & Kewaunee Counties PUMA, WI (9.03k out of 101k people) live below the poverty line, a number that is lower than the national average of 12.6%. The largest demographic living in poverty are Females 25 - 34, followed by Females 55 - 64 and then Females 35 - 44.

The most common racial or ethnic group living below the poverty line in Manitowoc & Kewaunee Counties PUMA, WI is White, followed by Hispanic and Two Or More.

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.

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.

Health

95.6% of the population of Manitowoc & Kewaunee Counties PUMA, WI has health coverage, with 54.8% on employee plans, 11.8% on Medicaid, 16.2% on Medicare, 11.2% on non-group plans, and 1.64% on military or VA plans.

Primary care physicians in Wisconsin see 1255 patients per year on average, which represents a 0.947% decrease from the previous year (1267 patients). Compare this to dentists who see 1395 patients per year, and mental health providers who see 441 patients per year.

Coverage

Patient to Clinician Ratios

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

1,255 to 1

Patient to Primary Care Physician Ratio in Wisconsin

Primary care physicians in Wisconsin see an average of 1,255 patients per year. This represents a 0.947% decrease from the previous year (1,267 patients).

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

Health Care Diversity

In 2021, insured persons according to age ranges were distributed in 22.3% under 18 years, 16.5% between 18 and 34 years, 41% between 35 and 64 years, and 20.2% over 64 years.

By gender, of the total number of insured persons, 49.6% were men and 50.4% were women.

The following chart shows the number of people with health coverage by gender.

Uninsured People

4.4%

Uninsured

54.8%

Employer Coverage

11.8%

Medicaid

16.2%

Medicare

11.2%

Non-Group

1.64%

Military or VA

Between 2020 and 2021, the percent of uninsured citizens in Manitowoc & Kewaunee Counties PUMA, WI grew by 8.27% from 4.07% to 4.4%.

The following chart shows how the percent of uninsured individuals in Manitowoc & Kewaunee Counties PUMA, WI changed over time compared with the percent of individuals enrolled in various types of health insurance.