Trussville, Center Point & Gardendale Cities PUMA, AL

Public Use Microdata Area (PUMA)

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2020 Population

175,530

1.02% 1-year decline

US Senator

Richard Shelby

Republican Party

US Senator

Tommy Tuberville

Republican Party

2020 Median Age

39.4

1.55% 1-year increase

2020 Poverty Rate

13.9%

0.611% 1-year decrease

2020 Median Household Income

$60,571

2.2% 1-year growth

2020 Median Property Value

$148,300

3.27% 1-year growth

2020 Employed Population

75,908

1.61% 1-year decline

About

In 2020, Trussville, Center Point & Gardendale Cities PUMA, AL had a population of 176k people with a median age of 39.4 and a median household income of $60,571. Between 2019 and 2020 the population of Trussville, Center Point & Gardendale Cities PUMA, AL declined from 177,346 to 175,530, a −1.02% decrease and its median household income grew from $59,266 to $60,571, a 2.2% increase.

The 5 largest ethnic groups in Trussville, Center Point & Gardendale Cities PUMA, AL are White (Non-Hispanic) (58.8%), Black or African American (Non-Hispanic) (34.9%), Two+ (Non-Hispanic) (2.05%), White (Hispanic) (1.4%), and Other (Hispanic) (1.31%).

3.68% of the households in Trussville, Center Point & Gardendale Cities PUMA, AL 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.

98.8% of the residents in Trussville, Center Point & Gardendale Cities PUMA, AL are U.S. citizens.

The largest universities in Jefferson County (Northeast)--Trussville, Center Point & Gardendale Cities PUMA, AL are Jefferson State Community College (1,284 degrees awarded in 2020) and Alabama State College of Barber Styling (5 degrees).

In 2020, the median property value in Trussville, Center Point & Gardendale Cities PUMA, AL was $148,300, and the homeownership rate was 75.1%.

Most people in Trussville, Center Point & Gardendale Cities PUMA, AL drove alone to work, and the average commute time was 28.6 minutes. The average car ownership in Trussville, Center Point & Gardendale Cities PUMA, AL was 2 cars per household.

Trussville, Center Point & Gardendale Cities PUMA, AL borders St. Clair & Blount Counties PUMA, AL, Birmingham City (West) PUMA, AL, Birmingham City (East) PUMA, AL, Hoover (North), Vestavia Hills & Homewood Cities PUMA, AL, Bessemer, Hueytown & Pleasant Grove Cities PUMA, AL, and Walker, Marion (South & West), Fayette & Lamar Counties PUMA, AL.

Population & Diversity

Trussville, Center Point & Gardendale Cities PUMA, AL is home to a population of 176k people, from which 98.8% are citizens. As of 2018, 2.02% of Trussville, Center Point & Gardendale Cities PUMA, AL residents were born outside of the country (3.56k people).

In 2018, there were 1.69 times more White (Non-Hispanic) residents (104k people) in Trussville, Center Point & Gardendale Cities PUMA, AL than any other race or ethnicity. There were 61.6k Black or African American (Non-Hispanic) and 3.63k Two+ (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 Trussville, Center Point & Gardendale Cities PUMA, AL are Spanish (4,212 households), German (457 households), and Urdu (223 households).

Population & Diversity

Residents by Gender and Age

RACE/ETHNICITY

91,503

Women

52.1%

83,990

Men

47.9%

The resident population of United States in 2020 was 175,493 inhabitants, with 47.9% men, and 52.1% 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

98.8%

2020 Citizenship

98.6%

2019 Citizenship

As of 2020, 98.8% of Trussville, Center Point & Gardendale Cities PUMA, AL residents were US citizens, which is higher than the national average of 93.4%. In 2019, the percentage of US citizens in Trussville, Center Point & Gardendale Cities PUMA, AL was 98.6%, meaning that the rate of citizenship has been increasing.

The following chart shows US citizenship percentages in Trussville, Center Point & Gardendale Cities PUMA, AL compared to that of it's neighboring and parent geographies.

Diversity

Race and Ethnicity

The 3 largest ethnic groups in Trussville, Center Point & Gardendale Cities PUMA, AL

White (Non-Hispanic)
104k ± 1.78k
Black or African American (Non-Hispanic)
61.6k ± 2.18k
Two+ (Non-Hispanic)
3.63k ± 856

2.99%

Hispanic Population

5.28k people

2.99% of the people in Trussville, Center Point & Gardendale Cities PUMA, AL are hispanic (5.28k people).

The following chart shows the 7 races represented in Trussville, Center Point & Gardendale Cities PUMA, AL as a share of the total population.

Global Diversity

Most Common Origin

Mexico
1,042 ± 790 people
Argentina
196 ± 344 people
Guatemala
189 ± 337 people

In 2020, the most common birthplace for the foreign-born residents of Trussville, Center Point & Gardendale Cities PUMA, AL was Mexico, the natal country of 1,042 Trussville, Center Point & Gardendale Cities PUMA, AL residents, followed by Argentina with 196 and Guatemala with 189.

Foreign-Born Population

2.02%

2018 Foreign-Born Population

3.56k people

2.22%

2016 Foreign-Born Population

3.91k people

As of 2018, 2.02% of Trussville, Center Point & Gardendale Cities PUMA, AL residents (3.56k people) were born outside of the United States, which is lower than the national average of 13.5%. In 2016, the percentage of foreign-born citizens in Trussville, Center Point & Gardendale Cities PUMA, AL was 2.22%, meaning that the rate has been decreasing.

The following chart shows the percentage of foreign-born residents in Trussville, Center Point & Gardendale Cities PUMA, AL compared to that of it's neighboring and parent geographies.

Non-English Households

Most Common Non-English Languages

Spanish
4,212 households (2.57%)
German
457 households (0.279%)
Urdu
223 households (0.136%)

3.68% of the households in Trussville, Center Point & Gardendale Cities PUMA, AL reported speaking a non-English language at home as their primary shared language, which is lower than the national average of 21.5%. 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 2020, the most common non-English language spoken in households in Trussville, Center Point & Gardendale Cities PUMA, AL was Spanish. 2.57% of the households in Trussville, Center Point & Gardendale Cities PUMA, AL reported speaking Spanish at home as the primary shared language between all members living in the household.

Military

Veterans

Most Common Service Period

Vietnam
3,414 ± 346
Gulf War (2001-)
1,963 ± 430
Gulf War (1990s)
1,766 ± 329

Trussville, Center Point & Gardendale Cities PUMA, AL has a large population of military personnel who served in Vietnam, 1.74 times greater than any other conflict.

Economy

The economy of Trussville, Center Point & Gardendale Cities PUMA, AL employs 75.9k people. The largest industries in Trussville, Center Point & Gardendale Cities PUMA, AL are General medical and surgical hospitals, and specialty (except psychiatric and substance abuse) hospitals (7,232 people), Elementary & secondary schools (4,471 people), and Construction (4,232 people), and the highest paying industries are Coal mining ($170,517), Real estate property managers, offices of real estate appraisers, and other activities related to real estate ($124,741), and Computer Systems Design ($101,174).

Males in Trussville, Center Point & Gardendale Cities PUMA, AL have an average income that is 1.27 times higher than the average income of females, which is $49,755. The income inequality in Trussville, Center Point & Gardendale Cities PUMA, AL (measured using the Gini index) is 0.423, which is lower than than the national average.

Employment

Workforce Diversity

Measure

RACE/ETHNICITY

37,441

Women

49.3%

38,467

Men

50.7%

The workforce of Trussville, Center Point & Gardendale Cities PUMA, AL in 2020 was 75,908 people, with 49.3% woman, and 50.7% men.

The visualization shows the distribution of the workforce by gender and age in Trussville, Center Point & Gardendale Cities PUMA, AL.

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

Occupations

75.9k

2020 Value

−1.61%

1 Year decline

± −1.61%

From 2019 to 2020, employment in Trussville, Center Point & Gardendale Cities PUMA, AL declined at a rate of −1.61%, from 77.1k employees to 75.9k employees.

The most common job groups, by number of people living in Trussville, Center Point & Gardendale Cities PUMA, AL, are Registered nurses (3,770 people), Driver/sales workers & truck drivers (3,074 people), and Customer service representatives (1,905 people). This chart illustrates the share breakdown of the primary jobs held by residents of Trussville, Center Point & Gardendale Cities PUMA, AL.

Unemployment Insurance Claims

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

This chart shows weekly unemployment insurance claims in Alabama (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

75.9k

2020 Value

−1.61%

1 Year decline

± −1.61%

From 2019 to 2020, employment in Trussville, Center Point & Gardendale Cities PUMA, AL declined at a rate of −1.61%, from 77.1k employees to 75.9k employees.

The most common employment sectors for those who live in Trussville, Center Point & Gardendale Cities PUMA, AL, are General medical and surgical hospitals, and specialty (except psychiatric and substance abuse) hospitals (7,232 people), Elementary & secondary schools (4,471 people), and Construction (4,232 people). This chart shows the share breakdown of the primary industries for residents of Trussville, Center Point & Gardendale Cities PUMA, AL, though some of these residents may live in Trussville, Center Point & Gardendale Cities PUMA, AL and work somewhere else. Census data is tagged to a residential address, not a work address.

Median Earnings by Industry

$50,186

Median earning men ± $1,412

$33,284

Median earning women ± $2,151

The industries with the best median earnings for men in 2020 are Public Administration ($71,098), Finance & Insurance, & Real Estate & Rental & Leasing ($61,841), and Transportation & Warehousing, & Utilities ($61,205).

The industries with the best median earnings for women in 2020 are Wholesale Trade ($55,089), Public Administration ($51,303), and Information ($47,180).

Employment by Industry Sector

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

Y-Axis

8.45%

Year-over-year growth

Employment change between May 2020 and May 2021

As of May 2021, there are 145M people employed in Alabama. This represents a 8.45% increase in employment when compared to May 2020.

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

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Domestic Trade

Domestic Production & Consumption

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

Top Domestic Production in Dollars

In 2020, the top outbound Alabama product (by dollars) was Motorized vehicles with $52.4B, followed by Pharmaceuticals ($22.9B) and Base metals ($20.4B).

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

Domestic Trade Growth

Showing data for Alabama.

$282B

2020 Value in Alabama

$539B

Projected 2050 Value in Alabama

91.3% growth

In 2020, total outbound Alabama trade was $282B. This is expected to increase 91.3% to $539B by 2050.

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

Interstate Trade

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

Most Common Trade Partners

Georgia
$31.7B
Florida
$21.3B
Tennessee
$14.3B

In 2020, the top outbound Alabama domestic partner for goods and services (by dollars) was Georgia with $31.7B, followed by Florida with $21.3B and Tennessee and $14.3B.

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

Civics

Richard Shelby and Tommy Tuberville are the senators currently representing the state of Alabama. In the United States, senators are elected to 6-year terms with the terms for individual senators staggered.

Alabama is currently represented by 7 members in the U.S. house, and members of the House of Representives are elected to 2-year terms.

Senators Elections

US Senators from Alabama

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

Richard Shelby

Senator from Alabama

Assumed office on January 3, 1987
Until 1994, Richard Shelby won election to the Senate as a member of the Democratic Party.

Tommy Tuberville

Senator from Alabama

Assumed office on January 3, 2021

Richard Shelby and Tommy Tuberville are the senators currently representing Alabama.

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

US Representatives Elections

US Representatives from Alabama

Alabama is currently represented by 7 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 Alabama have changed over time starting in 2008.

Education

In 2020, universities in Trussville, Center Point & Gardendale Cities PUMA, AL awarded 1,289 degrees. The student population of Trussville, Center Point & Gardendale Cities PUMA, AL in 2020 is skewed towards women, with 3,067 male students and 5,465 female students.

Most students graduating from Universities in Trussville, Center Point & Gardendale Cities PUMA, AL are White (876 and 69.6%), followed by Black or African American (285 and 22.7%), Hispanic or Latino (42 and 3.34%), and Two or More Races (24 and 1.91%).

The largest universities in Trussville, Center Point & Gardendale Cities PUMA, AL by number of degrees awarded are Jefferson State Community College (1,284 and 99.6%) and Alabama State College of Barber Styling (5 and 0.388%).

The most popular majors in Jefferson County (Northeast)--Trussville, Center Point & Gardendale Cities PUMA, AL are General Studies (224 and 17.4%), Registered Nursing (215 and 16.7%), and General Engineering Technology (131 and 10.2%).

Admissions & Enrollments

Enrollments by Gender and Races

In 2020 there were 8,532 students enrolled in Trussville, Center Point & Gardendale Cities PUMA, AL, 35.9% men and 64.1% women.

By race, the largest number of students enrolled was concentrated in White with 5,628 records, of which 62.4% were women and 37.6% men.

Completions

Concentrations

Most Common

General Studies
224 degree-majors awarded
Registered Nursing
215 degree-majors awarded
Liberal Arts & Sciences
99 degree-majors awarded

In 2020, the most common concentation for Associates Degree recipients in Jefferson County (Northeast)--Trussville, Center Point & Gardendale Cities PUMA, AL was General Studies with 224 degrees awarded.

This visualization illustrates the percentage of students graduating with a Associates Degree from schools in Jefferson County (Northeast)--Trussville, Center Point & Gardendale Cities PUMA, AL according to their major.

Universities

Gender

Race

Largest Universities by degrees awarded

Jefferson State Community College
1,284 degrees awarded
Alabama State College of Barber Styling
5 degrees awarded

In 2020, the institution with the largest number of graduating students was Jefferson State Community College with 1,284 degrees awarded.

Student Diversity

In 2020, 502 men were awarded degrees from institutions in Trussville, Center Point & Gardendale Cities PUMA, AL, which is 0.638 times less than the 787 female students who received degrees in the same year.

In 2020 the most common race/ethnicity group awarded degrees at institutions was White students. These 876 degrees mean that there were 3.07 times more degrees awarded to White students then the next closest race/ethnicity group, Black or African American, with 285 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 ($4,920) is the sector with the highest median state tuition in 2020.

Public, 2-year ($930) is the sector with the highest median state fee in 2020.

Public, 2-year ($2,162) 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 2020, 0.506% of men over 25 years of age had not completed any academic degree (no schooling), while 0.604% 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 Trussville, Center Point & Gardendale Cities PUMA, AL in 2020 were High School or Equivalent (41.8k), Some college (35.3k), and Secondary Education (19.8k).

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 Trussville, Center Point & Gardendale Cities PUMA, AL was $148,300 in 2020, which is 0.645 times smaller than the national average of $229,800. Between 2019 and 2020 the median property value increased from $143,600 to $148,300, a 3.27% increase. The homeownership rate in Trussville, Center Point & Gardendale Cities PUMA, AL is 75.1%, which is approximately the same as the national average of 64.4%.

People in Trussville, Center Point & Gardendale Cities PUMA, AL have an average commute time of 28.6 minutes, and they drove alone to work. Car ownership in Trussville, Center Point & Gardendale Cities PUMA, AL is approximately the same as the national average, with an average of 2 cars per household.

Median household income in Trussville, Center Point & Gardendale Cities PUMA, AL is $60,571. In 2020, the PUMA with the highest Median Household Income in Trussville, Center Point & Gardendale Cities PUMA, AL was Hoover (North), Vestavia Hills & Homewood Cities PUMA, AL with a value of $83,941, followed by Shelby County PUMA, AL and Huntsville City (Far West & Southwest) PUMA, AL, with respective values of $78,851 and $70,933.

Housing

Property

$148,300

Median Property Value 2020

±$4,117

$50,659

Median Property Taxes

±$2,021

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 Trussville, Center Point & Gardendale Cities PUMA, AL the largest share of households pay taxes in the < $800 range.

The chart underneath the paragraph shows the property taxes in Trussville, Center Point & Gardendale Cities PUMA, AL compared to it's parent and neighbor geographies.

Rent vs Own

75.1%

Homeownership

2020

68%

Homeowners with Mortgage

2020

In 2020, 75.1% of the housing units in Trussville, Center Point & Gardendale Cities PUMA, AL were occupied by their owner. This percentage grew from the previous year's rate of 74.6%.

This chart shows the percentage of owner in Trussville, Center Point & Gardendale Cities PUMA, AL 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 2020, the PUMA with the highest Median Household Income (Total) in Trussville, Center Point & Gardendale Cities PUMA, AL was Hoover (North), Vestavia Hills & Homewood Cities PUMA, AL with a value of $83,941, followed by Shelby County PUMA, AL and Huntsville City (Far West & Southwest) PUMA, AL, with respective values of $78,851 and $70,933.

The following map shows all of the PUMAs in Trussville, Center Point & Gardendale Cities PUMA, AL 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.

$60,571

Median Household Income

± $1,806

67k

Number of Households

± 1,830

In 2020, the median household income of the 67k households in Trussville, Center Point & Gardendale Cities PUMA, AL grew to $60,571 from the previous year's value of $59,266.

The following chart displays the households in Trussville, Center Point & Gardendale Cities PUMA, AL 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

0.423

2020 Wage GINI in Trussville, Center Point & Gardendale Cities PUMA, AL

0.418

2019 Wage GINI in Trussville, Center Point & Gardendale Cities PUMA, AL

In 2020, the income inequality in Trussville, Center Point & Gardendale Cities PUMA, AL was 0.423 according to the GINI calculation of the wage distribution. Income inequality had a 1.17% growth from 2019 to 2020, which means that wage distribution grew somewhat less even. The GINI for Trussville, Center Point & Gardendale Cities PUMA, AL was lower than than the national average of 0.478. In other words, wages are distributed more evenly in Trussville, Center Point & Gardendale Cities PUMA, AL in comparison to the national average.

This chart shows the number of workers in Trussville, Center Point & Gardendale Cities PUMA, AL across various wage buckets compared to the national average.

Transportation

Commuter Transportation

Most Common Commute in 2020

Drove Alone (87.1%)
Carpooled (8.33%)
Worked At Home (3.36%)

In 2020, 87.1% of workers in Trussville, Center Point & Gardendale Cities PUMA, AL drove alone to work, followed by those who carpooled to work (8.33%) and those who worked at home (3.36%).

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

28.6 minutes

Average Travel Time

Using averages, employees in Trussville, Center Point & Gardendale Cities PUMA, AL have a longer commute time (28.6 minutes) than the normal US worker (26.9 minutes). Additionally, 1.98% of the workforce in Trussville, Center Point & Gardendale Cities PUMA, AL have "super commutes" in excess of 90 minutes.

The chart below shows how the median household income in Trussville, Center Point & Gardendale Cities PUMA, AL compares to that of it's neighboring and parent geographies.

Car Ownership

2 cars

Average Number

The following chart displays the households in Trussville, Center Point & Gardendale Cities PUMA, AL distributed between a series of car ownership buckets compared to the national averages for each bucket. The largest share of households in Trussville, Center Point & Gardendale Cities PUMA, AL have 2 cars.

Poverty

Poverty & Diversity

13.9% of the population for whom poverty status is determined in Trussville, Center Point & Gardendale Cities PUMA, AL (24.2k out of 174k people) live below the poverty line, a number that is higher than the national average of 12.8%. The largest demographic living in poverty are Females 25 - 34, followed by Males 6 - 11 and then Females 6 - 11.

The most common racial or ethnic group living below the poverty line in Trussville, Center Point & Gardendale Cities PUMA, AL is Black, followed by White and Hispanic.

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

92.9% of the population of Trussville, Center Point & Gardendale Cities PUMA, AL has health coverage, with 50.3% on employee plans, 16.3% on Medicaid, 12.2% on Medicare, 12.4% on non-group plans, and 1.7% on military or VA plans.

Per capita personal health care spending in Alabama was $7,281 in 2014. This is a 4.07% increase from the previous year ($6,996).

Primary care physicians in Alabama see 1534 patients per year on average, which represents a 0.583% decrease from the previous year (1543 patients). Compare this to dentists who see 2005 patients per year, and mental health providers who see 923 patients per year.

COVID-19

Daily New Cases by Date

Showing data at the state level for Alabama. 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 Alabama, as a 7-day rolling average, compared with the four states with the most similar number of confirmed cases.

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Patient to Clinician Ratios

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

1,534 to 1

Patient to Primary Care Physician Ratio in Alabama

Primary care physicians in Alabama see an average of 1,534 patients per year. This represents a 0.583% decrease from the previous year (1,543 patients).

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

Community Mobility

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

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

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Coverage

Health Care Diversity

In 2020, insured persons according to age ranges were distributed in 26.5% under 18 years, 17.9% between 18 and 34 years, 39.8% between 35 and 64 years, and 15.8% over 64 years.

By gender, of the total number of insured persons, 46.7% were men and 53.3% were women.

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

Uninsured People

7.12%

Uninsured

50.3%

Employer Coverage

16.3%

Medicaid

12.2%

Medicare

12.4%

Non-Group

1.7%

Military or VA

Between 2019 and 2020, the percent of uninsured citizens in Trussville, Center Point & Gardendale Cities PUMA, AL declined by 2.21% from 7.28% to 7.12%.

The following chart shows how the percent of uninsured individuals in Trussville, Center Point & Gardendale Cities PUMA, AL changed over time compared with the percent of individuals enrolled in various types of health insurance.