Kansas Information for Communities - Notes and Definitions

Public Health Informatics
Bureau of Epidemiology and Public Health Informatics
Division of Public Health
Kansas Department of Health and Environment
This page was updated on January 2026.

---

It's our goal to make KIC user friendly. Some individuals may be first time users. There may be unfamiliar features, terms, or analyses. Its also important to know the source of the data and other caveats. Some aspects of KIC may differ slightly from methodology used in other reports. These technical notes apply to Kansas Information for Communities. We want you to understand the uses and limits of the KIC data. Before proceeding to a KIC category, take a moment to read the Notes and Definitions for that category. This page is formatted for easy printing. Direct specific questions to the KDHE Bureau of Epidemiology and Public Health Informatics.

All data in KIC are reported on a calendar year basis. Unless otherwise noted, data are reported for Kansas residents.

Close this page

Race and Hispanic Origin |
Population Estimates |
Healthy Kansans 2010 Indicators |
Death Statistics |
Cause of Death |
Residency Definitions |
General Definitions - Vital Statistics
Statistical Measures
Birth Statistics |
Rates Ratio Formulas |
Pregnancy Statistics |
Rate Reliability |
Age-Adjusted Mortality Rates |
Downloading Tables |
Hospital Discharge Statistics |
Emergency Department Statistics |
Hospital Discharge - Data Updates |
Hospital Discharge - Coding |
Confidence Intervals and Significance Tests |
Confidentiality and Suppression |
KIC Maps Documentation |
Data Sources |
FastStats: County Profiles |
FastStats: Special Links |

---

[ Top ] |

Race and Hispanic Origin

The Kansas Department of Health and Environment (KDHE) collects race and Hispanic origin information on vital events in accordance with OMB 15 standards. These new methods allow for a wider selection of choices for race, enable the entry of literal text, and allow for a selection of choices for Hispanic origin. Statistics reported this way may not always be comparable to data collected under different reporting methods.

Changes in the collection of race and Hispanic origin information in the U.S. Census and on Kansas vital event certificates, have resulted in an incompatibility of race-based rates reported for births and deaths between 2004 and the years following. The effect of this change is most notable in the rates for persons of other race. Such rates should be used with extreme caution.

The 2000 U.S. Census implemented the new collection methods. The new methods were incorporated in 2005 when Kansas adopted new vital event certificates. Current certificates include a series of check boxes for persons to select one or more races and make one or more selection for Hispanic origin.

One effect of this change is that on birth and death certificates, the race for persons of Hispanic origin was more frequently listed as "other." Prior to 2005 such responses would have been coded to "white" for vital statistics. Presently, KDHE does not recode any responses for race and Hispanic origin selections. The increased number of persons of "other" race artificially biases the rate calculations for 2005 forward.

The department has adopted the use of population groups (see page 145 of the 2006 Annual Summary) for analyses and reports. This approach combines race and Hispanic origin into single categories for reporting purposes only and will be incorporated into the next generation of KIC. Data for years prior to 2005 will then become more compatible.

[ Top ] |

Methodological Differences - Race and Hispanic Origin

Methodological differences in reporting race and Hispanic origin will occasionally result in count differences between Kansas Information for Communities (KIC) and the Annual Summary of Vital Statistics. Population groups used in the annual summary code persons of unknown Hispanic origin into a non-Hispanic category based on their race. KIC, however, considers race and Hispanic origin as separate constructs, each with a category for "unknown". Persons of unknown Hispanic origin are not assigned to race category, thus accounting for the difference. Mortality rate differences resulting from the different approaches are relatively small.

[ Top ] |

Healthy Kansans 2010 Indicators The 10 Leading Health Indicators are nationally developed indicators utilized in the Healthy Kansans 2010 process to measure Kansas' progress towards achieving the goals set forth in Healthy People 2010. There are a total of 19 health objectives contained in the 10 Leading Health Indicators. Of the 19 health objectives, 11 of the objectives are specific to adults and collected by the KDHE. Data for these 11 objectives comprise the FastStats system.

Eight of the eleven objectives that include moderate physical activity, obesity, cigarette smoking, binge drinking, flu and pneumonia vaccination, health insurance and ongoing primary care are routinely collected, analyzed and reported by the Kansas Behavioral Risk Factor Surveillance System (BRFSS). BRFSS is an annual population-based telephone survey system collecting health information on non-institutionalized adults 18 years and older. The Office of Health Promotion, Kansas Department of Health and Environment, conducts this survey annually, thus providing an ability to examine and monitor the trends of various diseases and risk factors/ behaviors of public health importance. The data are used in developing public health programs, policy making and establishing state and local priorities to address health related issues.

The remaining three objectives that include rates of death due to motor vehicle crashes and homicide and the percentage of pregnant women beginning prenatal care in the first trimester are tracked by the KDHE Bureau of Epidemiology and Public Health Informatics. These objectives are based on the analysis of birth and death collected by the Bureau. Birth and death rates represent residence level, incidence statistics for the geographic area displayed.

The data for all 11 objectives on KIC are reported for the state and geographically by six KDHE district regions, 16 bioterrorism regions and individually for 4 large counties. The results of objectives that use BRFSS data are presented as prevalence estimates with their corresponding 95% confidence interval. Data from BRFSS was aggregated for 3 years for the time periods to provide results for the State, 6 KDHE and 16 bioterrorism regions. The results for the 4 individual counties are provided as single year estimates. Most recent single year estimates for the State are also provided.

The population of Kansas is unequally spread across 105 counties, which results in many counties not having sufficient sample of survey respondents, births or deaths for a particular objective to produce scientifically valid statistics. Some regions also may not have sufficient counts to produce statistics. In those instances instead of a rate, the cell will display N/A. Results for the four largest counties (Johnson, Sedgwick, Shawnee, and Wyandotte) are provided on an annual basis because of the larger sample of survey respondents. N/A will also denote those cells where due to an insufficient number of survey responses, scientifically valid estimates could not be calculated.

The criterion for reporting BRFSS-based objectives is at least 50 respondents answering the associated survey question and at least 6 respondents within each category of the response to the survey question. The criteria for suppressing death rates include fewer than 20 events to residents of a county, region or state.

FastStats Health Indicators is by no means the complete summary of the health outcomes and prevalence information available through the agency. A list of internal and external data sources can be found here.

[ Top ] |

Death Statistics

Death statistics are compiled from death certificates which are filed by state law with the Bureau of Epidemiology and Public Health Informatics at the Kansas Department of Health and Environment. The death certificate system has been in place in Kansas continuously since 1911, although changes in data items and definitions have taken place over the years. The denominator for rates is the population of residents. Kansas cooperates with other states in the exchange of death records. Therefore, data concerning deaths of Kansas residents include virtually all Kansas resident deaths regardless of where the death took place. See residency definitions.

"Cause of death" in these tables refers to the underlying cause of death. The underlying cause of death is defined as the disease or injury which initiated the chain of events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury. The causes of death presented here are classified in accordance with International Classification of Diseases (ICD-10) for deaths occurring in 1999 or later. The ICD classification system is the result of close collaboration among many nations and non-governmental organizations, under the auspices of the World Health Organization. Its original use was to classify causes of mortality. Later, it was extended to include diagnoses in morbidity. For example, the "clinical modification" of the ICD is used in categorizing hospital diagnoses. In practice, the ICD has become the international standard diagnostic classification for all general epidemiology and many health management purposes. The ninth revision of the ICD has been used to classify deaths beginning January 1, 1979, through December 31, 1998. Beginning January 1, 1999, deaths have been classified using the tenth revision of the ICD. Deaths prior to 1999 have been grouped into ICD-10 categories for purposes of this query tool. The cause of death notes contain more information on the causes of death available through the two-tier query system and information on comparing different years of data.

While every effort is made to assure the KIC data summaries parallel the results in the Kansas Annual Summary of Vital Statistics, there are some slight differences. When the age, race, sex or county of residence values are unknown or not stated, these values are not in a separate column. The number of unknowns can be computed by subtracting the sum of the sub-categories from the respective row, column or table total. For example, 23,928 Kansas residents died in 1999. Race information was not stated for four of those deaths. You can arrive at that figure by adding the totals for white, black and other race deaths (23,924) and subtracting that from the total deaths.

KIC death rates are age-adjusted to the standard U.S. 2000 population. Users can also select age-adjusting to 1940 and 1970 standard populations but it is not recommended. Age-adjusting methodology follows that outlined by the National Center for Health Statistics (NCHS) in Technical Appendix From Vital Statistics of United States, 1999, Mortality. When the KIC analysis performed includes age-group specific rates, only the all ages total will be age adjusted. Rates for years 1990 to 1999 may differ slightly from those in published KDHE reports because KIC uses the updated bridged race intercensal population estimates prepared by the U.S. Census Bureau for NCHS. The population estimates used for 2000 forward are from the bridged race postcensal population estimates prepared by the U.S. Census Bureau for NCHS. For more information on bridged race census estimates visit the NCHS Population Web Site.

[ Top ] |

Cause of Death
The "cause of death" in KIC tables refers to an underlying cause of death. The underlying cause is defined as the illness or injury which initiated the chain of events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury. The causes of death presented here are classified in accordance with the International Classification of Diseases (ICD). ICD classification is the result of close collaboration among many nations and non-governmental organizations, under the auspices of the World Health Organization. Periodically, it's updated to reflect changes in medical knowledge. ICD9 was in use from 1979 through 1998. Beginning January 1, 1999, the Bureau of Epidemiology and Public Health Informatics (BPHI) began classifying deaths using ICD10.

Causes of Death under ICD10
Under ICD10 causes of death are grouped differently and coding rules are different. If you notice a sudden change in counts and rates for a certain cause group between 1998 and 1999, follow up to see whether the change can be explained by the ICD-9/ICD-10 transition rather than by a real change in the pattern of causes of death. In some instances death counts changed because the underlying cause was coded or assigned differently. Categories in which substantial changes occurred include: Alzheimer's disease, pneumonia and influenza, diabetes, and kidney diseases. Additional information on the impact of mortality coding changes is in the BPHI report Preliminary Findings, Comparison of Kansas Mortality ICD-9 vs. ICD-10, 1990-1999 or visit the National Center for Health Statistics for more information on comparability ratios.

The ICD10 classification system limits the bias of human coding of mortality information. The system also attempts to reduce the effect of spelling errors or placement of literal information in the cause of death fields. One limitation however is the system's inability to take into account differences in knowledge and attitudes among physicians who complete the cause of death information. Individual biases, unfamiliarity with the patient, or inability to perform an autopsy may affect the information available to the physician when certifying the cause of death. While many death certificates contain four full lines of detailed information on the events or illnesses leading up to the death, some death certificates merely state, "ADVANCED AGE/DEBILITY".

Groups of Causes of Death
The "leading causes" of death are also based on international standards. The ranking of causes is in large part determined by the way causes are grouped. The groupings used in the cause of death profiles on this site are based on those used by the National Center for Health Statistics (NCHS), which in turn are based on international tabulation lists. For example, cancer is usually the second leading cause of death in Kansas and the United States.  However, if one considered kinds or sites of cancer separately - e.g., leukemia, lymphoma, lung cancer - then they would have lower rankings. On the other hand, if all communicable and infectious diseases, or all injuries were combined, they would each have a higher ranking than they have when considered separately.

KIC uses modified versions of the NCHS 39 Selected Leading Causes of Mortality and 113 Selected Leading Causes of Mortality lists. In the first tier there are 30 categories. In Tier one cancer categories are collapsed to a single group and an "other" disease category for some causes has been created. Tier two categories number 114. At both tiers HIV/AIDS mortality information is not available. Because of the sensitive nature, AIDS/HIV deaths have been recoded to unknown throughout KIC. Thus, totals for the year will agree with the Annual Summary of Vital Statistics. The Annual Summary of Vital Statistics contains statewide AIDS/HIV death totals. For more detail, contact the Bureau of Epidemiology and Public Health Informatics.

Tier One Cause of Death Categories (30)

1. Tuberculosis
   
2. Septicemis
   
3. Syphilis
   
4. Other infections and parasites
   
5. Cancer
   
6. Diabetes
   
7. Alzheimer's disease
   
8. Heart disease
   
9. Essential hypertension
   
10. Cerebrovascular disease (Stroke)
    
11. Atherosclerosis
    
12. Other circulatory diseases/disorders
    
13. Pneumonia and influenza
    
14. Chronic lower respiratory diseases
    
15. Pneumonitis due to solids and liquids
    
16. Other respiratory diseases
    
17. Peptic ulcer
    
18. Chronic liver disease & cirrhosis
    
19. Kidney disease (nephritis/nephrotic syndrome/nephrosis)
    
20. Other digestive diseases
    
21. Pregnancy complications
    
22. Birth Defects
    
23. Conditions of perinatal period (early infancy)
    
24. Sudden Infant Death Syndrome (SIDS)
    
25. Motor vehicle accidents
    
26. All other accidents & adverse effects
    
27. Suicide
    
28. Homicide
    
29. Other external causes
    
30. Other causes
    

Tier Two Cause of Death Categories (114) (see footnote at bottom)

1. Salmonella infections
   
2. Shigellosis and amebiasis
   
3. Certain other intestinal infections
   
4. Respiratory tuberculosis
   
5. Non-Respiratory tuberculosis
   
6. Whooping cough
   
7. Scarlet fever and erysipelas
   
8. Meningococcal infection
   
9. Septicemia
   
10. Syphilis
    
11. Acute polio
    
12. Arthropod-borne viral enceph
    
13. Measles
    
14. Viral hepatitis
    
15. Malaria
    
16. Oth/unspec infectious/parasitic
    
17. Malignant neoplasm of lip, mouth and pharynx
    
18. Malignant neoplasm of esophagus
    
19. Malignant neoplasm of stomach
    
20. Malignant neoplasm of colon, rectum and anus
    
21. Malignant neoplasm of liver + intrahepatic bile ducts
    
22. Malignant neoplasm of pancreas
    
23. Malignant neoplasm of larynx
    
24. Malignant neoplasm of trachea, bronchus and lung
    
25. Malignant melanoma of skin
    
26. Malignant neoplasm of breast
    
27. Malignant neoplasm of cervix uteri
    
28. Malignant neoplasm of uterus
    
29. Malignant neoplasm of ovary
    
30. Malignant neoplasm of prostate
    
31. Malignant neoplasm of kidney and renal pelvis
    
32. Malignant neoplasm of bladder
    
33. Malignant neoplasm of meninges, brain and other CNS
    
34. Hodgkins disease
    
35. Non-Hodgkins lymphoma
    
36. Leukemia
    
37. Multiple myeloma and immunoproliferative neoplasms
    
38. Other and unspec malig neo of lymphoid hematopoietic & related tissue
    
39. Other and unspecified malignant neoplasms
    
40. Benign/in situ/uncertain/unknown neoplasms
    
41. Anemias
    
42. Diabetes
    
43. Malnutrition
    
44. Other nutritional deficiencies
    
45. Meningitis
    
46. Parkinsons disease
    
47. Alzheimers Disease
    
48. Rheumatic heart diseases: acute and chronic
    
49. Hypertensive heart disease
    
50. Hypertensive heart and renal disease
    
51. Acute myocardial infarction
    
52. Other acute ischemic heart diseases
    
53. Atherosclerotic cardiovascular disease (so described)
    
54. All other forms of chronic ischemic heart disease
    
55. Acute and subacute endocarditis
    
56. Diseases of pericardium and acute myocarditis
    
57. Heart failure
    
58. All other forms of heart disease
    
59. Essential (primary) hypertension/hypertensive renal disease
    
60. Cerebrovasc (Stroke)
    
61. Atherosclerosis
    
62. Aortic aneurysm and dissection
    
63. Other diseases of arteries/arterioles/capillaries
    
64. Other disorders of circulatory system
    
65. Influenza
    
66. Pneumonia
    
67. Acute bronchitis and brochiolitis
    
68. Unspecified acute lower resp infection
    
69. Bronchitis: chronic and unspecified
    
70. Emphysema
    
71. Asthma
    
72. Other chronic lower resp diseases
    
73. Pneumoconioses and chemical effects
    
74. Pneumonitis due to solids and liquids
    
75. Other diseases of respiratory system
    
76. Peptic ulcer
    
77. Diseases of appendix
    
78. Hernia
    
79. Alcoholic liver disease
    
80. Other chronic liver disease and cirrhosis
    
81. Cholelithiasis/gallbladder
    
82. Acute nephrotic syndrome
    
83. Nephritis not acute/chronic
    
84. Renal failure
    
85. Other disorders of kidney
    
86. Infections of kidney
    
87. Hyperplasia of prostate
    
88. Female PID
    
89. Pregnancy/abortive outcome
    
90. Other maternal deaths
    
91. Perinatal conditions
    
92. Congenital/chromosomal anomalies
    
93. Symptoms and signs
    
94. All other diseases
    
95. Motor vehicle crashes
    
96. Other land transport accidents
    
97. Water, air, space, oth/unspec tranport accidents
    
98. Falls
    
99. Accidental discharge of firearms
    
100. Accidental drowning and submersion
     
101. Accidental exposure to smoke fire and/or flames
     
102. Accidental poisoning and exposure to noxious substances
     
103. Other/unspec nontransport accidents
     
104. Intentional self-harm (suicide) by discharge of firearms
     
105. Intentional self-harm (suicide) by other/unspecified means
     
106. Assault (homicide) by discharge of firearms
     
107. Assault (homicide) by other/unspecified means
     
108. Legal intervention
     
109. Discharge of firearms of undetermined intent
     
110. Oth/unspec events of undetermined intent
     
111. War/sequelae
     
112. Complics of med and surgical care
     
113. SIDS
     
114. Other digestive diseases
     

Tier Two footnote. Differences from the NCHS 113 List: AIDS/HIV is not available in KIC, SIDS and other digestive diseases are retained because they are listed in the Tier One table.

---

[ Top ] |

Residency
All data that are queried through KIC are resident data. Definitions for selected datasets are as follows:

• Death Statistics
  Residence is the place (county) where the decedent lived most of the time (usual place of residence at the time of death), regardless of where the death took place. Kansas receives death certificates from other states for Kansas residents dying in those states. Temporary residence such as a visit, business trip or vacation are not considered usual place of residence. However, place of residence during a tour of military duty or attendance at college is counted as usual place of residence. If a person had been living in a long-term institution, nursing home or prison, this is considered usual place of residence.

• Birth and Pregnancy Statistics
  Residence is the place (county) where the mother lived prior to the pregnancy outcome, regardless of where the event took place. The child is considered to have the same residence as the mother. Kansas receives birth certificate, fetal death, and abortion data from other states for Kansas-resident events occurring in those states.

NOTE: The birth rate for a county containing a college may appear to be low because female college students are included in the county population when calculating the birth rate, even though few of them will become mothers while in college.

[ Top ] |

General Definitions - Vital Statistics
The following terms are defined for more meaningful interpretations of the KIC data summaries.

---

Abortion	The purposeful interruption of pregnancy with the intention other than to produce a live born infant or to remove a dead fetus and which does not result in a live birth.
Adequacy of Prenatal Care Utilization (APNCU) Index	An assessment of the adequacy of prenatal care measured by the APNCU Index (often referred to as the Kotelchuck Index), a composite measure based on gestational age of the newborn, the trimester prenatal care began, and the number of prenatal visits made.
Age-Adjusted Death Rate	A calculation by which the age composition of a population is defined as constant so that differences In age composition can be eliminated from the analysis.
Annulment	The invalidation of a marriage contract.
Birth Order	Birth order is determined from birth certificates specifying the total number of live births (living and dead) the mother had. It is calculated as the sum of the prior live births plus the current birth.
Birthweight	The weight of the fetus or infant at the time of delivery.
Cause of Death	The underlying cause of death, or that condition giving rise to the chain of events leading to death.
Congenital Anomalies	Defects existing at and usually before birth regardless of causation.
Divorce	The dissolution of a legally binding marriage contract.
Fetal Death:	Any complete expulsion or extraction from its mother of a product of human conception the weight of which is in excess of 350 grams, irrespective of the duration of pregnancy, resulting in other than a live birth, and which is not an induced termination of pregnancy.
Gestation	The period of time between the last reported normal menses and the delivery of the fetus or infant measured in completed weeks.
Hebdomadal Death	The death of a liveborn infant which occurs prior to the seventh day of life.
I.C.D. Code	A uniform code assigned to a cause of death in accordance with the International Classification of Disease. The 9th revision was used for death from 1979 to 1998. The 10th revision is used for deaths that occurred in 1999 and years thereafter.
Infant Death	The death of a liveborn infant which occurs within the first year of life.
Legal Intervention	Includes legal execution and injuries inflicted by the police or other law-enforcing agents, including military on duty in the course of arresting or attempting to arrest law breakers, suppressing disturbances, maintaining order and other legal action.
Live Birth	The complete expulsion or extraction of a product of human conception from its mother, irrespective of the duration of pregnancy, that, after such expulsion or extraction, shows any evidence of life such as breathing, heartbeat, pulsation of the umbilical cord, or voluntary muscle movement, whether or not the umbilical cord has been cut or the placenta attached.
Low Birth Weight:	Weight of a fetus or infant at delivery which is under 2,500 grams (less than five pounds, 8 ounces).
Maternal Death	The death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes (Included in these deaths are ICD-10 codes A34, O00-O95, and O98-O99).
Medical Procedure I	Refers to use of the drug mifepristone as a pregnancy termination procedure.
Medical Procedure II	Refers to use of the drug methotrexate as a pregnancy termination procedure.
Natural Increase	Live births minus total deaths of a population within a given year.
Neonatal Death	The death of a liveborn infant which occurs prior to the twenty-eighth day of life.
Occurrence Data	Vital statistics compiled on the basis of where the vital event happened.
Perinatal Period III Death	The aggregate total of fetal deaths (fetus weighs over 350 grams) and hebdomadal deaths (deaths that occur prior to the 7th day of life).
Population Density	The average number of inhabitants per square mile.
Post-Hebdomadal Death	The death of a live-born infant occurring seven days to prior to the twenty-eighth day of life.
Post-Neonatal Death	The death of a live-born infant occurring 28 days to prior to the 365th day of life.
Pregnancy-Associated Death	The death of any woman, from any cause, while pregnant or within one calendar year of termination of pregnancy, regardless of the duration and the site of pregnancy. Maternal deaths are a subset of pregnancy-associated deaths.
Prenatal Care	Medical care during pregnancy before birth.
Previous Pregnancy	Includes all previous reported spontaneous terminations, previous induced abortions, children born still living and children born now dead.
Puerperium	Period of time after delivery, usually six to eight weeks during which all maternal reproductive organs return to the normal pre-pregnancy condition.
Residence Data	Vital statistics compiled on the basis of the usual place of residence of the person(s) to whom the vital event occurred.
Stillbirth	Any complete expulsion or extraction from its mother of a product of human conception, the weight of which is in excess of 350 grams, irrespective of the duration of pregnancy, resulting in other than a live birth, and which is not an induced termination of pregnancy.
Teenage Pregnancy	A live birth, fetal death or abortion occurring to a female under 20 years of age.
Trimester	A three-month period of time.  First trimester care, for example, refers to care initiated in the first three months of pregnancy.
Very Low Birth Weight	Weight of a fetus or infant at delivery which is under 1,500 grams (less than 3 pounds, 5 ounces).
Years of Potential Life Lost (YPLL)	A measurement of the number of years of potential life lost by each death occurring before the average life expectancy.

[ Top ] |

Birth Statistics
Birth Statistics are compiled from birth certificates which are filed by state law with the Bureau of Epidemiology and Public Health Informatics at the Kansas Department of Health and Environment. The Birth Certificate system has been in place in Kansas continuously since 1911, although changes in data items and definitions have taken place over the years. The denominator for birth statistics is the total number of births for which the value of particular indicator or measure could be calculated. The rate is expressed as a percent. The most current year of data, 2018, was added August 13, 2019.

Kansas cooperates with other states in the exchange of birth records. Therefore, data concerning births to Kansas residents include virtually all Kansas resident births regardless of where the birth took place. See residency definitions.

Many birth outcome characteristics are summarized as percentages of the total number of events in which the specific outcome is known. This is true with the statistics generated by Birth Statistics KIC, which reports percentages as rates per 100 births where the specific birth outcome was not missing. These rates or percentages will be generated for the following outcomes: birth in which there were four or more prior births, the four levels of the Kotelchuck Adequacy of Prenatal Care Index, prenatal care in the first trimester, no prenatal care, mother's weight gain less than 15 pounds, normal weight gain, weight gain over 44 pounds, c-section delivery, vaginal birth after a prior c-section delivery, spacing since prior birth greater than 18 months, low birthweight, very low birthweight, gestation under 37 weeks, and whether mother reported smoking. Birth Statistics KIC reports marital status, residence county, and race percentages as a percent of all births.

This KIC module includes only live birth outcomes. Prenancy KIC is used to create statistics and population based rates for all birth outcomes - stillbirths (fetal deaths), abortions, and live births.

While every effort is made to assure the KIC data summaries parallel the results in the Kansas Annual Summary of Vital Statistics, some slight differences may occur. When the age, race, county of residence or any of the birth outcomes are not stated or unknown, these values are not in a separate column. In some instances you will be able to calculate the number of not stated or unknown values by deducting the sum of the all of the categories of known values from the total number of births.

Birth Indicators

* = Group Identifier All Births* Birth Plurality: Single* Birth Plurality: Twins Birth Plurality: Triplets or Higher Birth Plurality: Unknown Prenatal Care (Kotelchuck Index): Inadequate Prenatal Care (Kotelchuck Index): Intermediate Prenatal Care (Kotelchuck Index): Adequate* Prenatal Care (Kotelchuck Index): Adequate Plus Prenatal Care (Kotelchuck Index): Unknown Prenatal Care Started In 1st Trimester* Prenatal Care Started In 2nd Trimester Prenatal Care Started In 3rd Trimester No Prenatal Care At All Prenatal Care Status Unknown Mom Weight Gain Less Than 15 Pounds Mom Weight Gain Normal* Mom Weight Gain Greater Than 44 Pounds Mom Weight Gain Unknown Birth Route: Vaginal* Birth Route: C-Section Birth Route: Unknown Vaginal Birth After C-Section* Birth Spacing: Less Than 18 Months Apart* Birth Spacing: Less 18-59 Months Apart Birth Spacing: 60 Months Or Greater Apart Birth Spacing: Unknown Birth Weight: Very Low Birth Weight: Low Birth Weight: Normal* Birth Weight: High Birth Weight: Unknown

Gestation: Early Pre-Term Less Than 34 Weeks Gestation: Pre-Term 34-36 Weeks Gestation: Early Term 37-38 Weeks Gestation: Full Term 39-40 Weeks* Gestation: Late Term 41 Weeks Gestation: Post Term 42 Weeks or Longer Gestation: Unknown Mother Smoked Before Pregnancy Mother Smoked Any Time During Pregnancy* Mother Smoked In 1st Trimester Mother Smoked In 2nd Trimester Mother Smoked In 3rd Trimester Breastfeeding Initiated: Yes* Breastfeeding Initiated: No Breastfeeding Status: Unknown Small For Gestational Age: 10th Percentile Or Greater Small For Gestational Age: Less Than 10th Percentile* Small For Gestational Age: Unknown Diabetes: None - Prior To or During Pregnancy* Diabetes: Prepregnancy Diabetes: Gestational Onset Diabetes: Unknown Hypertension: None Hypertension: Prepregnancy (Chronic) Hypertension: Gestational Onset (PHI Pre-eclampsia)* Hypertension: Eclampsia Hypertension: Unknown Mother's Prepregnancy BMI: Less Than 18.5 (Underweight) Mother's Prepregnancy BMI: 18.5-24.9 (Normal Weight)* Mother's Prepregnancy BMI: 25.0-29.9 (Overweight) Mother's Prepregnancy BMI: 30.0 Plus (Obese) Mother's Prepregnancy BMI: Unknown All Unknowns (Birth Plurality; click here for more)*

---

[ Top ] |

Statistical Measures
The Bureau of Epidemiology and Public Health Informatics of the Kansas Department of Health and Environment uses standard methods for calculating indicators, rates, and ratios. These are outlined briefly in the Rates and Ratio |  formulas below. There are instances when because of methodological differences or availability of information, measures might be calculated differently. Please review the information on the respective measure in these technical notes for additional detail.

[ Top ] |

Rate and Ratio Formulas - Vital Statistics
These are the standard formulas for the creation of rates and ratios involving Vital Statistics data.  Results for formulas in Red are created by KIC Death Statistics.  Results for the formulas in Green are created by KIC Pregnancy Statistics.  Other rates or ratios can be prepared by obtaining the numerator and denominator values via the appropriate KIC inquiry.

---

Abortion Rate	induced abortions in a specific age-group population in a specific age-group	x 1,000
Abortion Ratio	induced abortions live births	x 1,000
Age-Adjusted Death Rate	sum across age groups of the age specific death rate x standard population for the age group total standard population	x 100,000
Age-Specific Death Rate	deaths in a specific age-group population in a specific age-group	x 100,000
Age-Specific Fertility Rate	live births in a specific age-group female population in a specific age-group	x 1,000
Birth Rate	live births total population	x 1,000
Cause-Specific Death Rate	cause-specific deaths total population	x 100,000
Death Rate	total deaths total population	x 1,000
Fertility Rate	live births female population 15-44	x 1,000
Fetal Death Rate	fetal deaths live births + fetal deaths	x 1,000
Infant Death Rate:	infant deaths live births	x 1,000
Natural Increase Rate	live birth rate minus total death rate
Out-of-Wedlock Birth Ratio	out-of-wedlock births live births	x 100
Teenage Pregnancy Rate	live births, fetal deaths, abortions for females in a specific age-group female population in a specific age-group	x 1,000

---

[ Top ] |

Pregnancy Statistics
Pregnancy statistics are compiled from birth certificates, stillbirth (fetal death) certificates, and reports of induced terminations of pregnancy which are filed by state law with the Bureau of Epidemiology and Public Health Informatics at the Kansas Department of Health and Environment. Reports on all three events have been collected continuously since 1971, although some longer than others. The denominator for rates is the population of women for the corresponding cohort of events. The most current year of data, 2012, was added October 11, 2013.

Kansas cooperates with other states in the exchange of live birth, stillbirth (fetal death), and abortion records. Therefore, data concerning Kansas residents include virtually all Kansas resident events regardless of where it took place. The KIC system summarizes these three events by outcome type, county of residence, race, education, marital status and age-group, producing age-group specific population based rates and teen pregnancy rates.

Data on all three outcomes are commonly used in creating pregnancy and fertility rates. Rates cited in KIC query results are per 1,000 female age-group population for 10-44 year old females. Because population data were not available on marital status, education level, and race for age-groups of less than five years in length, rates are not calculated. Rates by outcome, age-group, and county are possible.

The KIC system suppresses counts less than 6 and rates based on fewer than 20 events. If your query is too specific, then the table values will be filled in with # signs to let you know that confidentiality rules have been invoked. If this happens, simply make your query more general. Pregnancy rates use population estimates or decennial census information from the U.S. Census Bureau. Since the Census Bureau did not provide detailed estimates for 2001 population, pregnancy rates are created using 2000 Kansas census data.In some instances age, race, county, or sex may not have been reported. Since KIC may not report the count of those unknowns, the individual cells in a row or column may not necessarily add up to the row or column total.

While every effort is made to assure the KIC data summaries parallel the results in the Kansas Annual Summary of Vital Statistics, some slight differences may occur. When the age-group, race, county of residence or any of the birth outcomes are not stated or unknown, these values are not in a separate column. In some instances you will be able to calculate the number of not stated or unknown values by deducting the sum of the all of the categories of known values for pregnancy outcomes.

Data on Kansas occurrence abortions to out-of-state residents are not included. The "abortion rate" reported by Pregnancy KIC is different from the "abortion ratio" reported in the Kansas Annual Summary of Vital Statistics. See the difference in formulas.

[ Top ] |

Rate Reliability
Vital statistics are easily influenced by random variation and single-year rates can fluctuate from year to year. A multiple-year rate such as a five- or ten- year average of single-year rates would be more accurate in formulating conclusions on vital events. For example, although the infant death rate for Kansas was 7.6 in 1994 and 6.9 in 1998, the 1994-1998 five-year infant death rate for Kansas was 7.4 infant deaths per 1,000 live births. A five or ten-year rate smoothes some of the variation in single-year rates and would be a more reliable indicator of infant death rates in Kansas.

Rates based on a small or large number of events in a sparsely populated area can vary widely. To exemplify the variation that may occur with a small number of events, in 1998, Greeley County was the least populated county in Kansas with 1,704 residents and Sedgwick County was the largest with 448,050 residents. With 24 deaths occurring in Greeley County in 1998, the crude death rate would be 14.1 deaths per 1,000 population, whereas, 3,640 deaths occurring in Sedgwick County represents a crude death rate of 8.1 deaths per 1,000 population. If five more deaths occurred in each county (e.g., multiple-death accident) Greeley County's crude death rate would increase to 17.0 deaths per 1,000 population. Sedgwick County's crude death rate would increase by only a few hundredths and with rounding, still remain 8.1 deaths per 1,000 population. Therefore, one must use caution when comparing rates of vital events between counties of extreme population size differences to avoid misleading conclusions.

[ Top ] |

Age-Adjusted Rates
Population-based rates, i.e., the number of cases per 100,000 people, are a common way to report death statistics so that comparisons can be made from year to year or among geographic areas. Crude rates compensate for the differences in population within the areas or time periods studied. Crude or unadjusted rates, however, do not compensate for the different age make up of compared populations. For example, some Kansas counties may have more older residents than other counties. To address this, statisticians prepare age-adjusted rates. The direct method for calculating age-adjusted death rates is used by the KIC Query System.

Age-adjusting is a process by which the age composition of a population is defined as a constant so that differences in age composition can be eliminated from the analysis. Age-adjusted rates allow for more meaningful comparison of public health risks over time and among groups.

For decades Kansas and many other states have used the 1940 standard population for age-adjusting. Other states have used a 1970 or 1980 population standard. Moving to a 2000 population standard, as recommended by the National Center for Health Statistics, eliminates confusion and misunderstanding created by the use of various population standards. Age-adjusted rates calculated using the 1940 population standard can't be compared to rates created using the 2000 standard. Since the benefit from age-adjusting rates comes only from using the same population standard, comparison between different standards would produce misleading results. Kansas and many other states will be recalculating prior years' age-adjusted rates to the 2000 population standard. For more information on the impact of the new age-adjusting population standard, the Bureau for Public Health Informatics (BPHI) produced the report Age Standardization of Kansas Death Rates: Implications of the Year 2000 Standard.

The KIC system performs age-adjusting on rates for mortality, disease reports, and hospital discharge reports. Recently-added KIC system queries can age adjust rates to the 1940, 1970 and 2000 population standards.

Age-adjusting is a process by which the age composition of a population is defined as constant so that differences in age composition can be eliminated from the analysis. This is needed because older populations have higher death rates, merely because death rates increase with age. Age-adjusted rates allow for more meaningful comparison of the risk of mortality over time and among groups.

Data users may discover slight differences in the KIC-generated age-adjusted rates when comparing them to age-adjusted rates prepared elsewhere. This may be due to a couple of factors: how the data user or the KIC system treats events where the age is unknown and whether the Census Bureau population estimates used for the analyses are the same. Age-adjusted rates calculated with KIC are prepared consistently regardless of year. The KIC system uses US Census Bureau population estimates for 1990 through 1999 and actual Census results for the year 2000. The Pregnancy KIC, which does not yet age-adjust the pregnancy outcomes data, uses 1999 US Census Bureau estimates by single year of age, by sex, by county.

[ Top ] |

Instructions for downloading KIC tables
When you download from KIC, you are downloading an ASCII comma delimited file (.csv). But unless your computer is configured for it, the file may be saved with a different extension. The following instructions were developed using Netscape and working in the Microsoft Excel or Corel Quattro Pro environment. These instructions can also be applied to other spreadsheet programs that import ASCII comma delimited files. The Kansas Department of Health and Environment does not endorse the use of Microsoft or Corel products, but the department uses these products.

• First, test to see if your machine is currently set up correctly.
• From one of the KIC tables, click on Download.
• If a box appears stating an "unknown file type," click on Cancel and skip to the instructions below.
• If Microsoft Excel or Corel Quattro Pro opens, no adjustments are required.
• If a gray box appears, asking if you want to Open It or Save to Disk, click on Open It. You may also want to uncheck the box marked Notify Each Time. After you do this, Excel or Quattro Pro -- depending on which spreadsheet program you have -- will automatically open and the gray box will not appear each time you request a download.

Instructions
(Note: some individuals with Windows NT and 2000, who have not been granted administrator access to their computer, may not be able to make the following changes to their file association settings)

1. Open your computer's main Control Panel
2. Under View, click on Options
3. Click on File Types
4. Highlight registered file types. While scrolling down, review File type details (lower half of window). Remove any file with an extension of "CSV" (comma separated values-mainly Excel or Quattro Pro files).
5. Click on New Type
6. For "Description of type," enter a name that will tell you that is your download from KIC file. A suggestion is KIC.
7. For "Associated extension," enter .csv (NOTE; Don't forget the period before csv.)
8. For "Content Type (MIME)," enter application/csv. ms-excel
9. Click on Confirm Open After Download and Always Show Extension
10. Click on New
11. For "Action" enter Open
12. For "Application used to perform action," enter within quotes the location of your executable Excel file. Example: "C:\Program Files\Microsoft Office\Office\Excel. exe" or "C:\Corel\Suite8\Programs\QPW.EXE" for Quattro Pro.
13. Click OK
14. Click Close and Close again
15. Restart browser and return to the MICA table you originally requested.
16. If a gray box appears, asking if you want to Open It or Save to Disk, click on Open It. You may also want to uncheck the box marked Notify Each Time. After you do this, Excel or Quattro Pro will automatically open and the gray box will not appear each time you request a download.

You are now set to download from KIC. Files downloaded will open with individual data each appropriate cell.

[ Top ] |

Hospital Discharge Data
General Information
Data used in KIC Hospital Discharge queries are provided by the Kansas Hospital Association (KHA). Data are reported on a calendar year basis, compiled from surveys submitted by most Kansas community hospitals. Community hospitals are non-federal, short-term, general or other special hospitals whose facilities are open to the public. Community hospitals are asked to submit data voluntarily to KHA which in turns compiles the dataset and provides it to the state of Kansas. While most of the state's hospitals are community hospitals that submit, facilities that are not included are: hospital units of institutions, long-term care hospitals, psychiatric hospitals, federal hospitals, and alcoholism and chemical dependency facilities.

The number of hospitals that submit varies from year to year. The KHA dataset may also contain discharge data on Kansas residents who were treated at community hospitals in adjacent states. The quantity of those records varies annually. Hospital discharge data includes information on patients who were admitted and had a length-of-stay of greater than 24 hours. Emergency department data are not included. Specialty hospital data are not included.

"Primary Payer" is defined as the primary payer reported at the time of patient hospital admission and may not reflect the actual payer of record when the hospital bill is ultimately settled.

Some records in the data submitted to the state may be missing race, ethnicity, age, or sex. The only field where this is a notable problem is age. For example, for the years 1995 - 1999, there were about 1.8 million records of which about 1.1% do not have a value for age. While those counts are reflected in the overall query totals, the count of the missing values is not displayed. One may deduce the count of unknowns by adding the individual cell values and subtracting that subtotal from the corresponding row or column total.

The extent of missing or unknown values in the data affects any population-based rates created by KIC. The greater the number of missing values, the lower the population-based rate will be. Keep this under-reporting of rates in mind when interpreting the results.

Datasets provided to the state change over time and improved analyses may result in different KIC results for prior years. Changes adopted in 2005 resulted in the removal of duplicate records from discharge datasets used in KIC. In some prior years additional records were added to reflect additions to the list of valid ICD-9-CM codes used to characterize morbidity. Thus, KIC counts and rates produced for a given period several years ago may be different if the same query was run against the revised data. It is a good practice when comparing current results to those generated a few years ago to re-run the original query to make sure the results have not changed.

Specific source information on events (numerator) and population (denominator) can be found at the KIC Data Source page.

Hospital Data: Residency
For hospital data (inpatient only), the county of residence is what was reported by the patient or informant when the patient was admitted. All admissions in the hospital discharge data available on KIC are associated with a Kansas county of residence. Admissions involving out-of-state residents have been excluded. Admissions of Kansas residents into out-of-state hospitals are included for Missouri, Colorado, Nebraska, and Iowa Hospitalizations.

For purposes of the data provided in the KIC query program, the term hospitalization refers to a hospital discharge of a Kansas resident from non-federal and non-state short-term (average length of stay less than 30 days) general and specialty hospitals whose facilities are open to the general public.

Excluded from hospitalization data are discharges from long-term care facilities, as well as those from long-term care units within general hospitals (i.e., swing bed, skilled nursing, and intermediate care units). Also excluded are discharges from residential care facilities and residential care units within licensed hospital facilities.

Newborns are a special category of hospital discharges. All newborns are recorded in the hospital discharge data as an admission and are included in the data processed by the KIC query engine. In addition, mothers who gave birth, as well as persons hospitalized for pregnancy and childbirth-related conditions are included. Additional information on pregnancy and birth events can be found at the KIC Births and Pregnancies sites.

Hospital Data: Race/Hispanic Origin
Beginning in 2003 Kansas hospitals began reporting Hispanic origin separately from race. This enabled tabulations by Hispanic origin. For procedure and diagnosis queries one module handles data from 2003 to the present and includes Hispanic Origin. A separate module exists for queries that do not require Hispanic origin for 1995 to present. Race in legacy hospital discharge data may be coded differently from traditional vital statistics data. Prior to the creation of a variable to capture Hispanic origin, hospitals may have reported a person's Hispanic origin in the race category as "other" instead of white as was done in vital statistics data prior to 2005.

Population-based rates involving race and Hispanic origin use the bridged-race population estimates provided to the National Center for Health Statistics by the U.S. Census Bureau as the denominator. For more information on the estimates, visit NCHS.

[ Top ] |

Hospital Discharge - Data Updates
Update History
Data for 1995-2002 were recompiled in February 2007. This was done to standardize files to the current ICD9-CM codes. Data for 2003-2006 were recompiled in January 2008. Pay source information has also been categorized differently. Provisional 2007 data were replaced with final 2007 data on November 24, 2009. Queries produced prior to November 24, 2009, will have different results. If you are comparing prior results to a new query, we recommend rerunning those prior queries.

Final 2007 discharge data were reprocessed in the same manner as the 2008 final data and posted on January 26, 2010. Final 2008 data replaced provisional data November 9, 2010. See the section below for coding changes implemented for 2008 hospital discharge data. Final 2009 discharge data were posted on May 10, 2011. These data were processed in the same manner as final 2008 data. The Final 2009 data no longer contains a pay source category called "free". See the section below for coding changes implemented for 2009 hospital discharge data.

[ Top ] |

Hospital Discharge - Coding
Clinical Classification Software
There are thousands of diagnostic or procedure codes that may be assigned to a hospitalization. It would be impossible to display each of those codes individually. Therefore, researchers have used different systems of grouping procedures or diagnostic categories. The diagnostic or procedure groupings used in KIC query results are based on the Clinical Classification Software (CCS). CCS is a tool for clustering patient diagnoses or procedures into a manageable number of clinically meaningful categories.

CCS was developed by the Agency for Healthcare Research and Quality (AHRQ). The system is updated periodically. The CCS compresses the 12,000 diagnosis codes of the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) into 259 mutually exclusive categories. In its multi-level mode, the system further categorizes these 259 into some 26 broader groupings. The 3,500 procedure codes of the ICD are similarly compacted into 231 groups. The system can be used with any data that are coded using the ICD-9-CM. It has proven helpful when used by managed care plans, insurers and researchers for understanding and analyzing patient data.

In 2007, CCS replaced the original CCS categories for mental health and substance abuse with categories from the Mental Health Substance Abuse Clinical Classification Software (CCS-MHSA). For KIC, a special archival version of the single-level CCS for diagnoses was created for doing longitudinal analysis involving past years. This version uses the original CCS format for mental health conditions (65-75), and applies it to the latest ICD-9-CM codes. A similar archival tool can be found on the AHRQ web site.

Further information on the clinical classification, as well as the lists of diagnoses and procedures utilized by CCS, can be found at the AHRQ web site. Detailed information on the ICD-9-CM system is best viewed at the National Center for Health Statistics site on Classification of Diseases.

There are other methods of classifying or grouping hospital discharges. One of these is a classification systems such as Diagnostic Related Groups (DRGs), employed by hospitals and payers to impose a rational order on payments made for covered procedures, and Major Diagnostic Categories (MDCs), an aggregated version of DRGs. Persons interested in examining hospital data grouped by DRG/MDC are encouraged to visit the KHA Website, where visitors can view the KHA statistical summary report.

[ Top ] |

Emergency Department Data

General Information
Data used in KIC Emergency Department Data (ED) queries are provided by the Kansas Hospital Association (KHA). Data are reported on a calendar year basis, compiled from data files submitted by most Kansas community hospitals. Community hospitals are non-federal, short-term, general or other special hospitals whose facilities are open to the public. Community hospitals are asked to submit data voluntarily to KHA which in turns compiles the dataset and provides it to the state of Kansas. While most of the state's hospitals are community hospitals that submit, facilities that are not included are: hospital units of institutions, long-term care hospitals, psychiatric hospitals, federal hospitals, and alcoholism and chemical dependency facilities.

Patients who were initially treated in a hospital emergency department (ED) and later become an inpatient admission are not included in the ED dataset. Statistics on those hospitalizations are included in the hospital discharge dataset.

The number of hospitals that submit varies from year to year. The KHA dataset may also contain emergency department data on Kansas residents who were treated at community hospitals in adjacent states. The quantity of those records varies annually. Emergency department data includes information on patients who had a length-of-stay of less than 24 hours. Specialty hospital data are not included.

"Primary Payer" is defined as the primary payer reported at the time of patient hospital admission and may not reflect the actual payer of record when the hospital bill is ultimately settled.

Some records in the data submitted to the state are missing race, ethnicity, age, or sex. KIC has a column to display the count of unknowns for these categories. The extent of missing or unknown values, especially age, affects population-based rates. The greater the number of missing values, the lower the population-based rate will be. Keep this under-reporting of rates in mind when interpreting the results.

The extent of missing or unknown values in the data affects any population-based rates created by KIC. The greater the number of missing values, the lower the population-based rate will be. Keep this under-reporting of rates in mind when interpreting the results.

Datasets provided to the state change over time and improved analyses may result in different KIC results for prior years. Number and rates may be influenced by number of hospitals contributing and any actual year to year comparison. Changes may therefore not be attributable to increases or decreases of specific disease. Also, KIC counts and rates produced for a given period several years ago may be different if the same query was run against the revised data. It is a good practice when comparing current results to those generated a few years ago to re-run the original query to make sure the results have not changed.

Coding of the diagnoses follows the same Clinical Classification Software method as noted above. Since procedures are rarely reported in ED data, there is not a procedure component to KIC ED. Race and Hispanic origin are reported in the same manner as hospital discharge KIC. KIC ED contains data for 2015 to the most recent year available. Data for prior years is not yet available.

NOTE: Data for 2015 has a mix of ICD-9-CM and ICD-10-CM coding.
     - Injury and poisoning sections are based on nature of injury instead of external cause.
     - Patients that were admitted to a hospital after visiting the Emergency Department are excluded from the ED data but included in the       hospital discharge data. Thus, there are no over-counts.

Specific source information on events (numerator) and population (denominator) can be found at the KIC Data Source page.

[ Top ] |

Population Data and Estimates
All of the population data used in KIC is produced by the U.S. Census Bureau (USCB) population estimates program. USCB produces a set of these estimates for the National Center for Health Statistics called the Bridged-race Population Estimates. All KIC query modules that use population data for rate calculations use the Bridged-race estimates. The Bridged-race estimates differ from the Census Bureau's unbridged estimates in that the race categories in the Bridged-race estimates are collapsed into fewer groups (White, Black, American Indian/Alaska Native, and Asian/Pacific Islander). Individuals who select unknown, other, or more than one race are reassigned by the Census Bureau in the Bridged-race estimates.

Population estimates are calculated for the midyear point of the year, except for 2010. Bridged-race population estimates for 2010 are based on the April 1, 2010 actual census counts. Because actual unbridged counts were used for rate calculations, rates reported in the 2010 Annual Summary of Vital Statistics may differ slightly from those calculated in KIC queries using Bridged-race estimates. Population estimates use both household and group quarters populations.

Information on the Bridged Race estimates can be found at http://www.cdc.gov/nchs/about/major/dvs/popbridge/datadoc.htm. The Census Bureau methodology for creating the population estimates can be found at http://www.census.gov/popest/topics/methodology/.

The KIC population estimate for a given year is the first postcensal estimate issued for that vintage year by USCB. While the Census Bureau revises previous year's estimates when issuing a new year's estimate, the KIC population data are not altered. This is in keeping with the methodology for producing the Kansas Annual Summary of Vital Statistics.

KIC-generated population-based rates may on occasion vary slightly from rates reported in the Kansas Annual Summary of Vital Statistics which has used some unbridged population estimates since 2006. More information on this approach can be found at http://www.kdheks.gov/hci/as/2006/AS06TECH.pdf.

After the 2000 Decennial Census the Census Bureau revised the population estimates for decade of the 1990s. KIC uses the USCB intercensal 1990 to 1999 Bridged-race population estimates for population-based rates and the population query module.
After the 2010 Decennial Census the Census Bureau revised the population estimates for decade of the 2000s. KIC uses the USCB intercensal 2000 to 2009 Bridged-race population estimates for population-based rates and the population query module.

[ Top ] |

Confidence Intervals and Significance Tests
A number of tests exist for public health researchers to determine the degree of certainty that can be placed on a given number or rate. Significance tests and confidence intervals prepared by KIC represent one way to analyze results. This note is not intended as a primer on the subject but rather an outline of how such tests are used.

Public health data are subject to different levels of completeness. In the case of births and deaths more than 99 percent are registered. In the case of infectious diseases, reporting ranges from 90 percent complete for AIDS to perhaps as low as 3-5 percent for Salmomellosis.

In the case of vital events, numbers are not subject to sampling errors, but they may be affected by non-sampling errors, such as mistakes in recording the mother's residence or age during the registration process. For other health data the completeness may change from year to year.

The potential impact of these variations increases as the number of events decreases. This makes any resulting rates subject to volatility, and requires caution when comparing them to rates from other populations, geographic areas, and time periods.

Confidence intervals help researchers determine whether the increase or decrease in the rates or frequency of events is not due to variations in the data. The KIC system produces three levels of confidence intervals to assist in interpreting the data: 95%, 98%, and 99%.

Whether the confidence intervals of two rates overlap, determines statistical significance. Non-overlapping confidence intervals indicates statistical significance. In this case significance refers to whether or not the difference between two rates indicates a small probability (less than 5%, 2% and 1%, respectively) the difference might have occurred by chance.

For example, the 95 percent confidence interval is the range of values for the number of events, rates or percent of events that you could expect in 95 out of 100 cases (95 out of 100 rule). The confidence limits are the end points of this range of values (the highest and lowest values). Confidence limits for numbers, rates and percents can be estimated from the actual number of events. Procedures differ for rates and percent calculations and also differ depending on the number of events on which the statistics are based.

If the difference between two rates would occur due to variability less than 5 times out of 100, the difference is statistically significant at the 95% level. In essence, there is a 95 percent level of confidence the difference is not due to the chance variability in the rates or the number of events on which the rates are based.

On the other hand, if the difference would occur more than 5 times out of 100, then the difference is not statistically significant. If the level of certainty is only 50 percent, or even 94 percent, the difference could not occur by chance, then the difference is not statistically significant.

[ Top ] |

KIC Maps Documentation
The KIC Map features were first implemented in December 2015 for births and deaths. Maps will work for all data years for these two events. Maps will be implemented for Cancer and Hospital Discharge data next. Each map created will include a table of the data used to create the map.

The KIC map modules can display statistical data by "Frequencies Only", such as counts, and "Frequencies & Percent / Rate", such as population based mortality rates or percentages of birth for a specific measure. All map results are displayed by county.

KIC Maps cannot filter out counties nor can it map data for various regional groupings like peer group, geographic region, or health preparedness region. State data will display with the map as well KIC Maps will display counts or rates/percent in three different ways: "Higher / Lower than State", "Quartiles", and "Quintiles". The quartiles feature groups the states counties into four categories and assigns colors based on the range of values. There are multiple color choices that can be selected. The quintiles feature groups the state's counties into five groups. The groups in quartiles and quintiles are assigned an equal number of counties.

The third approach to displaying results "Higher / Lower than State" is a map that compares county rates or percents to the state's rate and determines if the county values are statistically higher, statistically lower, or not statistically different from the state rate. Each county's rate is categorized as "High", "N/S" (Not Significant), or "Low" and category determination is based on a 95% Confidence Interval.

KIC Maps calculates upper and lower confidence intervals for each county's rate. If those intervals overlap the state rate's confidence intervals, the category is set to N/S indicating there is no significant difference between the county rate and the state rate. This feature is valuable when comparing rates and percents. The feature is not recommended when you are mapping counts.

KIC Maps has a suppression feature to address instances when individual county rates in do not support an equal distribution of counties in to quartiles or quintiles. When this suppression rule is implemented the map graphic does not appear but the data table is visible. Absence of the map is due to the data distribution not being suitable for a map. This is determined by the difference between the data set's first element and the element 'one fourth' of the way through is less than 0.1 or the difference between the data set's element three fourths of the way through and the last element is less than 0.1, when either or both of these conditions are true the map is suppressed. Often you can add more years to the map query to change the distribution of counties so that quintiles or quartiles will display.

Features such as download and rotate, commonly available in KIC tabular outputs are turned off in KIC Maps. However, users can perform a screen grab to capture the image. You can also copy the contents of the statistical table in the KIC Maps output and paste that into a spreadsheet program. Alternately, you can also print out the page to a printer or PDF file if you have the appropriate software. KIC Maps uses the same source data as the corresponding tabular data modules. These modules will be updated as new data is added to the tabular modules.

[ Top ] |

Data Source Information
This information is designed to give researchers citation for the data used for various KIC modules.

Birth
The source of data for KIC queries involving live births is the annual Birth History file of the Bureau of Epidemiology Public Health Informatics, Kansas Department of Health and Environment (KDHE). This is a cohort reflecting the live birth outcomes of Kansas resident women during a given calendar year regardless of where the birth occurred. Birth data starts with 1995.

Death
The source of data for KIC queries involving deaths is the annual Death History file of the Bureau of Epidemiology and Public Health Informatics. This is a cohort of reflecting the deaths that occurred to Kansas residents during a given calendar year regardless of where the death occurred. The death data starts with 1990.

Pregnancy
The source of data for KIC queries involving pregnancy outcomes is the annual history files for births, stillbirths, and abortions of the Bureau of Epidemiology and Public Health Informatics. These separate files are combined to produce a cohort of Kansas resident women who had a pregnancy outcome during a given calendar year regardless of where the event occurred. The pregnancy outcome data starts with 1995.

Population
The source of population data for KIC queries involving population and for any query that produces population-based rates is the United States Census Bureau. Annual population estimates for July 1 of a given year are used. While the Census Bureau revises previous years' population estimates, the estimates are not revised in the KIC query system. This is done to preserve comparability with rates published in the Annual Summary of Vital Statistics. After every decennial census the Census Bureau publishes a complete revision of population estimates for the previous decade. Once available, those estimates are incorporated in the KIC system. Population data are available from 1990.

Cancer
The source of the cancer data for KIC queries is the Kansas Cancer Registry operated by the University of Kansas Medical Center under contract to KDHE. Each year an updated dataset of Kansas resident cancer cases is provided to KIC. This file includes a new calendar year's worth of data and any additional cancer cases reported in previous years. Thus the number of cancer cases for previous years may increase as older case information is reported to the Kansas Cancer Registry. The cancer data starts with 1998.

BRFSS
The source of the Behavioral Risk Factor Surveillance System (BRFSS) data in KIC FastStats is the Office of Health Promotion of the Kansas Department of Health and Environment (KDHE). This survey data are collected and analyzed in accordance with guidelines from the U.S. Centers for Disease Control and Prevention.

Hospital Discharge Data
Hospital discharge data are provided to the State of Kansas by the Kansas Hospital Association (KHA). KHA compiles record level discharge data and processes it into a single file that is supplied to the KDHE Division of Health Care Finance. A file containing hospital discharge data is submitted on a federal fiscal year basis (October 1 to September 30 of the year following). Thus it takes two data submissions to KHPA for all four quarters of a calendar year to be received. In 2015 KDHE-DHCF began receiving the data on a quarterly basis, allowing for an earlier posting of final calendar year data. Beginning with calendar year 2007, provisional and final data have been received for hospital discharges. The main portal to hospital discharge queries will have information on whether the data in use are provisional or final.

To the extent they were made available to KHA, out-of-state occurrence hospitalizations to Kansas residents are included in the file. Not every discharge record in the file has a procedure. This accounts for the difference in the number of hospital discharges between tabulations involving diagnoses and procedures. Hospital discharge data starts with 1995. Hospital discharge data with information on Hispanic origin started in 2003. For purposes of evaluating legacy discharge information, there are modules that exclude Hispanic origin as part of the query.

Emergency Department Data
Emergency Department data are provided to the State of Kansas by the Kansas Hospital Association (KHA). KHA compiles record level emergency department data and processes it into a single file that is supplied to the KDHE-Division of Health Care Finance (KDHE-DHCF). A file containing emergency department data is submitted on a federal fiscal year basis (October 1 to September 30 of the year following). KHA submits emergency department data to KDHE-DHCF on a quarterly basis, allowing final calendar year data to be posted sooner than if the data was submitted annually.

To the extent they were made available to KHA, out-of-state occurrence hospitalizations to Kansas residents are included in the file.

Other Sources
Whenever other data are cited in any KIC Webpage, the source of that data is noted. Where available, a URL link to the data source has been provided. If you have questions about data sources, please contact us.

[ Top ] |

Confidentiality and Suppression
None of the KIC datasets use record level information. By using pre-summarized data the KIC system provides some confidentiality. The implementation of confidentiality rules that suppress counts or rates adds an additional level of protection against disclosure of individually identifiable information. These rules are in use universally in KIC. Thus users will see certain cells or blocks of cells suppressed in the query results. One rule suppresses counts when the count is less than 6. Another rule prevents users from seeing the inside contents of a table when the difference between any individual table cell and the table total is less than 10. In KIC cancer queries a third confidentiality rule reports a value range instead of a single value when individual cell counts fall below a certain threshold.

KIC results will be suppressed when any of the above conditions are met, even though in some instances such counts are not suppressed in paper or static reports available from KDHE. Static reports can't be subjected to follow up queries or other steps to deduce values. The very nature of interactive queries in KIC makes alternate queries possible. Suppression is required to protect the confidentiality of the individuals as required by state law.

If suppressed data presents an issue for use of the information, please check the other online static reports on KIC to find an unsuppressed table, or e-mail your question to the KDHE Bureau of Epidemiology and Public Health Informatics.

[ Top ] |

FastStats: County Profiles
FastStats County Profile provides a snapshot of county health indicators and social determinants. Information is grouped into eight categories; Vital Statistics, Population, Health Care, Environment, Labor, Education, Poverty, and Crime. Each county is shown in comparison to the state of Kansas. FastStats County Profile provides a brief overvew providing the most current data for each county. For a more comprehensive look at any given county, please use query KIC..

FastStats County Profile is an Excel spreadsheet. You will need Excel or Excel Viewer on your computer to access the file in your browser. Hyperlinks are embedded in the spreadsheet. If you click on the links, you will exit the spreadsheet. The Excel file may be saved to your computer. It has been password protected to prevent inadvertent changes. Click on the yellow box in the spreadsheet to access the dropdown menu to select your county. The profile is formatted to print to a standard sheet of paper.

As new information is available to KDHE, the County Profile will be updated. Check the comment box at the top of the spreadsheet for the revision date. If you would like to be added to our mailing list to receive notices about updates and other statistical information, please send an e-mail to Kansas.Health.Statistics@kdheks.gov.

How to select a county
To see results for a county, simply make a selection from the yellow drop-down box at the top of the browser window. A dropdown menu will allow you to select a county. Once a county is select its results will be displayed. To change a selection simply pick a new county from the drop-down box.

How to use the results
Once a county is selected the profile will be updated. Each indicator or measure is displayed in its own section. Each section will have a title and footnotes. The Excel page has been created to easily allow for printing of the results. There are currently four pages that will print. The dropdown menu will not print.

Dataset Notes
Footnotes for each category are shown in the resulting table. They are also listed here for your convenience.
[1] Rates for birth, marriage, and marriage dissolution are reported per 1,000 persons. Rates for death are reported per 100,000 persons. Birth and death are reported by county of residence. Marriage and Marriage dissolution are reported by county of occurrence.

[2] Population figures are based on the most current year's Bridged Race Estimates prepared by the U.S. Census Bureau in consultation the National Center for Health Statistics. For more information about Bridged Race Estimates, go to: National Center for Health Statistics.

[3] The federal government considers race and Hispanic origin to be separate concepts. The Kansas Department of Health and Environment collects race and Hispanic origin separately and maintains the raw data in this manner. In order to better characterize the population of Kansas, Fast Stats displays population data by mutually exclusive groups of race and Hispanic origin categories. These population or ethnic groups are thus more closely aligned to the way each group perceives itself and is therefore more useful in measuring health disparity among population groups. note: Due to rounding, percentages may not add up to 100%.

[4] Primary Care Physicians are defined as MDs, DOs, or PAs whose practice includes any of the Primary Care specialties: Family Practice, General Practice, Internal Medicine, Obstetrics/Gynecology, and Pediatrics. Each Primary Care Provider is counted only once, in the county where he/she practices the most time. The Primary Care Provider Ratio is the population of the county divided by the number of Primary Care Providers whose principal practices are located in that county.

[5] Vaccination data taken from the most recent report at a href="http://www.kdheks.gov/immunize/retro_survey.html" target="_blank" >Retrospective Immunization Coverage Survey. Coverage is reported for the 4-3-1-3-3 (DTP4, Polio3, MMR1, Hib3, HepB3) vaccine series. A shortage of the DTP vaccine in 2001-2002 led to lower vaccination coverage than in the previous year for most counties. Survey results are provided in percentages. N/A represents Not Available for county total.

[6] Rate of cancer is reported per 100,000 persons. Rate for hospital discharge is reported per 10,000 persons. Cancer and hospital discharge are reported by county of residence.

[7] Hospital discharges represent the number of hospital admissions wherein a person's length of stay was greater than 24 hours. Multiple admissions of the same person during a reporting year are counted as separate discharges.

[8] Statistics on numbers of uninsured are taken from a US Bureau of the Census program, Experimental Small Area Health Insurance Estimates by County.

[9] Radon readings are measured in picocuries per liter of air - pCi/L. One picocurie is equal to the decay of two radioactive atoms per minute. 4 pCi/L is equal to 8-9 atoms decaying every minute in every liter of air inside the house. A 1,000 square foot house at 4 pCi/L has 2 million decays per minute. At 1.25 pCi/L an individual receives over half (55%) of their average annual dose of radiation from radon exposure in their homes, schools, and buildings where they spend time. To learn more click on Radon Basics.

[10] Lead data were provided by theKansas Childhood Lead Poisoning Prevention Program, which receives reports on all laboratory tests for blood lead involving Kansas resident children, including tests done in out-of-state labs. Visit the Lead Hazard Prevention Program for more information.

[11] Labor statistics provided by the Kansas Department of Labor. People are considered employed if they did any work at all for pay or profit. Counts of unemployment include persons 16 years of age and older who do not have a job, have actively looked for work in the prior four weeks, and currently available for work. The labor force includes the employed and unemployed. The unemployment rate is calculated by dividing the number of unemployed by the labor force. Not in labor force is the population 16 or older minus the civilian labor force. Labor force participation is calculated by dividing the civilian labor force by the total population 16 and older. Labor flow statistics compiled from US Bureau of the Census. Labor flow statistics are based on place of employment, not place of residence, and are therefore not directly comparable to other labor statistics.

[12] School registration, reduced meal, attendance, and graduation received from Kansas Department of Education. Student attendance rate determined by dividing the average daily attendance by the total average daily membership. Graduation rate is calculated using the formula: Graduates / (Graduates + Year 4 Dropouts + Year 3 Dropouts + Year 2 Dropouts + Year 1 Dropouts).

[13] Poverty rates and median incomes provided by the US Census Bureau's Small Area Income and Poverty Estimates. For details on how poverty estimates are created visit County Level Estimation Details.

[14] Kansas crime statistics were abstracted from the Kansas Bureau of Investigation (KBI) report "Reported Crime Index" for the most current year available. The full report may be found on the Statistics page at the KBI website. Numbers may be incomplete because some law enforcement jurisdictions did not submit full reports in the given year, and therefore any incidents from those jurisdictions are absent from the KBI dataset.

Kansas crime statistics have been aggregated into two broad categories: Violent Crimes and Property Crimes. Violent crimes are counted per victim; property crimes (other than motor vehicle theft) are counted per incident; and motor vehicle thefts are counted per vehicle stolen. Crime rates (per 1000 population) are calculated using population estimates for each law enforcement jurisdiction provided by the FBI. When summed to the county level, these estimates are close, but not identical to the population estimates obtained by KDHE from the US Census Bureau. KDHE staff have used these estimates to indicate the percentage of the population of each county for which data was available. Please refer to the original KBI report for breakdowns by individual law enforcement jurisdiction and individual crime type. N/A represents Not Available since actual counts are not provided for county total.

[ Top ] |

FastStats: Special Links
Some of the data and information at FastStats is provided through links to the original provider of the information. These providers may be universities or other state or federal agencies. Those data providers are solely responsible for the information. Inclusion of the links in FastStats does not constitute an endorsement by KDHE of the provider's site, policies, or methodology. Users of this information sould read the documentation made available at each site.
[ Top ] |

---