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This document provides its users with an overview of the events contributing to the health status of Kansans.  The facts contained in this report are essential for effective health policy decisions and program planning.  It is designed to provide governmental agencies, businesses, industries, and citizens with information on vital statistics in Kansas.

Comments concerning the format or content of this report are welcomed.  The Annual Summary of Vital Statistics is a summary of the health data collected  by the State of Kansas on vital events.  More detailed information is available upon request. The information contained in this report may be obtained electronically by contacting the Kansas Department of Health and Environment, Center for Health and Environmental Statistics, Office of Health Care Information (785-296-5644) or e-mail ksommer@kdheks.gov.  The Annual Summary of Vital Statistics is also available on the Internet at the KDHE home page on the World Wide Web. The address is: http://www.kdheks.gov/hci/.   For copies of this report please call (785-296-8627).

ADA Statement:  If you desire a copy of this publication in alternative form because of a disability, contact the Kansas Department of Health and Environment, Center for Health and Environmental Statistics, Office of Health Care Information, Landon State Office Building, Room 904-N, 900 SW Jackson , Topeka, KS  66612-1220, 785-296-8627, or 1-800-332-6262 (TDD/TT).

Please note: KDHE has recently moved to: 1000 SW Jackson, Topeka, KS 66611 (12-20-2001 - JC)

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Registration of Kansas vital events (live births, deaths, fetal deaths, marriages, and marriage dissolutions) decreased 3.9 percent from 97,023 in 1988 to 93,265 in 1998.  (Table 1, Figure 2)

Between 1988 and 1998, the most significant changes in vital events were a 54.4 percent increase in the out-of-wedlock birth ratio and a 22.0 percent decrease in the marriage dissolution rate.  (Table 1)

The number of out-of-wedlock births to Kansas residents reached a record high in 1998 at 10,657. This represented 27.8 percent of all Kansas resident births, which is the highest proportion ever reported.  (Table 1)

The live birth rate in 1998 (14.6) decreased 5.8 percent from the 1988 rate of 15.5.  The death rate decreased 1.1 percent, from 9.2 in 1988 to 9.1 in 1998.  The marriage rate in 1998 decreased 14.3 percent, from 9.1 in 1988 to 7.8 in 1998.  (Table 1, Figure 3)

The birth rate (14.6) for Kansas residents in 1998 increased for the second year after six consecutive years of decrease to 14.2 in 1996, the lowest on record (dating from 1935). (Table 1, Figure 3)

Fetal, hebdomadal, perinatal, neonatal  and infant death rates decreased from 1988-1998, with percentage decreases of 14.8, 19.0, 15.7, 6.3, and 12.7, respectively.  (Table 1, Figure 3)

In 1998, the number of couples married in Kansas declined as it has since 1992 and the number of marriage dissolutions (divorces and annulments) granted in the state also declined, as it has since 1991.  (Table 1)

Almost half (10,106) of the marriages in 1998 were first marriages for both the bride and groom.  (Figure 2)

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Kansas increased in population from 2,594,840 residents in 1997 to 2,629,067 residents in 1998, a 1.3 percent increase.  Butler, Johnson, and Jefferson counties had the largest increases in population from 1994 to 1998 with percent changes of 11.1, 9.3, and 8.4 respectively.  Geary, Wichita, and Edwards counties had the largest decreases in population with percent changes of 18.4, 8.4, and 6.9 respectively. (Table 2)

According to U.S. Census Bureau estimates, there were 2,629,067 Kansans in 1998, a 12.6 percent increase in total population since 1978. (Figure 4)

The rate of natural increase has steadily declined from a  rate of 15.0 in 1958.  In 1998, the natural increase rate was 5.5, a 5.8 percent increase from 5.2 in 1997. (Figure 5)

The median age of Kansans in 1998 was 35.2 years, an 8.6 percent increase from the 32.4 median age in 1988. The median age for Kansas males and females in 1998 was 34.0 and 36.4 respectively. (Figure 6)

The percent increase in the Kansas total population from 1988-1998 was 5.4 percent, including a 5.6 percent increase for Kansas males and a 5.2 percent increase for Kansas females.  Shifts in the Kansas population distribution by age from 1988 to 1998 include decreases in the 0-4,  25-34, 55-64, and 65-74 age-groups of 4.7,22.2,3.2, and 3.3 percent respectively.  An increase of 23.8 percent in residents 35-44 years of age and 41.2 percent in residents 45-54 years of age reflects the aging of the baby boomers.  Furthermore, there were 8.1, 6.9,  and 14.3 percent increases in the 5-14, 15-24, and 75 and over age-groups respectively. (Figure 7, Table 4)

The population density of Kansas was 32.1 persons per square mile in 1998, a 24.9 percent increase from 25.7 persons per square mile in 1958 and a 5.2 percent increase in population density since 1988.  For comparison, the population density of the U.S. has increased from 48.3 to 72.4 persons per square mile from 1958 to 1998 respectively, a 49.9 percent increase. (Figure 8)

In 1998, 27 of Kansas' 105 counties had population densities of less than 5.0 persons per square mile.  The most sparsely populated county was Wallace, which had a density of 2.0 persons per square mile.  The most densely populated county was Wyandotte, with 1,009.0 persons per square mile. (Figure 9)

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During 1998, 38,372 live births occurred to Kansas residents, representing a birth rate of 14.6 per 1,000 population.  There was a 2.1 percent increase in the 1998 birth rate from the 1997 rate of 14.3.  (Table 5)

In 1998,  Finney, Geary, and Seward  counties had the highest county birth rates of 25.0, 25.0, and 24.3 births per 1,000 population respectively.  Junction City, Garden City, and Dodge City had the highest 1998 city birth rates of 27.6, 27.3, and 26.5 births per 1,000 population respectively. (Table 5 and Table 6, Figure 11)

Geary, Finney and Seward counties had the highest five-year county birth rates of 26.0, 24.5, and 23.0 births per 1,000 population respectively. (Table 5)

Since 1958, birth rates for Kansas followed national trends and have steadily declined.  Kansas birth rates have decreased 40.7 percent during the last 40 years from a rate of 24.6 births per 1,000 population in 1958 to a rate of 14.6 in 1998. After being above the U.S. birth rate since 1975, the Kansas rate dropped below the national rate in 1987.  (Table 7, Figure 10)

Kansas fertility rates have followed national trends and indicate a steady decline from 126.1 to 67.0 births per 1,000 female population aged 15-44 in 1958 and 1998 respectively.  The increase in the fertility rate from 68.0 in 1989 to 70.1 in 1990 can be explained, in part, by the use of actual census counts for the 1990 female population.  The Kansas fertility rate in 1998 (67.0) was 1.5 percent higher than the national rate of 66.0.  (Table 7, Figure 12)

Age-specific fertility rates for Kansas during the years 1988-1998 decreased 9.9 percent for the 15-24 age-group.  Concurrently, age-specific fertility rates increased 15.1  percent for the 25-34 age-group and 43.7 percent for the 35-44 age-group.  These shifts in fertility rates by age-group reflect the continuing trend in Kansas for women to delay childbirth until later years.  (Table 8, Figure 13)

In 1998, 39.2 percent of all Kansas live births occurred to women in the 15-24 age-group, 49.3 percent of live births occurred to women in the 25-34 age-group and 11.2 percent occurred to women in the 35-44 age-group.  For comparison, in 1998, 23.8 percent of all Kansas live births had fathers in the 15-24 age-group, 54.6 percent had fathers in the 25-34 age-group, and 19.8 percent had fathers in the 35-44 age group.  (Table 9 and Table 10)

Of the births to mothers 10-19 years of age, where the age of the father is known, just over one-third (36.2 percent) had fathers who were 10-19 while nearly two-thirds (63.8 percent) had fathers who were 20 and over.  (Table 9)

Over eight percent (8.4) of live births in 1998 were preterm (less than 37 completed weeks of gestation) while 92 percent (91.6) occurred at 37 or more weeks of gestation.  (Table 11)

In 1998, 85.7 percent of all Kansas resident births were to mothers who received prenatal care that began in the first trimester (first 3 months) of pregnancy, 11.4 percent began in the second trimester, and 2.2 percent began in the third trimester.  Nearly 1 percent (0.7) received no prenatal care.  (Table 12)

In 1998, 82.3 percent of Kansas live births both occurred to women 15-34 years of age and weighed between 2,500-4,499 grams.  (Table 14)

Birth weights for Kansas live births in 1998 were distributed as follows: 7.0 percent of live births weighed under 2,500 grams (low birth weight), 91.4 percent weighed 2,500-4,499 grams (normal birth weight), and 1.6 percent weighed over 4,499 grams (heavy birth weight).  (Table 13 and Table 14)

In 1998, 38.5 percent of Kansas live births were first births.  Of the 14,786 first births, 56.6 percent occurred to women in the 15-24 age-group.  (Table 15, Figure 14)

In 1998, 89.3 percent of Kansas live births were to white mothers, 7.2 percent were to black mothers, and 3.5 percent were to mothers of other races.  Furthermore, 51.3 percent of Kansas live births were male and 48.7 percent were female.  (Table 16)

In 1998, there were 10,657 out-of-wedlock births to Kansas residents.  Of those births, 71.8 percent occurred to women in the 15-24 age-group. For comparison, in 1988, 71.9  percent of the 6,969 out-of-wedlock births occurred to women in this age group.   (Table 17)

The out-of-wedlock birth ratio has continued an upward trend over the years in both Kansas and the U.S.  Out-of-wedlock births comprised 27.8 percent of all live births that occurred to Kansas residents in 1998, a 54.4 percent increase from 18.0 percent of live births in 1988.  The out-of-wedlock birth ratio in 1998 was 15.2 percent lower than the U.S. proportion (32.8 percent) of births to unmarried women.  (Figure 15)

The pregnancy rate for females ages 10-19 decreased 3.9 percent from 33.7 pregnancies per 1,000 in 1988 to 32.4 in 1998.  Teen pregnancy rates for females ages 10-17 decreased 13.2 percent during this same time frame.  (Table 18, Figure 16)

In 1998, 87.1 percent of non-teen mothers of live births received prenatal care in the first trimester of pregnancy while only 72.3 percent of teen mothers received prenatal care in the first trimester.  The percent of teens who received no prenatal care (1.0) was higher than that for non-teens (0.7). (Figure 17)

Of the births to teenage women in 1998, 82.3 percent were to whites and 14.5 percent were to blacks.  For comparison, in 1988, 79.6 percent of births to teenage women were to whites and 18.0 percent were to blacks.  (Figure 18)

In 1998, the abortion ratio for Kansas residents was 167.8 abortions per 1,000 live births, an increase of 36.2 percent from the 123.2 ratio in 1988.  The large increase between the 1990 and 1991 abortion ratios (50.2 percent) does not reflect an increase in the number of abortions being performed but rather an increase in the number of providers reporting data.  (Figure 19, Table 21)

The abortion ratio for Kansas residents in 1998 varied substantially by age-group. The ratio per 1,000 live births was highest for adolescents-women under 20 years of age. Since 1980, the abortion ratio declined for women in age groups 15-19 and 30 years old and older.  (Figure 20)

In 1998, 6,440 abortions that were reported were performed for Kansas residents and 5,184  were performed for non-Kansans.  Of the 6,440 resident abortions, 129 occurred out of state. (Figure 22, Table 21 and Table 23)

Of Kansas residents having abortions, 55.6 percent were in the 15-24 age-group, 80.7 percent were unmarried and 79.5 percent were white.  (Figure 22, Table 22)

In 1998, 58.5 percent of all reported abortions occurred prior to nine completed weeks of gestational age. Over  fourteen (14.8) percent of teenage women obtained an abortion after 16 weeks gestation, compared to 8.2 percent of women 20 and older. ( Table 23, Figure 23)

Over eighty percent (80.7) of all reported abortions in 1998 were to unmarried women.  Among black  women, 90.1 percent were unmarried,  while 79.8 percent of white women and 75.9 percent of Hispanic women were unmarried. (Table 24)

Eighty-three percent (82.9) of all reported abortions were performed prior to the 13th week of gestation.  Suction curettage was the procedure used in 98.3 percent of these terminations.  Only 9.8 percent of induced terminations were performed after 16 weeks gestation, and 53.3 percent of these used dilation and evacuation. (Table 26)

The percentage of women who obtained an abortion early in pregnancy (less than 9 weeks of gestation) increased with age, and the percentage who obtained an abortion late in pregnancy (greater than 21 weeks of gestation) decreased with age for women up to 20-24 years of age and remained stable in older age-groups. (Figure 24)

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In 1998, 58.8 percent of the reported fetal deaths occurred to mothers in the 20-29 age-group.  (Table 27)

In 1998, 77.3 percent of all fetal deaths weighed less than 2,500 grams, with a fetal death rate of 53.9 deaths per 1,000 deliveries (live birth + fetal death) by selected characteristic.  For comparison, in 1988, 73.0 percent of reported fetal deaths weighed 2,500 grams or less but occurred at a rate of 66.7 deaths per 1,000 deliveries.  (Figure 25)

Examining the components that constitute perinatal period III mortality, the numbers of fetal deaths and hebdomadal deaths declined 49.4 percent and 73.3 percent respectively from 1968 to 1998.  In 1998, there were 331 perinatal period III deaths, representing a death rate of 8.6 deaths per 1,000 total deliveries.  This rate has decreased 65.2 percent from the 1968 rate of 24.7.  (Table 28 and Table 29, Figure 26)

A total of 263 infant deaths occurred to Kansas residents in 1998. The overall infant death rate for 1998 was 6.9 infant deaths per 1,000 live births.  This rate is identical to the 1995 rate and the lowest ever recorded for Kansas residents.  For comparison, the 1998 rate (6.9) represents a decrease of 6.8 percent from the infant death rate of 7.4  in 1997 and a 64.8 percent decrease from the rate of 19.6 in 1968.  The white infant death rate was 6.8 deaths per 1,000 live births in 1998, a decrease of 63.6 percent from the rate of 18.7 in 1968.  The 1998 infant death rate of 9.7 for black residents of Kansas is the lowest recorded for black infants.  The 1998 black infant death rate represents a 41.2 percent decline from the 1997 rate of 16.5 and a 71.5 percent decline from the 1968 rate of 34.0 (Figure 27, Table 30)

During the five-year period, 1994-1998, the infant death rate for Kansas was 7.4.  Chautauqua county had the highest infant death rate (30.5) during this time period.  Of those counties reporting infant deaths, Allen county had the lowest rate (2.3).  Eleven counties had no infant deaths.  (Table 31)

Of all infant deaths, 44.5 percent were attributed to conditions originating in the perinatal period, 24.7 percent were attributed to congenital anomalies, 12.5 percent to sudden infant death syndrome and 18.3 percent to all other causes.  (Table 32)

The rate of maternal deaths for Kansas and the U.S. declined between 1968 and 1998.  The maternal death rate for Kansas in 1998 was 0.8 deaths per 10,000 live births, a 68.0 percent decrease from the 1968 rate of 2.5.  (Figure 29)

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There were 23,928 resident deaths recorded in Kansas during 1998, an increase of 1.4 percent from the 1997 total of 23,609.  (Table 34)

Comanche, Decatur, and Osborne counties had the highest five-year (1994-1998) county death rates of 18.1, 17,9, and 17.2 deaths per 1,000 population respectively.  Riley, Douglas, and Finney counties had the lowest five-year death rates of 4.1, 5.4, and 5.6 deaths per 1,000 population respectively.  (Table 34, Figure 30)

Belleville, Eureka, and Neodesha had the highest five-year city death rates (1994-1998) of 25.3, 22.3, and 19.7 respectively.  Olathe, Lawrence, and Lenexa experienced the lowest five-year city death rates of 4.7, 4.9 and 5.1 respectively.  (Table 35)

The Kansas death rate in 1998 was 9.1 deaths per 1,000 population, which was 5.8 percent higher than the estimated U.S. rate of 8.6 deaths per 1,000 population.  (Figure 31)

The Kansas age-adjusted death rate was below that of the U.S. between 1988 and 1995. In 1998, Kansas and the U.S. had identical rates of 4.7 per 1,000 standard U.S. 1940 population. (Table 37, Figure 32)

The average age at death of Kansas residents in 1998 was 74.3 years, a 1.8 percent increase from the average age at death of 73.0 years in 1988.  (Figure 33, Table 38)

The average age at death for the white population in 1998 was 74.9 years, eleven years older than that of the black population, whose average age at death was 63.7 years.  (Table 39)

The two leading causes of death in Kansas in 1998, heart disease and malignant neoplasms, had average ages at death of 78.9 and 71.6 years respectively.  Atherosclerosis, with an average age at death of 87.0 years, had the highest average age at death of any of the leading causes of death.  (Table 42)

The average age at death for male unintentional injury victims for 1988 and 1998 was 43.5 and 47.3 respectively, while for females the average age was 55.7 and 59.6 years respectively.  For this time period, the average age at death increased for female unintentional injury victims 7.0 percent while for male unintentional injury victims it increased 8.7 percent.  (Table 42)

The cause-specific death rate for suicides in Kansas was 12.5 deaths per 100,000 population in 1998.  The rate for males (21.4) was more than 5 times higher than the rate for females (3.8).  (Table 42)

The cancer death rate for 1998 was 194.3 deaths per 100,000 population, 2.2 percent lower than the rate of 198.6 in 1988.  (Table 42 and Table 43)

In 1998, the unintentional injury death rate was 42.9 deaths per 100,000 population, 8.9 percent higher than the rate of 39.4 in 1988.  (Table 42 and Table 43)

The Kansas homicide and legal intervention death rate was 6.1 deaths per 100,000 population in 1998, 4.7 percent lower than the U.S. rate of 6.4 in 1998.  (Table 43)

Heart disease, the number one cause of death in Kansas, reached a high of 393.4 deaths per 100,000 population in 1973 and gradually declined to 272.5 deaths per 100,000 population in 1998.  Conversely, cancer rates have steadily increased from 140.6 to 207.1 deaths per 100,000 population in 1956 and 1996 respectively. In 1997, the cancer death rate decreased to 200.3 deaths per 1,000 population, and it decreased further to 194.3 in 1998.  (Figure 34)

In 1998, Kansans died from cerebrovascular disease at about half the rate of forty years ago, with the death rates for this disease going from a high in 1958 of 137.0 to 69.3 in 1998.  The death rate for unintentional injury also declined, going from 59.9 in 1958 to 42.9 in 1998, a 28.4 percent decrease.  (Figure 34)

In 1998, unintentional injury deaths were the leading cause of death for Kansas residents 1-44 years of age.  (Figure 35)

In 1998, cancer of the respiratory organs, digestive organs, and breast were the leading causes of cancer deaths in women.  (Table 45)

The dominant occupations for deaths due to unintentional injuries and homicides and legal intervention were operators, fabricators and laborers.  (Table 49)

Mortality in Kansas was responsible for 186,841 years of potential life lost in 1998.  Cancer was the second leading cause of death in Kansas, but accounted for the most years of potential life lost (40,164).  Unintentional injuries represented almost two times the years of potential life lost among men (19,871 years) compared to women (10,121 years).  (Table 51, Figure 36)

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In 1998, 20,403 marriages occurred in Kansas, a decrease of 0.7 percent from the 1997 total of 20,537 marriages.  (Table 53)

The greatest number of marriages (3,956) occurred in Sedgwick county, but Geary county had the highest marriage rate of 19.4 marriages per 1,000 population.  Comanche county had the fewest marriages (1) and also had the lowest marriage rate of 0.5 marriages per 1,000 population.  (Table 50, Figure 37)

The Kansas marriage rate in 1998 was 7.8 marriages per 1,000 population, which was 14.3 percent lower than the 1988  rate of 9.1. The 1998 rate was 7.1 percent lower than the estimated U.S. rate of 8.4. marriages per 1,000 population.  (Figure 39)

More wedding ceremonies were performed in June (12.2 percent) than any other month in 1998, with May and July being the second and third most popular months.  (Figure 41)

First-time marriages for both partners have made up less than half  of the marriages in Kansas since 1985. The distribution between the categories remains relatively unchanged in 1998 with 49.7 percent of the total involving first-time partners.  (Table 55)

Kansas couples are delaying marriage.  In 1988, 14.6 percent of the brides and 5.5 percent of the grooms were under 20 years of age.  However, in 1998, 11.4 percent of the brides and 4.6 percent of the grooms were under 20.  (Table 56)

The average age of all brides in 1998 was 29.4 years and that of grooms was 31.6 years.  Women marrying for the first time averaged 24.2 years while first time grooms averaged 26.4 years.  Of those persons who remarried during 1998, women were, on the average, 37.9 years old and men were 40.8 years of age.
(Figure 42)

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In 1998, 10,363 marriage dissolutions (10,010 divorces and 353 annulments) occurred in Kansas, a decrease of 2.4 percent from the 1997 total of 10,618.  (Table 54 and Table 58)

The greatest number of marriage dissolutions (2,906) occurred in Sedgwick county, but Coffey county had the highest marriage dissolution rate (17.2) per 1,000 population. Comanche county had no marriage dissolutions in 1998, and Gove and Kearny counties had 3.  The lowest dissolution rate was in Gove County with a marriage dissolution rate of 1.0 per 1,000 population.  (Table 54, Figure 38)

The Kansas marriage dissolution rate in 1998 was 3.9 marriage dissolutions per 1,000 population, which was 22.0 percent lower than the 1988 rate of 5.0.  The Kansas rate in 1998 was the lowest since 1970. (Figure 40)

Kansas has generally reported a higher marriage dissolution rate than the U.S. for most years since 1951.  However, Kansas' rate in 1995 (4.3) was lower than the U.S. rate (4.4) for the first time since 1951.  The Kansas  rate in 1998 (3.9) was 11.4 percent higher than the U.S. rate (3.5).  (Figure 40)

The ratios of marriages to divorces for Kansas and the U.S. were both roughly 2 to 1, with Kansas at 2.0:1 and the U.S. at 2.4:1.  (Table 53 and Table 54)

The most common age-group of wives involved in marriage dissolutions  in 1998 was 25-29, while for husbands it was the 35-39 age-group. For couples of the same age-group, the most common age-group was 25-29. (Table 57)

The average age at marriage dissolution in 1998 was 35.2 years for wives and 37.5 years for husbands, as compared to 32.7 years for wives and 35.0 years for husbands in 1988.  (Figure 43)

In 1998, 43.0 percent of marriages ending in divorce or annulment lasted four years or less.  (Table 58)

There were 10,063 minor children affected as a result of marriage dissolutions in 1998.  At  least one minor child was reported in over half (52.9 percent) of the marriage dissolutions.  (Table 59, Figure 44)

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Technical Notes

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City population estimates for 1994-1998 were derived as in the following example for 1997:

Population estimates by age-group and sex were obtained from the State Population and Household Estimates, with Age, Sex, and Components of Change: 1982-89, Series P-25, No. 1058, U.S.C.B. Population counts for 1990 were obtained from the Census of Population, U.S.C.B. Population estimates for 1991-1992 were obtained from the U.S. Bureau of the Census, Press Release CB92-93 and CB92-276, respectively. Population estimates for 1993-1998 were obtained from the Census and You, Vol. 29, No. 4, April 1994, Vol. 30, No. 4, April 1995, Vol. 31, No. 3, March, 1996 and Vol. 32, No. 7, July, 1997 U.S.C.B., respectively. Population estimates for 1997 were obtained on the Internet at: www.census.gov/population/estimates/statepop.html. These estimates were used in age-specific and age-adjusted calculations.

Due to rounding and variation in estimation methods within the U.S. Census Bureau, some discrepancies may be found in population data. (Table 2 and Table 4) Usually differences are negligible and rarely result in discrepancies in the totals. We advise you to utilize state totals from the county population totals when a total population estimate is needed.

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The same calculation was used for the 15-19 age-group. Once the 10-19 age-group estimates were derived, they were used as denominators for calculating pregnancy rates for females 10-19. Actual population counts for 1990 and population estimates for 1991-1998 were obtained from the U.S. Bureau of the Census.

The 1998 county estimates for females 10-17 and 10-19 were compiled by the U.S. Census Bureau as of 7/1/97. These estimates were then adjusted to the 1998 Census total for the state.

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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.

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From July,1970 through June,1995, only hospitals in Kansas were required by K.S.A. 65-445 to keep and submit to the Secretary of the Department of Health and Environment, written records of all pregnancies terminated in the hospital. During this reporting period, nonhospital providers reported terminations only on a voluntary basis. Although Kansas has a comprehensive coverage of providers, there could be a small number of abortions not reported. This means that the data may be, to a certain degree, underreported. However, effective July 1, 1995, the Kansas legislature amended K.S.A. 65-445 in Senate Bill 384 to broaden the record-keeping and reporting requirement to include every medical care facility and every person licensed to practice medicine and surgery.