CONTEXT: Higher rates of microvascular complications have been reported for minorities. Disparate access to quality health care is a common explanation for ethnic disparities in @entity6 complication rates in the US population. Examining an ethnically diverse population with uniform health care coverage may be useful. OBJECTIVE: To assess ethnic disparities in the incidence of @entity6 complications within a nonprofit prepaid health care organization. DESIGN AND SETTING: Longitudinal observational study conducted January 1, 1995, through December 31, 1998, at Kaiser Permanente Medical Care Program in northern California. @entity1 : A total of 62 432 @entity6 @entity1 , including Asians (12%), blacks (14%), Latinos (10%), and whites (64%). MAIN OUTCOME MEASURES: Incident @entity583 ( @entity583 ), @entity64 , @entity712 ( @entity712 ), and nontraumatic lower extremity amputation (LEA), defined by primary hospitalization discharge diagnosis, procedures, or underlying cause of @entity204 ; and @entity454 ( @entity454 ), defined as @entity177 requiring renal replacement therapy or transplantation for survival or by underlying cause of @entity204 . RESULTS: Patterns of ethnic differences were not consistent across complications and frequently persisted despite adjustment for a wide range of demographic, socioeconomic, behavioral, and clinical factors. Adjusted hazard ratios (relative to that of whites) were 0.56, 0.68, and 0.68 for blacks, Asians, and Latinos, respectively (P<.001), for @entity583 ; 0.76 and 0.72 for Asians and Latinos, respectively (P<.01), for @entity64 ; 0.70 and 0.61 for Asians and Latinos, respectively (P<.01), for @entity712 ; 0.40 for Asians (P<.001) for @entity33650 ; and 2.03, 1.85, and 1.46 for blacks, Asians, and Latinos, respectively (P<.01), for @entity454 . There were no statistically significant black-white differences for @entity64 , @entity712 , or LEA and no Latino-white differences for LEA. CONCLUSIONS: This study confirms previous reports of elevated incidence of @entity454 among ethnic minorities, despite uniform medical care coverage, and provides new evidence that rates of other complications are similar or lower relative to those of whites. The persistence of ethnic disparities after adjustment suggests a possible genetic origin, the contribution of unmeasured environmental factors, or a combination of these factors.

Ethnic disparities in XXXX complications in an insured population.

@entity1 :: ('9606', 'Species') :: ['patients', 'PARTICIPANTS'] @entity712 :: ('MESH:D006333', 'Disease') :: ['congestive heart failure', 'CHF'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke'] @entity6 :: ('MESH:D003920', 'Disease') :: ['diabetic'] @entity33650 :: ('CHEBI:59295', 'Chemical') :: ['LEA'] @entity177 :: ('MESH:D051437', 'Disease') :: ['renal insufficiency'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarction', 'MI'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death'] @entity454 :: ('MESH:D007676', 'Disease') :: ['end-stage renal disease', 'ESRD']
@entity6 :: (MESH:D003920,Disease) :: ['diabetic']
