What impact do racial and ethnic disparities have on disadvantaged men in a prostate cancer public-assistance program? In this examination of California's IMPACT program, authors evaluate racial and ethnic differences in health services utilization and patient-reported health care outcomes. They identify modifiable factors that might explain persistent disparities in this health care setting. 

Findings: IMPACT's bilingual clinical care coordinators, interpreter services and Spanish-language educational materials contributed to exceptionally high satisfaction among Spanish-speaking Hispanic men. Less acculturated Spanish-speaking Hispanic men likewise reported high satisfaction, in part because traditional distrust of health care services may contribute to fewer unmet-expectations. Although challenges to care remained among white and black men, the high satisfaction reported by Hispanic men indicate that "the needs of this often difficult-to-reach population are being met," according to the authors.