Effect of advocacy, gender, and policy on men's health in California

The issue of and need for the reduction and elimination of health disparities among race/ethnic groups is widely recognized. Similarly, there has been a growing recognition of the need to address gender inequities in health care resulting in a series of efforts focused on the improvement of health care access for women. Since the 1980s, women have successfully moved the issue of women's health rapidly up the policy agenda on state and national levels. One example of their success was the establishment of the National Breast and Cervical Cancer Early Detection Program in 1991 and expansion of the program as it was implemented by states. In 2000, the California State Legislature created a statewide program that provides free prostate cancer treatment to low-income, uninsured or underinsured men (IMPACT – Improving Access, Counseling, and Treatment for Californians with Prostate Cancer), modeled after the state's Breast and Cervical Cancer Treatment Program (BCCTP). Despite a similar incidence and mortality rates for breast and prostate cancer in California, these programs were developed with significant differences. Even with an ongoing and documented need for the IMPACT Program, it has been threatened with closure on numerous occasions and continues to face significant challenges in its implementation. This presentation will 1) compare these two programs and discuss how advocacy, gender issues, and health and legislative policy have played a role in their development and funding; and 2) make recommendations for changes to health policy to guide an equitable distribution of health care resources to all vulnerable populations.