The overall goal was to identify modifiable factors that influence racial disparities in prostate cancer outcomes and hypothesized that the quality of treatment received and the health related quality of life of prostate cancer patients will differ according to race and access to healthcare, even after accounting for patient and disease characteristics, type of primary treatment and other factors. Multilevel contextual models were used to estimate effects of individual and community-level healthcare access (including health insurance) on treatment quality and health related quality of life after accounting for disease characteristics, age, comorbidity, type of primary treatment, time since diagnosis and other factors.