About

Dylan H. Roby, PhD, is the chair and professor of health, society, and behavior at UC Irvine. He has over 25 years of expertise in health policy research, reform, and capacity-building, with experience spanning from Capitol Hill to academia. Dr. Roby has dedicated his career to addressing disparities in health care outcomes, focusing his research primarily on the health policy impacts on underserved populations, including those served by public hospitals, community health centers, and Medi-Cal. His research interests include health reform, insurance markets, the passage and implementation of the Affordable Care Act, and related topics. He co-founded and conducts research at the UC Berkeley/UCLA California Simulation of Insurance Markets (CalSIM), an initiative aimed at helping health policy stakeholders and Covered California understand how policy changes may affect different populations through modeling. His work at CalSim has been used to estimate the impact of state-based reforms such as expanding subsidies, reinstating the individual mandate, and expanding Medi-Cal eligibility for undocumented young adults.

Research topics

• Medicine
• Sociology
• Political Science
• Family medicine
• Demography
• Environmental health
• Internal medicine
• Surgery
• Law
• Medical emergency
• Economic growth
• Economics
• Gynecology
• Demographic economics

Selected publications

• Can Adverse Childhood Experiences Screening Promote Health Care Utilization?

  Journal of General Internal Medicine · 2025-07-11

  letterOpen access
  PublisherOA PDFDOI

• Organizational Perspectives on the Public Charge Rule and Health Care Access for Latino Immigrants in California

  Health Services Research · 2025-08-26

  articleOpen access

  OBJECTIVE: To examine how mis- and disinformation about the Public Charge Ground of Inadmissibility final rule ("public charge rule") influences health care access for Latino immigrants in California as seen through the perspectives of leaders in health-serving organizations. STUDY SETTING AND DESIGN: This qualitative study included semi-structured interviews with healthcare and community-based organizational leaders serving Latino immigrants in California. Viswanath et al.'s structural influence model of communication and equity guided the analyses and interpretation of the findings. DATA SOURCES AND ANALYTIC SAMPLE: Between May 2024 and April 2025, primary data were collected from 31 organizations, resulting in 32 semi-structured interviews with 38 participants. Interviews were conducted via Zoom and transcribed verbatim. Researchers coded the data based on recurring themes using Dedoose software. PRINCIPAL FINDINGS: Participants identified the public charge rule as a significant barrier to health care access for Latino immigrants. The policy has discouraged many Latinos from accessing public benefits, particularly the state's Medicaid and Supplemental Nutrition Assistance Program. In addition, immigrants' trusted sources of information (e.g., family, friends, and attorneys) were often misinformed about the policy, which amplified confusion and fear. Organizations respond by providing accurate information and connecting individuals with reliable resources to clarify that using public benefits would not necessarily result in being classified as a public charge. However, most efforts focused on education rather than directly countering mis- and disinformation. CONCLUSIONS: Healthcare and community-based organizations offer unique perspectives as trusted intermediaries who help Latino immigrant families navigate health care and public benefits. Their close daily interactions reveal how misinformation about the public charge rule deters families from accessing essential services and makes it more challenging for organizations to fulfill their missions. These insights underscore the need for culturally responsive outreach and policy solutions that address information gaps and the climate of fear affecting community health.

  PublisherOA PDFDOI

• Public Benefit Avoidance And Safety Concerns Among Mixed-Status Latino Families In California, 2021–22

  Health Affairs · 2025-10-01 · 2 citations

  article

  Many Latino immigrants avoid public benefits because of fears about their immigration status or that of family members, which is heightened by anti-immigration rhetoric. This study used data from the Latino Youth Health Study and the 2021-22 California Health Interview Survey to examine decisions not to apply for noncash public benefits, such as Medicaid, food assistance, and housing subsidies, as well as safety perceptions among income-eligible Latino families in California. We also analyzed differences by parental citizenship and household language. Compared to families with two US citizen parents, families with one or both noncitizen parents were more likely (by 38.4 and 46.7 percentage points, respectively) to avoid applying for benefits because of immigration-related concerns, and such families were also more likely to fear deportation for themselves or a family member or close friend. Spanish-only and bilingual households showed similar patterns. These findings underscore the need for accurate information on public benefit eligibility and immigration policies to ensure that immigrant families can access health care and resources to which they are legally entitled.

  PublisherDOI

• Does Early Life Adversity Limit Delivery of High‐Quality Health Care Among Children?

  Child Care Health and Development · 2025-04-12 · 1 citations

  articleOpen access

  BACKGROUND: Adverse childhood experiences (ACEs) have been associated with poor health and underuse of preventive health services. However, less is known about how ACEs are associated with quality of care that children receive, like care that involves shared decision-making. METHODS: Using data from the 2021-2022 National Survey of Children's Health (n = 47 179) the association between ACEs, both individual and cumulative and (1) needing medical decisions made in the past 12 months and (2) three different measures of always receiving care that involved shared decision-making. Logistic regression models were used to calculate odds of each outcome. Each of the 11 ACEs and the cumulative number of ACEs served as independent variables each in separate models. RESULTS: After accounting for confounders, the number of ACEs experienced, and most individual ACE items were associated with higher odds of needing medical decisions made, and lower odds of receiving health care that involved providers always engaging in the three measures of shared decision-making. CONCLUSIONS: This study expands the research showing a deleterious impact of ACEs on utilization of health care by showing that ACEs are associated with lower quality health care. This can be particularly determinantal to children with a history of ACEs because they have a greater need for health care and are less likely to use many types of health care. Efforts to improve health care quality for all children will be of particular benefit to vulnerable groups, like those with a history of ACEs.

  PublisherOA PDFDOI

• Investments in the Social Safety Net Should Outlast Crises

  American Journal of Public Health · 2025-10-08

  articleOpen access1st authorCorresponding
  PublisherOA PDFDOI

• Equity in Health Care Access, Utilization, and Experiences for Latino Children in California by Parental Citizenship and Household Language, 2021–22

  Academic Pediatrics · 2025-05-22

  articleOpen access

  OBJECTIVE: This study examines health care access, utilization, and experiences among Latino children in California by parental citizenship and household language. METHODS: Merged data from the 2021-22 California Health Interview Survey and the follow-up Latino Youth Health Study of the same years were analyzed. Primary outcomes were parental reports of children's health care access, utilization, and experiences in the past year. The main predictors were variables stratified by parental citizenship status (both citizen parents vs 1 citizen and 1 noncitizen parent or both noncitizen parents) and household language (English-only vs English-and-Spanish, or Spanish-only). Multivariable analyses were adjusted for parental education, family income, parent-reported child's health status, child's age, and child's insurance. RESULTS: Findings showed no significant differences in health care access across groups. However, children with both noncitizen parents and from Spanish-only households were more likely to have had well-child visits and general doctor visits than children with both citizen parents and in English-only households. Additionally, parents of children with both noncitizen parents were more likely to feel respected by doctors than those with both citizen parents. Conversely, compared to parents with both citizen parents, parents of children with 1 citizen and 1 noncitizen parent were less likely to report that doctors spent enough time with their children and less likely to express high satisfaction with their children's health care. CONCLUSIONS: Patterns of health care access, utilization, and experiences among Latino children in immigrant families in California are improving, which are likely associated with recent inclusive health policies in the state.

  PublisherOA PDFDOI

• The American Rescue Plan Act and Access to Health Care for Latinos According to Citizenship Status

  Medical Care · 2024-12-27

  article

  OBJECTIVE: We studied patterns in health care access between Latino and non-Latino White adults according to citizenship status before and after the American Rescue Plan Act (ARPA) of 2021 was enacted to determine whether inequities changed. METHODS: This study used 2019-2022 National Health Survey Interview data. Differences in predicted probabilities from logistic regression models were used to estimate changes in health care access outcomes (any insurance coverage, private insurance coverage, delaying care due to cost, and having a usual source of care) among Latino citizens, Latino noncitizens, and non-Latino White citizens in periods before and after ARPA's enactment (2019-2020 vs 2021-2022). RESULTS: Adjusted models observed that inequities in health care access did not change between Latino and non-Latino White citizens from the 2019-2020 period to the 2021-2022 period. Moreover, the health insurance gap widened by 5.8 percentage points between Latino noncitizens and non-Latino White citizens ( P < 0.01) and by 5.2 percentage points between Latino noncitizens and Latino citizens ( P < 0.05) from the 2019-2020 period to the 2021-2022 period. The private insurance coverage gap widened by 6.8 percentage points between Latino noncitizens and non-Latino White citizens ( P < 0.01) and by 6.9 percentage points between Latino noncitizens and Latino citizens ( P < 0.01) from the 2019-2020 period to the 2021-2022 period. CONCLUSION: ARPA may have helped increase White citizens' insurance coverage, but this benefit did not extend to Latinos, regardless of citizenship status. Developing more inclusive health policies that do not have restrictions based on citizenship and legal authorization status is an important step toward reducing health care inequities.

  PublisherDOI

• Health Care Access and Utilization and the Latino Health Paradox

  Medical Care · 2024-04-08 · 5 citations

  article

  BACKGROUND: The Latino health paradox is the phenomenon whereby recent Latino immigrants have, on average, better health outcomes on some indicators than Latino immigrants who have lived in the United States longer and US-born Latinos and non-Latino Whites. This study examined whether the paradox holds after accounting for health care access and utilization. METHODS: The 2019-2020 National Health Interview Survey data were used. The main predictors included population groups of foreign-born and US-born Latinos (Mexican or non-Mexican) versus US-born non-Latino Whites. Predicted probabilities of health outcomes (self-reported poor/fair health, overweight/obesity, hypertension, coronary heart disease, diabetes, cancer, and depression) were calculated and stratified by length of residence in the United States (<15 or ≥15 years) among foreign-born Latinos and sex (female or male). Multivariable analyses adjusted for having a usual source of care other than the emergency department, health insurance, a doctor visit in the past 12 months, predisposing and enabling factors, and survey year. RESULTS: After adjusting for health care access, utilization, and predisposing and enabling factors, foreign-born Latinos, including those living in the United States ≥15 years, had lower predicted probabilities for most health outcomes than US-born non-Latino Whites, except overweight/obesity and diabetes. US-born Latinos had higher predicted probabilities of overweight/obesity and diabetes and a lower predicted probability of depression than US-born non-Latino Whites. CONCLUSIONS: In this national survey, the Latino health paradox was observed after adjusting for health care access and utilization and predisposing and enabling factors, suggesting that, although these are important factors for good health, they do not necessarily explain the paradox.

  PublisherDOI

• Improving health equity through health care systems research

  Health Services Research · 2023-11-28 · 41 citations

  articleOpen access

  OBJECTIVE: To describe health equity research priorities for health care delivery systems and delineate a research and action agenda that generates evidence-based solutions to persistent racial and ethnic inequities in health outcomes. DATA SOURCES AND STUDY SETTING: This project was conducted as a component of the Agency for Healthcare Research and Quality's (AHRQ) stakeholder engaged process to develop an Equity Agenda and Action Plan to guide priority setting to advance health equity. Recommendations were developed and refined based on expert input, evidence review, and stakeholder engagement. Participating stakeholders included experts from academia, health care organizations, industry, and government. STUDY DESIGN: Expert group consensus, informed by stakeholder engagement and targeted evidence review. DATA COLLECTION/EXTRACTION METHODS: Priority themes were derived iteratively through (1) brainstorming and idea reduction, (2) targeted evidence review of candidate themes, (3) determination of preliminary themes; (4) input on preliminary themes from stakeholders attending AHRQ's 2022 Health Equity Summit; and (5) and refinement of themes based on that input. The final set of research and action recommendations was determined by authors' consensus. PRINCIPAL FINDINGS: Health care delivery systems have contributed to racial and ethnic disparities in health care. High quality research is needed to inform health care delivery systems approaches to undo systemic barriers and inequities. We identified six priority themes for research; (1) institutional leadership, culture, and workforce; (2) data-driven, culturally tailored care; (3) health equity targeted performance incentives; (4) health equity-informed approaches to health system consolidation and access; (5) whole person care; (6) and whole community investment. We also suggest cross-cutting themes regarding research workforce and research timelines. CONCLUSIONS: As the nation's primary health services research agency, AHRQ can advance equitable delivery of health care by funding research and disseminating evidence to help transform the organization and delivery of health care.

  PublisherOA PDFDOI

• The Relationship Between Peripheral Arterial Disease Severity and Socioeconomic Status

  Annals of Vascular Surgery · 2023-02-01 · 4 citations

  article
  PublisherDOI

Frequent coauthors

• Alexander N. Ortega

  53 shared

• Gerald F. Kominski

  UCLA Health

  49 shared

• Nadereh Pourat

  UCLA Health

  32 shared

• Jie Chen

  29 shared

• Héctor E. Alcalá

  21 shared

• David Grande

  University of Pennsylvania

  20 shared

• Ken Jacobs

  16 shared

• Matthew J. O’Brien

  Northwestern University

  16 shared

Education

• Ph.D., Public Health

  University of California, Los Angeles

  2002

• Other, Public Health

  University of California, Los Angeles

  1998

• B.A., Sociology

  University of California, Los Angeles

  1995