About

Héctor E. Alcalá is an Assistant Professor at the University of Maryland School of Public Health, within the Department of Behavioral and Community Health. His research focuses on understanding health inequities, particularly around race, ethnicity, sexual orientation, religion, nativity, and generation. He examines the impact of Adverse Childhood Experiences (ACEs) on cancer, cancer screening, and healthcare utilization, as well as the use of tobacco products. Additionally, his work explores the effects of discrimination on health and healthcare utilization. Dr. Alcalá holds a PhD in Public Health from UCLA Fielding School of Public Health, earned in 2015, an MPH in Community Health Sciences from UCLA in 2011, and a BA in Psychology and Political Science from UCLA in 2009.

Research topics

• Sociology
• Medicine
• Demography
• Political Science
• Environmental health
• Obstetrics
• Psychology
• Geography
• Internal medicine
• Gerontology

Selected publications

• The burden of bias: Patient experiences and providers’ perspectives on weight bias

  Obesity Pillars · 2026-02-19

  articleOpen access

  Weight bias is pervasive, occurs in a variety of contexts, and is associated with a range of suboptimal outcomes, including delays or avoidance in seeking health care, misdiagnosis, and denial of services. The aim of this study was to quantitatively describe the relationship between experiences of weight bias and eating behaviors of patients in a lifestyle medicine program and qualitatively describe healthcare providers’ insights about weight bias. This study utilized an explanatory sequential design that drew on one-time survey data collected from 109 patients of a Plant-Based Lifestyle Medicine (PBLM) Program in New York City in 2019. Ordinary Least Squares and logistic regression models examined the association between weight bias and healthful plant-based eating and emotional eating after adjusting for sociodemographic characteristics. Qualitative data come from asynchronous interviews with five healthcare providers from the PBLM program completed in 2024 which were analyzed using rapid coding. Survey participants were on average 53 years old, 67.0% female, 68.6% Black, Indigenous, and other people of color (BIPOC), and 56.2% reported experiencing weight bias. Weight bias was associated with 4.07 fewer points on the healthful plant-based eating measure (95%CI: -6.86, -1.27), and participants had 5.06 times the odds (95%CI: 1.76, 14.59) of emotional eating compared to those not reporting weight bias. Interview themes were: (1) Weight bias negatively influences patient lives, (2) Weight bias is negatively associated with patients’ mental health, (3) Promising weight-inclusive approaches, and (4) Recommendations for providers to address weight bias. Experiences of weight bias were associated with suboptimal eating behaviors and poor mental health. Providers observed their patients experience harm in connection with weight bias, suggested weight-inclusive approaches, and identified recommendations that would mitigate weight bias in healthcare environments including routinely screening for weight bias, training providers on weight inclusive care, incorporating mental health services into care teams, and creating size inclusive spaces. This study demonstrates that weight bias is linked to deleterious outcomes and the importance of weight-inclusive care delivery and environments. • Our study revealed that weight bias is commonly experienced by patients and negatively impacts their eating behaviors and mental health. • Lifestyle medicine providers identified strategies for programs and providers to implement weight-inclusive practice in healthcare settings, including addressing patient concerns, deemphasizing weight loss in favor of healthful behaviors, focusing on achievable steps/goals, and encouraging self-compassion with patients. • Recommendations for reducing weight bias in healthcare settings, including enhanced training for providers on non-stigmatizing, patient-centered care; inclusion of mental health professionals in the care team; formal assessment of patients for experiences of weight bias; and creating size-inclusive environments may encourage the adoption of health promoting behaviors among patients.

  PublisherDOI

• Responsible laboratory surveillance of pediatric patients with inflammatory bowel disease on biologic infusion therapy

  JPGN Reports · 2026-02-12

  articleOpen access

  The annual healthcare spending on pediatric inflammatory bowel disease (IBD) has increased over time. The objectives of the study were to investigate the cost of routine laboratory surveillance in pediatric IBD patients during outpatient maintenance biologic infusions and determine their impact on clinical management. We performed a retrospective chart review between June 30, 2020 and July 1, 2021 of subjects aged 0-21 years with IBD receiving maintenance biologic infusions at Stony Brook Children's Hospital (SBCH). Thirty-four subjects met the inclusion criteria. A total of 248 lab sets/infusions were reviewed during the study window. The average hospital charge for studies obtained per infusion was $1308.36 ± $136.66 with an average annual cost of $9543.44 ± $1885.44 per patient. Fifteen (6%) instances of change in clinical management were found. Our study suggests routine laboratory surveillance during infusions does not affect clinical management and may represent excess financial spending.

  PublisherOA PDFDOI

• Selected Teen-Reported Adverse Childhood Experiences (ACEs) and Mental Health Care Use

  Academic Pediatrics · 2025-10-28

  articleOpen accessSenior author
  PublisherOA PDFDOI

• Can Adverse Childhood Experiences Screening Promote Health Care Utilization?

  Journal of General Internal Medicine · 2025-07-11

  letterOpen access1st authorCorresponding
  PublisherOA PDFDOI

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

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

  articleOpen access1st authorCorresponding

  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

• Pediatric Gastroenterologists' Practice Styles and Compliance With European/North American Helicobacter pylori Guidelines

  Cureus · 2025-12-20

  articleOpen access

  Objective This study aims to determine pediatric gastroenterologists’ adherence to the management, diagnosis, and treatment of Helicobacter pylori (H. pylori) per the joint European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN)/North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) guidelines for H. pylori in children (update 2016). Methods A survey was sent to the pediatric gastroenterology listserv to assess the knowledge of guidelines, workup, and treatment of H. pylori infection. The survey was open to respondents between 4/13/2022 and 5/12/2022. Results A total of 302 individuals completed the survey, representing 25 countries. The most ordered test for H. pylori was the stool antigen test (n = 151, 56.62%), followed by upper endoscopy (n = 97, 32.12%). Based on positive non-invasive test, 123 (40.72%) providers would never or not often treat H. pylori. Most providers treat H. pylori on histopathology in the absence of peptic ulcer disease. The majority of providers did not send H. pylori susceptibility testing. Most waited for the appropriate time after discontinuing antibiotics/anti-acid medication prior to testing for H. pylori. In the absence of susceptibility testing, 121 (40.5%) providers utilized proton pump inhibitors, amoxicillin, and clarithromycin to treat H. pylori compared to 79 (26.4%) providers who utilized proton pump inhibitors, high-dose amoxicillin, and metronidazole. Conclusion Areas where gastroenterologists adhere to the 2016 guidelines include waiting time after stopping antibiotics/anti-acid therapy and testing for eradication. Pediatric gastroenterologists had less adherence with the use of non-invasive testing for the diagnosis of H. pylori, treatment based on non-invasive test, diagnosis of H. pylori by endoscopy, utilizing culture and susceptibility testing, and antibiotic regimen used to treat H. pylori. Our survey results indicate that pediatric gastroenterologists require further education, especially now that the updated 2024 guidelines have been released.

  PublisherOA PDFDOI

• 9. Resisting the Disentanglement of Race and Religion in Public Health: How the Racialization of Religion Impacts Health

  American Public Health Association eBooks · 2024-01-01

  book-chapter
  PublisherDOI

• “They Don’t Care If We Live or Die”: A Qualitative Analysis Examining the US Immigration System’s Treatment of Undocumented Communities during the COVID-19 Pandemic

  Ethnicity & Disease · 2024-01-01 · 1 citations

  articleOpen access

  Historically, the US immigration system (ie, institutions, agencies, and laws) has served the goals and principles of white supremacy through its treatment of globally displaced people and this appears to have continued through the COVID pandemic. Yet, the implications for immigrant health are not routinely addressed in mainstream public health discourse, and especially so in regard to public health disasters. This study conducted a series of focus groups with participants from social justice organizations working with immigrants, migrants, undocumented persons, refugees, persons seeking asylum, and persons detained in immigration jails to collect stories on how the immigration system undermined efforts to control the spread of COVID-19 and exacerbated health inequity within immigrant jails and across related community contexts during the pandemic. Focus groups were conducted to explore issues related to immigrants and immigration detention during the COVID-19 pandemic. There was a total of N=14 participants across the 4 focus groups with a dedicated focus group on perspectives of Black immigrants/from Black immigrant organizations only. Each focus group consisted of 3 to 4 participants. Five key themes emerged: 1) dehumanization of immigrants and migrants and devaluation of their lives; 2) inhumane conditions of confinement that propagate risk of disease; 3) denial of resources for COVID-19 prevention and mitigation; 4) expansion of intersecting oppressive systems; and 5) community-based resistance and mobilization against immigration policies and enforcement. Our findings highlight the harms from policing, criminalization, and exclusion that racialized communities face as a result of the (in)actions within the immigration system during a public health disaster including the COVID context.

  PublisherOA PDFDOI

• Pediatric Traumatic Brain Injury Outcomes and Disparities During the COVID-19 Pandemic

  Journal of Pediatric Surgery · 2024-02-01 · 7 citations

  article
  PublisherDOI

• Disparities in Screening for Adverse Childhood Experiences

  The Journal of the American Board of Family Medicine · 2024-01-01 · 4 citations

  articleOpen access1st authorCorresponding

  INTRODUCTION: Screening for adverse childhood experiences (ACEs) in the clinical setting is set to become more commonplace with continued efforts to reimburse clinicians for screening. However, an examination of disparities in ACEs screening and related attitudes and beliefs is needed. METHODS: Using the 2021 California Health Interview Survey (CHIS), this study examined if several measures of socioeconomic status, access to care and identities were associated with 3 outcomes: 1) getting screened for ACEs by a clinician; 2) beliefs about the importance of screening and 3) satisfaction with efforts to address the impacts of ACEs. Logistic regressions were used to estimate odds of the outcomes. RESULTS: Black, Latinx, and Asian individuals had lower odds of being screened for ACEs than non-Hispanic Whites. A recent doctor's visit, higher burden of ACEs, and serious psychological distress were associated with higher odds of being screened. Latinx individuals, women, bisexual individuals, those with a recent doctor's visit and those with serious psychological distress had higher odds of believing clinicians asking about ACEs was very important, relative to their counterparts. Latinx individuals, American Indian or Alaska native individuals, Asian individuals, those with higher educational attainment and those with serious psychological distress had lower odds of being very satisfied with providers' efforts to address the impact of ACEs, relative to their counterparts. CONCLUSIONS: Efforts to expand ACEs screening should consider the disparities in screening that currently exist. Given the wide-ranging impacts that ACEs have on health, an equitable approach to screening is necessary.

  PublisherOA PDFDOI

Frequent coauthors

• Alexander N. Ortega

  31 shared

• Mienah Z. Sharif

  University of Washington

  27 shared

• Amanda E. Ng

  21 shared

• Dylan H. Roby

  University of California, Irvine

  21 shared

• Brent A. Langellier

  Drexel University

  15 shared

• Nicholas Tkach

  New York Institute of Technology

  15 shared

• Goleen Samari

  Columbia University

  14 shared

• Jie Chen

  13 shared