Papers by Viviana Martinez-Bianchi
Open Forum Infectious Diseases, 2020
Background: Emerging evidence suggests that Black and Hispanic communities in the United States a... more Background: Emerging evidence suggests that Black and Hispanic communities in the United States are disproportionately affected by coronavirus disease 2019 (COVID-19). A complex interplay of socioeconomic and healthcare disparities likely contribute to disproportionate COVID-19 risk. Methods: We conducted a geospatial analysis to determine whether individual and neighborhood level attributes predict local odds of testing positive for SARS-CoV-2. We analyzed 29,138 SARS-CoV-2 tests within the 6-county catchment area for Duke University Health System from March to June 2020. We used generalized additive models to analyze the spatial distribution of SARS-CoV-2 positivity. Adjusted models included individual-level age, gender, and race, as well as neighborhood level ADI, population density, demographic composition, and household size. Results: Our dataset included 27,099 negative and 2,039 positive unique SARS-CoV-2 tests. The odds of a positive SARS-CoV-2 test were higher for males (OR 1.43, 95% CI 1.30-1.58), Blacks (OR 1.47, 95% CI 1.27-1.70), and Hispanics (OR 4.25, 955 CI 3.55-5.12). Among neighborhood-level predictors, percent Black population (OR 1.14, 95% CI 1.05-1.25) and percent Hispanic population (OR 1.23, 95% CI 1.07-1.41) also influenced the odds of a positive SARS-CoV-2 test. Population density, average household size, and area deprivation index were not associated with SARS-CoV-2 test results after adjusting for race. Conclusions: The odds of testing positive for SARS-CoV-2 were higher for both Black and Hispanic individuals, as well as within neighborhoods with a higher proportion of Black or Hispanic residentsconfirming that Black and Hispanic communities are disproportionately affected by SARS-CoV-2.
Oxford University Press eBooks, May 1, 2019
Chapter 2 asks: what is health equality? It is the attainment of the highest level of health for ... more Chapter 2 asks: what is health equality? It is the attainment of the highest level of health for all people. This so-called “high level” is determined by a mixture of personal responsibility, biology, and the options and possibilities for good health available to each individual. Health equality, the chapter argues, matters from many perspectives and the economic survival of an entire community is affected by health equality. The chapter goes on to look at the issues associated with attaining health equality and how to teach it. It argues for the benefits of having a passion for health for all and a desire to make a difference beyond the confines of health care walls.
North Carolina medical journal, Jul 1, 2021
The Latinx Advocacy Team & Interdisciplinary Network for COVID-19 (LATIN-19), a multisector coali... more The Latinx Advocacy Team & Interdisciplinary Network for COVID-19 (LATIN-19), a multisector coalition, was formed to support the Latina community during the COVID-19 pandemic. Achievements include influencing local and state policies and coordination of efforts by community organizations. The success of this volunteer organization serves as a model for collaboration.
Primary Care, Dec 1, 2019
This article defines population health as the health outcomes of a group of individuals, includin... more This article defines population health as the health outcomes of a group of individuals, including the distribution of such outcomes within the group. Population health includes health outcomes, patterns of health determinants, and policies and interventions that link these two. Attention to social and environmental, as well as medical, determinants of health is essential. The population health lens can be used at the individual, practice, institutional, and community levels. The need for primary care to engage in population health stems from the importance of social and environmental factors, the nature of primary care, and contextual changes.
Primary Care, Sep 1, 2010
Dysuria is urination that is painful or uncomfortable. It is often associated with increased urin... more Dysuria is urination that is painful or uncomfortable. It is often associated with increased urinary frequency, abnormally frequent urination, or urgency, an abrupt, strong, often overwhelming need to urinate. The most common cause of dysuria is urethral or bladder inflammation, often because of infection. Patients with acute dysuria have symptoms of short duration, usually a few days, often associated with frequency and urgency. Most of these patients have an infection. Table 1 shows the causes of dysuria in four categories: gynecologic, urological, inflammatory, and miscellaneous. Chronic dysuria is defined as pain with urination that has been continuous or recurrent for at least 6 months. It is closely tied to chronic pelvic pain syndrome in women, and prostatodynia (chronic prostate pain) in men. Associated symptoms include allodynia (nonpainful stimuli are perceived as painful) and hyperalgesia (painful stimuli are perceived as more painful than expected). Chronic dysuria is associated with changes in the central nervous system (CNS) that may maintain the perception of pain in the absence of acute injury. 1 The various causes of chronic dysuria are shown in Table 2. PAINFUL BLADDER SYNDROME AND INTERSTITIAL CYSTITIS Painful bladder syndrome (PBS) is a chronic disease of unknown etiology. PBS presents with chronic pelvic pain, nocturia, increased urinary frequency, and urgency. 2 The International Continence Society (ICS) defines PBS as ''the complaint of suprapubic pain related to bladder filling, accompanied by other symptoms such as increased daytime and night-time frequency, in the absence of proven urinary infection or other obvious pathology.'' 3 The European Society for the Study of Bladder Pain Syndrome/ Interstitial Cystitis calls the disease bladder pain syndrome (BPS), including a history of more than 6 months of pelvic pain, pressure, or discomfort perceived to be related
BMJ Global Health, Jul 1, 2019
Open Forum Infectious Diseases, Sep 8, 2020
Background. Emerging evidence suggests that black and Hispanic communities in the United States a... more Background. Emerging evidence suggests that black and Hispanic communities in the United States are disproportionately affected by coronavirus disease 2019 (COVID-19). A complex interplay of socioeconomic and healthcare disparities likely contribute to disproportionate COVID-19 risk. Methods. We conducted a geospatial analysis to determine whether individual-and neighborhood-level attributes predict local odds of testing positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We analyzed 29 138 SARS-CoV-2 tests within the 6-county catchment area for Duke University Health System from March to June 2020. We used generalized additive models to analyze the spatial distribution of SARS-CoV-2 positivity. Adjusted models included individual-level age, gender, and race, as well as neighborhood-level Area Deprivation Index, population density, demographic composition, and household size. Results. Our dataset included 27 099 negative and 2039 positive unique SARS-CoV-2 tests. The odds of a positive SARS-CoV-2 test were higher for males (odds ratio [
The Journal of Urology, Apr 1, 2016
The Journal of Urology, Apr 1, 2016
Progress in Community Health Partnerships: Research, Education, and Action
The Latinx (used as a gender inclusive term when referring to people who have identified as Hispa... more The Latinx (used as a gender inclusive term when referring to people who have identified as Hispanic, Latino or Latina) community in the United States has experienced a higher case volume and death rate from COVID-19 (the disease caused by the severe acute respiratory syndrome coronavirus 2) than the non-Latinx White community. 3,4 In addition, Latinx individuals have been among those most affected by the socioeconomic consequences of the pandemic, such as losing employment
Atención Primaria, 2021
La 74ª Asamblea Mundial de la Salud aprobó en mayo del 2021 el «Plan de acción mundial para la se... more La 74ª Asamblea Mundial de la Salud aprobó en mayo del 2021 el «Plan de acción mundial para la seguridad del paciente 2021-2030» con el fin de potenciar la seguridad de este como un componente esencial en el diseño, los procedimientos y la evaluación del desempeño de los sistemas de salud de todo el mundo. Se trata de un plan estratégico que orienta a los gobiernos de los países, a las entidades del sector salud, a las organizaciones sanitarias y a la secretaría de la Organización Mundial de la Salud, sobre cómo aplicar la resolución concerniente a la seguridad del paciente de la Asamblea. El despliegue del plan reforzará la calidad y la seguridad de los sistemas de salud en todo el mundo, abarcando todo el proceso de atención a la salud de las personas, desde el diagnóstico hasta el tratamiento y los cuidados sanitarios, reduciendo la probabilidad de causar daño en el curso de la atención recibida. La Declaración de la Conferencia mundial sobre atención primaria de salud en Astaná en 2018, instó a los países a fortalecer sus sistemas de atención primaria como paso esencial para lograr la cobertura sanitaria universal y dar acceso a una atención segura y de calidad sin menoscabo económico. Por ello, el despliegue del plan estrategico de seguridad del paciente en atención primaria constituye una acción de política sanitaria de alta prioridad. El plan de acción está estructurado en siete objetivos estratégicos con 35 acciones. En este documento, presentamos un análisis de las acciones estratégicas para las organizaciones sanitarias y los retos futuros para su implementación específica en los centros de atención primaria.
Primary care, 2014
Universal screening for prostate cancer (Pca) using prostate-specific antigen-based testing is no... more Universal screening for prostate cancer (Pca) using prostate-specific antigen-based testing is not recommended, as the potential harms of screening (overdiagnosis and overtreatment) outweigh potential benefits. The case for Pca screening requires a paradigm shift, which emphasizes the risks of screening over the risks of undetected cancer. Physicians are encouraged to use shared decision making with patients who express an interest in Pca screening, taking into account both the patient's screening preferences and individual risk profile. New models of care informed by the Patient Protection and Affordable Care Act are intended to assist clinicians in providing recommended preventive services.
Health Equity
Introduction: The purpose of this study is to identify forms of systemic racism experienced by La... more Introduction: The purpose of this study is to identify forms of systemic racism experienced by Latinx communities in North Carolina during the COVID-19 pandemic as identified by Latinx community health workers (CHWs) and community-based organization (CBO) leaders. Methods: We conducted three focus groups in July 2022 (N = 16). We performed qualitative analysis of data using an iterative inductive approach of the original language in Dedoose. Results: Four central themes emerged: (1) Access to resources for Latinx individuals; (2) Immediate, transitional, and future fears; (3) Benefits of CHWs; and (4) Lessons learned. Discussion: Institutional and state policies often do not involve community members, such as CHWs and CBO leaders, at the start of the development process, leading to ineffective interventions that perpetuate health disparities and systemic racism. Health Equity Implications: Community-informed policy recommendations can improve alignment of community and policy priorities to create more effective interventions to address systemic racism and promote health equity.
North Carolina Medical Journal, 2021
The Latinx Advocacy Team & Interdisciplinary Network for COVID-19 (LATIN-19), a multisector coali... more The Latinx Advocacy Team & Interdisciplinary Network for COVID-19 (LATIN-19), a multisector coalition, was formed to support the Latina community during the COVID-19 pandemic. Achievements include influencing local and state policies and coordination of efforts by community organizations. The success of this volunteer organization serves as a model for collaboration.
North Carolina Medical Journal, 2021
The COVID-19 pandemic did not create health disparities among African American, Latinx, and Ameri... more The COVID-19 pandemic did not create health disparities among African American, Latinx, and American Indian populations, but it illuminated ways that systemic and long-term structural inequities create cumulative disadvantages for historically marginalized populations. This article highlights strategies implemented by the Historically Marginalized Populations Workgroup of the North Carolina Department of Health and Human Services to mitigate COVID-19's impact.
Family Medicine, 2019
Achieving health equity requires an evaluation of social, economic, environmental, and other fact... more Achieving health equity requires an evaluation of social, economic, environmental, and other factors that impede optimal health for all. Family medicine has long valued an ecological perspective of health, partnering with families and communities. However, both the quantity and degree of continued health disparities requires that family medicine intentionally work toward improvement in health equity. In recognition of this, Family Medicine for America’s Health (FMAHealth) formed a Health Equity Tactic Team (HETT). The team’s charge was to address primary care’s capacity to improve health equity by developing action-oriented approaches accessible to all family physicians. The HETT has produced a number of projects. These include the Starfield II Summit, the focus of which was “Primary Care’s Role in Achieving Health Equity.” Multidisciplinary thought leaders shared their work around health equity, and actionable interventions were developed. These formed the basis of subsequent work ...
Family medicine, 2016
Die Zahl der radikalen Prostataektomien (RPE) ist in den letzten Jahrzehnten -infolge der Entdeck... more Die Zahl der radikalen Prostataektomien (RPE) ist in den letzten Jahrzehnten -infolge der Entdeckung des prostataspezifischen Antigens (PSA) -massiv gestiegen. Eine schwedische Studie spricht von einer 25-fachen Steigerung zwischen 1988 und 2008 [1]. Die Ärzte stellen die OP-Indikation für eine RPE seit ein paar Jahren zwar wieder deutlich vorsichtiger, dennoch lag 2012 die OP-Rate in Deutschland bei rund 25.000 [2]. Und auch wenn die OP-Techniken mittlerweile schonender sind, leiden zwischen 3 und 69 Prozent der Männer post-OP an einer Belastungsinkontinenz. Die Zahlen variieren stark, je nachdem wie Kontinenz defi niert wurde und ob Patient oder Operateur befragt wurde [3-5]. Klassisches Beckenbodentraining ist unzureichend → Physiotherapie ist bei Belastungsinkontinenz unverzichtbar. Das unterstreicht das Therapie | Belastungsinkontinenz physiopraxis 10/16 Dieses Dokument wurde zum persönlichen Gebrauch heruntergeladen. Vervielfältigung nur mit Zustimmung des Verlages.
The Journal of Urology, 2016
The Journal of Urology, 2016
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Papers by Viviana Martinez-Bianchi