About

Viviana Sandra Martinez-Bianchi is a Professor in the Department of Family Medicine and Community Health at Duke University. She is associated with the Family Medicine Center, Picken, located at 3886 DUMC in Durham, North Carolina. Her role involves teaching, research, and community health initiatives within the department, contributing to the academic and clinical missions of Duke University School of Medicine.

Research topics

• Political Science
• Medicine
• Nursing
• Computer Science
• Environmental health
• Public relations
• Engineering
• Psychology
• Family medicine
• Medical education
• Demography
• Management
• Marketing
• Geography
• Economic growth
• Business
• Internal medicine
• Gerontology

Selected publications

• Medicaid Is an Important Driver of a Healthier North Carolina, But Not Enough to Dismantle Persistent Health Inequities

  North Carolina Medical Journal · 2025-12-23

  articleOpen access1st authorCorresponding

  Medicaid expansion has improved coverage for low-income North Carolinians, but persistent racial and geographic inequities limit its impact. Despite early gains and innovative social-care pilots, Black and Hispanic communities continue to face barriers to access, continuity, and outcomes. Lasting improvement will require sustained investment in primary care, navigation support, and the social factors that shape health.

  PublisherOA PDFDOI

• Revisiting the Essence of Global Health Partnerships in Family Medicine

  Family Medicine · 2025-05-01 · 1 citations

  articleOpen access
  PublisherOA PDFDOI

• Caring for the caregivers: a global imperative for family doctors’ wellbeing

  The Lancet Primary Care · 2025-08-01 · 1 citations

  articleOpen accessSenior author
  PublisherOA PDFDOI

• Family and community medicine workforce training and practice in the Americas

  Revista Panamericana de Salud Pública · 2025-12-30

  articleOpen access

  Objectives: This study sought to analyze the current state of the training for and practice of family medicine and family and community medicine to identify gaps and opportunities to implement strategic actions to strengthen the health workforce. Methods: This paper reports the results of an observational, analytical, cross-sectional study carried out in countries in the World Health Organization's Region of the Americas in 2024. A 22-item survey was administered to members of professional associations of family medicine and family and community medicine practitioners, and a 12-item survey was administered to specialists in this field. Nineteen professional associations and 291 specialists took part in the study. The data were analyzed using descriptive statistics and content analysis. Results: Training in family medicine and family and community medicine is primarily conducted through specialization (68.4%, 13/19) and residency programs (63.2%, 12/19), and a competency exam is required in 63.2% (12/19) of the 23 countries included in the study, represented by 19 professional associations. Training programs cover topics relevant to professional practice, but progress needs to be made, especially in addressing emerging topics. There are few opportunities for continuing education, as reported by 53.7% (29/54) of specialists in Central America, the Latin Caribbean and Mexico, and 35.0% (79/226) in South America. There is a gap in actions aimed at improving working conditions, with policies for well-being and retention implemented in only 36.8% (7/19) of the countries. In addition, responses to open-ended questions indicated that many professionals had a heavy workload, and that their jobs were insecure and precarious, as well as that remuneration was incompatible with their functions, that infrastructure was inadequate, and there was a lack of resources for practice. Despite sampling limitations related to the non-probabilistic design of the study and the unequal participation among countries, it nonetheless provides valuable evidence about training and practice in family and community medicine in the Region of the Americas. Conclusions: Although the practice of family medicine and family and community medicine has been established for more than three decades in the Region, the field faces significant implementation challenges. Strategic investments are needed to strengthen the recognition and perceived value of family and community medicine as a specialty, ensure adequate working conditions and improve the quality of education. Strengthening family and community medicine by undertaking coordinated actions across multiple stakeholders is crucial for building resilient health systems grounded in primary health care.

  PublisherDOI

• Write LIFE: Start Writing Without a Research Project

  Family Medicine · 2025-06-03

  articleOpen access
  PublisherOA PDFDOI

• Models of global primary care post-2030

  The Lancet Primary Care · 2025-08-21 · 4 citations

  reviewOpen access

  Primary care is currently a central focus in global health policy; however, renewed attention has not translated into the investment needed to build systems that are fit for the future. As 2030 approaches, many health systems are converging towards primary care models that provide community-based, first-contact access, but they omit the other core functions of comprehensiveness, continuity, and coordination. In this Viewpoint, we argue that these primary care lite models are ill-equipped to manage the increasing burden of multimorbidity; harness technological disruption; and reduce health inequities. We propose a new trajectory towards hybrid models of care that anchor community-oriented outreach workers within multidisciplinary teams that are trained in family medicine. Although artificial intelligence and digital tools can magnify impact and reach, we warn that their uninformed adoption could create digital gatekeepers and deepen disparities. To future-proof primary care, policy makers should invest in integrated models that deliver robust, equitable, and person-centred care that is needed to meet future challenges.

  PublisherDOI

• Ethical Considerations and Recommendations for Humanizing Immigrant Language in Health Equity Data Collection, Reporting, and Measurement

  UNC Libraries · 2025-06-05

  articleOpen access

  Collecting accurate and consistent sociodemographic data is needed to improve health measurement and public health interventions. Missing or inaccurate data hinders the adequate assessment of the state of access, quality, and coverage in the overall population and communities experiencing social marginalization. Health measurement requires data labels that humanize all populations living, working, and residing across the United States and territories. Humanization is fundamentally grounded in the concepts of human dignity and ethical identity integrity. An often-overlooked form of exclusion in health care is the long-standing use of dehumanizing language, including its use in health measurement and data collection efforts, to refer to immigrant populations. In this perspective, we delineate ethical concerns regarding the use of dehumanizing language when referring to immigrant populations. We provide recommendations for health providers, researchers, and policy makers in improving humanizing language in health equity data collection and reporting through engagement of community experts, use of alternative language, implementation, and monitoring.

  PublisherDOI

• No Data, No Problem: Quantifying Latine Individuals Eligible for but Not Enrolled in Medicaid or Affordable Care Act Marketplace‐Based Insurance in North Carolina

  Milbank Quarterly · 2025-06-30 · 2 citations

  articleOpen access

  Policy Points Latine communities in the United States experience disproportionately high uninsurance rates because of systemic barriers, including limited language equity, lack of provider (clinical or nonclinical) concordance, discrimination, misinformation, and immigration-related fears. Data on individuals eligible for but not enrolled in insurance programs are lacking, which prevents the identification of barriers, population impacted, and tailored approaches to meet specific needs of vulnerable communities. We propose community-informed policy strategies, including culturally tailored outreach, involvement of trusted community health workers, and improved health equity data collection. Framing data in terms of eligible but not enrolled individuals shifts the focus to existing coverage gaps and the potential for improvement, encouraging states to take more proactive enrollment actions.

  PublisherOA PDFDOI

• Ethical Considerations and Recommendations for Humanizing Immigrant Language in Health Equity Data Collection, Reporting, and Measurement

  Health Equity · 2025-05-27 · 1 citations

  articleOpen accessSenior author

  Collecting accurate and consistent sociodemographic data is needed to improve health measurement and public health interventions. Missing or inaccurate data hinders the adequate assessment of the state of access, quality, and coverage in the overall population and communities experiencing social marginalization. Health measurement requires data labels that humanize all populations living, working, and residing across the United States and territories. Humanization is fundamentally grounded in the concepts of human dignity and ethical identity integrity. An often-overlooked form of exclusion in health care is the long-standing use of dehumanizing language, including its use in health measurement and data collection efforts, to refer to immigrant populations. In this perspective, we delineate ethical concerns regarding the use of dehumanizing language when referring to immigrant populations. We provide recommendations for health providers, researchers, and policy makers in improving humanizing language in health equity data collection and reporting through engagement of community experts, use of alternative language, implementation, and monitoring.

  PublisherDOI

• We Are Not All the Same: Implications of Heterogeneity Among Latiné/e/x/o/a, Hispanic, and Spanish Origin People

  The Annals of Family Medicine · 2024-05-01 · 11 citations

  articleOpen access

  There is great variation in the experiences of Latiné/e/x/o/a, Hispanic, and/or Spanish origin (LHS) individuals in the United States, including differences in race, ancestry, colonization histories, and immigration experiences. This essay calls readers to consider the implications of the heterogeneity of lived experiences among LHS populations, including variations in country of origin, immigration histories, time in the United States, languages spoken, and colonization histories on patient care and academia. There is power in unity when advocating for community, social, and political change, especially as it pertains to equity, diversity, and inclusion (EDI; sometimes referred to as DEI) efforts in academic institutions. Yet, there is also a critical need to disaggregate the LHS diaspora and its conceptualization based on differing experiences so that we may improve our understanding of the sociopolitical attributes that impact health. We propose strategies to improve recognition of these differences and their potential health outcomes toward a goal of health equity.

  PublisherOA PDFDOI

Frequent coauthors

• Kim Yu

  50 shared

• Christina Kelly

  Twitter (United States)

  50 shared

• Sarah Davis

  Walker (United States)

  49 shared

• Brian Frank

  Oregon Health & Science University

  49 shared

• Michael Rodríguez

  Campbell University

  49 shared

• Jay W. Lee

  Palomar Health

  49 shared

• Jennifer Edgoose

  49 shared

• Ronna D. New

  McGill University

  49 shared