Community Focus on Improving Health Inequities in Latinx Population Leads to an Increase in COVID-19 Vaccinations

As Director for Health Equity in the Department of Family Medicine and Community Health at Duke University and an American Board of Family Medicine (ABFM) board-certified, practicing family physician, Dr. Viviana Martinez-Bianchi anticipated a need in her North Carolina community and saw many opportunities unfold as the world came to grips with COVID-19.

She mobilized resources and joined with colleagues and community members to create the “Latinx Advocacy Team & Interdisciplinary Network for COVID-19.” Widely known as “LATIN-19,” this multisector coalition was initially formed to support the Latinx community during the COVID-19 pandemic.

In March 2020, Dr. Martinez-Bianchi, and her colleague, pediatrician Dr. Gabriela Maradiaga Panayotti, began convening weekly meetings with multisector stakeholders interested in addressing the community’s anticipated needs because of the pandemic. They convened health system professionals, community-based professionals and organizations, and concerned people to expand conversations about gaps in health care access and education for Hispanic/Latinx patients, address community needs with appropriate resources, and advocate for change to better align care delivery models to underserved communities.

The rapid learning environment that LATIN-19 created turned from simply sharing information about these needs to actively coordinating care delivery to reduce disparities in care. One year into their work, Dr. Martinez-Bianchi and her colleagues sought to increase COVID-19 vaccinations in the Latinx community by 30%. They collaborated with hospital systems, health departments, and community and faith-based organizations to host vaccination events that were uniquely tailored to the needs and preferences of this diverse community.

They included cultural music and visited locations trusted by the people they were trying to reach. At one follow-up event for the second vaccine, they offered other primary preventive services such as fecal occult blood kits, testing for high cholesterol, diabetes, and hypertension, along with oral and vision screenings. The result: COVID-19 vaccinations among Hispanic/Latinx in the county increased from 2% to 67%, reaching the highest percentage of peopled vaccinated by ethnicity!

Using this experience, Dr. Martinez-Bianchi selected ABFM’s COVID-19 Self-Directed Performance Improvement (PI) activity to meet her ABFM PI requirement by telling the story of how LATIN-19 intervened where there was a need to create more equitable and improved care delivery. She encourages other family physicians to not overthink the performance improvement process. “It’s an opportunity to show people how you can actually record, report, and get credit for work you’re already doing,” says Dr. Martinez-Bianchi.

As a Latina, who’s been practicing family medicine in the US for 30 years, Dr. Martinez-Bianchi has advocated for Hispanic/Latinx communities since her career began.

“I’ve always been calling for attention to the community’s needs and strengths. ‘Hey this is happening to my community,’” says Dr. Martinez-Bianchi.

“Before there was some pushback, but now policy makers and health industry leaders are hearing directly from those who are suffering and realizing changes need to be made.” There is now wider recognition across the state of the structural factors that lead to inequities affecting vulnerable communities, and LATIN-19 continues to see new initiatives to target those inequities.

Dr. Martinez-Bianchi hopes LATIN-19 will serve as a model for other teams with similar missions, with the overarching goal of reaching health equity in North Carolina and far beyond.

“I never dreamed that the work of LATIN-19 would be so impactful. We got it started and then suddenly made a huge difference by influencing local and state decisions on testing and vaccination access. This community was so marginalized, and now we are collectively fighting for health equity,” says Dr. Martinez-Bianchi.

“There is still much to do,” she continues. “Not only is the pandemic not over, but there are multiple epidemics that affect the community. With so many partners listening and learning from the community, we hope to not only continue to recognize problems, but also reach for solutions and improve health.”