Análise da tendência da mortalidade feminina por agressão no Brasil, estados e regiões

A classification model for municipalities in the paraense Amazon regarding the risk of violence against women: A multicriteria approach

Violence against women (VAW) is a serious violation of the rights to life, health, and physical integrity. Recent studies point out that social, economic, and demographic factors directly impact the advance of this type of violence. In view of these facts, the state has its responsibility increased when it cannot provide the public equipment necessary for management strategies that collaborate with the confrontation of violence. This project aims to develop a multicriteria decision analysis model (MCDA) to classify Pará municipalities with regard to the propensity for VAW crime, based on the mapping of assistance and protection equipment, as well as socioeconomic indicators of each municipality. The model developed and the research findings represent an important step in elaboration. In turn, this model demonstrates its ability to be a possible instrument that decision makers and implementers of public policies aimed at protecting and supporting women victims of violence in order to anticipate new occurrences.

Spatial modeling of homicide mortality in the Northeast region of Brazil

OBJECTIVE

To analyze the spatiotemporal distribution of homicide mortality and association with social determinants of health in the Northeast Region of Brazil.

METHODS

Ecological study with spatiotemporal modeling of homicide deaths between 2000 and 2019. Temporal trends were analyzed by segmented linear regression. Crude mortality was calculated and adjusted by smoothing the local empirical Bayesian method and analyzed by the Global/Local Moran Index and spatiotemporal scan statistics. The association between social determinants of health and homicide mortality was performed using multiple linear regression and autoregressive spatial models.

RESULTS

353,089 deaths were recorded. Mortality increased from 2000 to 2019, with an annual increase of 4.37 in males and 3.57 in females. High risk spatial and spatiotemporal clusters were identified in the coastal region of the states. The spatial regression model showed an association with socioeconomic inequalities.

CONCLUSIONS

High risk areas for homicides associated with socioeconomic inequality, which should be considered as a priority for designing and investing in public health policies were investigated.

Time trend and spatial distribution of the cases of lethal violence against women in Brazil

OBJECTIVE

to analyze the time trend and the spatial distribution of the cases of lethal violence against women in Brazil, according to age group and to race/skin color.

METHOD

an ecological study of time series, with spatial distribution of the deaths of women victims of aggression, registered in the Mortality Information System, resident in Brazil, Brazilian geographic regions and states. Due to underreporting of deaths in some states, correction factors of the mortality rates were employed. For the trend analysis, we adopted the polynomial regression model. In addition to that, the mean rates and annual upward/downward trends were distributed considering the Brazilian federative units as analysis units.

RESULTS

the mean rate was 6.24 cases of lethal violence per 100,000 women, with a significant variation across the Brazilian regions and states. The main victims of violent death in Brazil are young, black-/brown-skinned and indigenous women, with a growing trend in these population segments. The North and Northeast regions stood out with the most significant mean annual increases (0.33; r2= 0.96 and 0.26; r2= 0.92, respectively).

CONCLUSION

there was a stable trend regarding lethal violence against women, with significant regional differences. Young, black-/brown-skinned and indigenous women are more vulnerable to violent death in Brazil.

Trend of incompleteness of cancer death records in the Mortality Information System database, state of Mato Grosso, Brazil, 2000 to 2016

OBJECTIVE

To describe the trend of incompleteness of cancer death records in the Mortality Information System (SIM, in Portuguese) database, state of Mato Grosso, Brazil, 2000 to 2016.

METHODS

This is a descriptive, ecological, time series study of records of death from cancer of people living in the state of Mato Grosso (codes C00 to C97 of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems - ICD-10), collected from SIM. To asses incompleteness in the filling of the variables of race/skin color, education, marital status, occupation and underlying cause of death, the relative frequency was calculated in the percentage of null values. The time trend analyzes of the incomplete percentage of categories and variables of interest was performed using linear regression (p<0.05).

RESULTS

From 2000 to 2016, there were 31,097 deaths from cancer among residents of the state of Mato Grosso. Race/skin color, marital status and occupation presented a stable trend of incompleteness; education and underlying cause of death were decreasing. An increasing trend was observed in the categories ignored (marital status) and retired (occupation); a decreasing trend was observed for blank (education), unidentified and housewife (occupation), and C76-other and ill-defined sites and C80-without specification of site (underlying cause of death). Incompleteness of occupation was classified as very poor, with emphasis on housewife and retired. For the remaining variables and categories, the classification was excellent or good.

CONCLUSIONS

Although most of the indicators showed satisfactory trend and classification, the marital status and occupation variables stood out for indicating poorer quality in the records.

Epidemiological surveillance: a brief history and the experiences of the United States and the state of São Paulo

OBJECTIVE

The objective of this narrative review was to list some historical aspects of epidemiological surveillance, a technological intervention model initially designed to help control communicable diseases in the last century.

METHODS

This narrative was built based on texts selected to record the development of epidemiological surveillance in the United States and in the state of São Paulo, Brazil.

RESULTS

The origins of some of the actions that constitute epidemiological surveillance activities are presented, as well as a brief history of the establishment of the originally named Center for Disease Control, a United States agency that is held up as an example in relation to the way surveillance has been performed, practically all over the world. Likewise, we outline the paths that led to the establishment of the surveillance system in the state of São Paulo, drawing some parallels with the Brazilian system.

CONCLUSION

The narrative concludes with a conceptual differentiation between epidemiological surveillance, monitoring and health surveillance.

Time trend and spatial distribution of the cases of lethal violence against women in Brazil

Objective:

to analyze the time trend and the spatial distribution of the cases of lethal violence against women in Brazil, according to age group and to race/skin color.

Method:

an ecological study of time series, with spatial distribution of the deaths of women victims of aggression, registered in the Mortality Information System, resident in Brazil, Brazilian geographic regions and states. Due to underreporting of deaths in some states, correction factors of the mortality rates were employed. For the trend analysis, we adopted the polynomial regression model. In addition to that, the mean rates and annual upward/downward trends were distributed considering the Brazilian federative units as analysis units.

Results:

the mean rate was 6.24 cases of lethal violence per 100,000 women, with a significant variation across the Brazilian regions and states. The main victims of violent death in Brazil are young, black-/brown-skinned and indigenous women, with a growing trend in these population segments. The North and Northeast regions stood out with the most significant mean annual increases (0.33; r²= 0.96 and 0.26; r²= 0.92, respectively).

Conclusion:

there was a stable trend regarding lethal violence against women, with significant regional differences. Young, black-/brown-skinned and indigenous women are more vulnerable to violent death in Brazil.

Tendencia temporal y distribución espacial de los casos de violencia letal contra la mujer en Brasil

Resumen Objetivo: analizar la tendencia temporal y la distribución espacial de los casos de violencia letal contra la mujer en Brasil, según la franja etaria y la raza/color. Método: estudio ecológico, de las series temporales, con distribución espacial de las muertes de mujeres víctimas de agresión, registradas en el Sistema de Información de Mortalidad, residentes en Brasil, regiones geográficas y estados brasileños. Debido a que hay subregistro de las muertes en algunos estados, se utilizaron factores de corrección para las tasas de mortalidad. Para el análisis de tendencias, adoptamos el modelo de regresión polinomial. Además, las tasas medias y las tendencias anuales de aumento/disminución fueron distribuidas considerando como unidad de análisis las unidades federativas de Brasil. Resultados: la tasa promedio fue de 6,24 casos de violencia letal por cada 100.000 mujeres, con variación significativa entre regiones y estados brasileños. Las principales víctimas de muerte violenta en Brasil son mujeres jóvenes, negras/morenas e indígenas y la tendencia es creciente en estas poblaciones. Las regiones Norte y Noreste presentaron los aumentos medios anuales más significativos (0,33; r2 = 0,96 y 0,26; r2 = 0,92, respectivamente). Conclusión: hubo una tendencia a la estabilidad de la violencia letal contra la mujer, con diferencias regionales significativas. Las mujeres jóvenes, negras/morenas e indígenas son más vulnerables a la muerte violenta en Brasil.

Tendência da incompletude dos registros de óbitos por câncer do Sistema de Informação sobre Mortalidade em Mato Grosso, Brasil, 2000 a 2016

RESUMO: Objetivo: Descrever a tendência da incompletude dos registros de óbitos por neoplasias do Sistema de Informação sobre Mortalidade (SIM) no estado de Mato Grosso, Brasil, no período de 2000 a 2016. Métodos: Trata-se de um estudo descritivo, ecológico, do tipo série temporal, com dados referentes aos óbitos de residentes em Mato Grosso por neoplasias (códigos C00 a C97 da 10ª revisão da Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde — CID-10), provenientes do SIM. Para a avaliação da incompletude no preenchimento das variáveis raça/cor, escolaridade, estado civil, ocupação e causa básica do óbito, foi calculada a frequência relativa em percentual de valores nulos. Análises de tendência temporal do percentual de incompletude das variáveis de interesse e categorias foram realizadas por meio de regressão linear (p<0,05). Resultados: De 2000 a 2016, ocorreram 31.097 óbitos por neoplasias em residentes no estado de Mato Grosso. Raça/cor, estado civil e ocupação apresentaram tendência estável da incompletude; escolaridade e causa básica do óbito foram decrescentes. Nas categorias, tendência crescente foi observada para ignorado (estado civil) e aposentado (ocupação); tendência decrescente foi verificada para em branco (escolaridade), não identificado e dona de casa (ocupação) e C76-outra localização e mal definidas e C80-sem especificação de localização (causa básica do óbito). Incompletude da ocupação foi classificada como muito ruim, com destaque para dona de casa e aposentado. Para as demais variáveis e categorias, a classificação foi excelente ou bom. Conclusões: Embora a maior parte dos indicadores tenha apresentado tendência e classificação satisfatórias, as variáveis estado civil e ocupação destacaram-se por indicarem piora na qualidade dos registros.

Factors associated with violence against women by an intimate partner in Northeast Brazil

This study examined the prevalence, and associated factors, of violence against women by an intimate partner amongst 369 women who attended nursing consultations at primary care centres in Northeast Brazil. Socio-demographic variables, substance use, mental health and the forms of violence were analysed. IPV was a reality for 65.4% of the women of reproductive age seen in the centres. IPV, including psychological violence, is associated with age, education and religion, particularly amongst female cannabis users whose partners were also substance users. Primary care providers are in a position to detect, screen, counsel and treat women who experience IPV.

The geography of femicide in Sergipe, Brazil: matriarchy, human development, and income distribution

AIM

This research analyzed a joint spatial distribution and explored the possible associations between epidemiological aspects and feminicide rates, in towns of the Sergipe State in Northeastern Brazil.

METHODOLOGY

An exploratory ecological study investigated the global spatial autocorrelation of epidemiological aspects with femicide rates from towns in Sergipe State, Brazil, (n = 75), in the 2013-2017 period, using the "global" and "local" Moran statistic method and a multiple spatial regression. The exposure variables included socioeconomic and demographic conditions, services and health condition, and femicide rates. We used the software Stata 11.0, SPSS 18.0 and GeoDa 0.95-i.

RESULTS

The spatial distribution of femicide rates was not random and showed high spatial autocorrelation and predominance of significant spatial groupings of towns with the highest mortality rates due to femicide in the central region of Sergipe State. In the multiple regression analysis, the percentage of women in charge of families and the Municipal Human Development Index were positively associated with the femicide rates in towns in Sergipe's municipalities in the studied period (p < 0.05). The opposite situation occurred between the Income Concentration Index (GINI) and the femicide rates.

CONCLUSION

This is the first study that has analyzed the factors associated with the spatial clusters of femicide rates in a geographical space where there is a predominance of patriarchal culture. There was a femicide increase in locations with the lowest social inequality, the highest human development and authority exercised by women in the family environment.

Contributions to the literature on violence and health in 25 years of the Brazilian public health Ciência & Saúde Coletiva

The authors conducted a literature review on the theme of violence and health published in the Brazilian public health journal "Ciência & Saúde Coletiva" (C&SC) from 1996 to 2019. The search also included two other Brazilian journals, "Cadernos de Saúde Pública" (CSP) and "Revista de Saúde Pública" (RSP) and two international journals, the "American Journal of Public Health" (AJPH) and the "Pan American Journal of Public Health" (PAJPH), totaling 1,179 articles. The analysis aggregated each journal's material in eleven themes, based on conceptual affinity. For the articles from C&SC, the authors analyzed variables such as year of publication, area of knowledge, institution's region, study scope, methodology, and target population. The analysis found that C&SC gave visibility to violence and health, standing out from the other journals since 2009. External causes, children and adolescents, quantitative studies, municipal and national scope, and institutions located in the Southeast region of Brazil predominated. There are gaps in topics such as self-mutilation and vulnerable populations, among other areas where more studies and publications should be encouraged.