Morbimortalidade de homens jovens brasileiros por agressão: expressão dos diferenciais de gênero

Aggressions in urgency and emergency care in Brazilian capitals: perspectives of 2011, 2014 and 2017 VIVA Survey

OBJECTIVES

To describe the profile of care provided by aggressions in emergency units from the VIVA Survey 2011, 2014 and 2017 data, and to compare the evolution of six indicators over four (2011 to 2014) and seven years (2011 to 2017).

METHODS

Cross-sectional study, using data from the last three editions of the VIVA Survey carried out in the Federal District and in 19 Brazilian capitals. The types of occurrence were selected: aggression/mistreatment and intervention by a public agent. The weighted frequencies of the characteristics of the people assisted, of the aggressions, injuries and evolution of the cases were calculated, according to sex. Differences between proportions were compared using the χ2 Test. Six indicators were also selected and their evolution over the years was evaluated by means of the percentage variation and the 95% confidence interval.

RESULTS

In most cases of aggression, the individuals were black, young and adult, of both sexes. The main nature of the assaults was physical, reaching over 85% in all investigations, followed by negligence. In the comparison between 2011 and 2017, "neglect" aggressions had a significant increase in both sexes and in children and the elderly; aggressions of a "sexual" nature had a significant increase only in children.

CONCLUSIONS

The VIVA Survey is an important tool for Brazil's Violence and Accident Surveillance System, providing evidence for public health decision-making and for coping with and preventing violence.

[Mortality from assault in young men in Brazil, 2010-2014: an ecological study]

The aim was to analyze the association between risk of death from assault in young males and socio-demographic characteristics in Brazilian municipalities. In this ecological study, the units of analysis were the 1,651 municipalities of Brazil with more than 20,000 inhabitants. Data were obtained from the Brazilian Mortality Information System (SIM) and indicators were obtained from the 2010 Population Census and Human Development Atlas. Mortality rate ratios were estimated by a negative binomial regression model. From 2010 to 2014, a total of 127,137 deaths from assault were reported in young males 15 to 29 years of age. Corrected mortality rate was 133.3/100 thousand inhabitants for the set of municipalities (median 71.5/100 thousand inhabitants). The rate increased with the municipalities' population size. In the adjusted model, higher rates ratios were observed in the more urbanized municipalities (1.95; 95%CI: 1.70-2.23), in intermediate categories of income inequality (1.10; 95%CI: 1.01-1.20) and poverty rate (1.69; 95%CI: 1.51-1.89), with lower proportion of youth attending Secondary School (2.05; 95%CI: 1.83-2.30), with higher proportion of unemployed youth 18 to 24 years of age (1.27; 95%CI: 1.16-1.40), and with more women than men (1.28; 95%CI: 1.05-1.58). Mortality from assault was high in young Brazilian men, especially in larger and more urbanized municipalities and those with a higher proportion of youth looking for work and not attending secondary school. The results show the relevance of social policies for dealing with violence against youth.

Mortality in Brazil according to gender perspective, years 2000 and 2010

OBJECTIVE

The article assessed the overall mortality in Brazil in 2000 and 2010.

METHODS

Data source was the Mortality Information System from Ministry of Health of Brazil.

RESULTS

The data show the high rate of mortality among men compared to women between ages of 20 to 59 years and an expressive lower life expectancy by this population. The main groups of death were: external causes; diseases of the circulatory system, diseases of the digestive system, infectious and parasitic diseases, diseases of the respiratory system; mental and behavioral disorders; diseases of the nervous system; endocrine, nutritional and metabolic diseases; neoplasia and diseases of the genitourinary system.

CONCLUSION

Unequal gender relations and distinct characteristics of exposure to risk factors can explain this mortality, highlighting the need to bring critical incorporation of relational gender perspective by public health policies.

Care for young victims of assault in public emergency services in 2011: Sex differences

This article aims to describe the characteristics of assaults among youth victims of violence treated in Public Emergency Departments, according to sex. This is a descriptive study using data from the Brazilian Violence and Accidents Surveillance System based on a multicenter survey conducted by the Ministry of Health in 71 public emergency departments, located in 24 state capitals and the Federal District in 2011. Male subjects predominated among the victims (75.1%) and also among aggressors (83.1% and 69.7% of cases of violence against male and female victims, respectively). Among female victims, episodes of violence were more frequent at home (43.6%). The perpetrator was a stranger in 49.7% and 26.8% of cases among male and female victims, respectively, while the perpetrator was a partner or ex-partner in 3.9% and 31.5% cases, respectively (p < 0.001). Greater severity of injuries among men was consistent with the higher proportion of deaths in the first 24 hours (2.1%) compared to women (0.2%) (p < 0.001). The violence profile among youth victims treated in Public Emergency Departments was substantially different according to the sex of the victims. The results highlight the need to implement intersectoral policies, in line with the Brazilian Youth Statute.

Study of the causes of facial fractures in a reference center in Rio de Janeiro, Brazil from 2003-2012

OBJECTIVE

This study describes the facial fractures of patients at a reference center in oral and maxillofacial surgery of a Public University Hospital in the city of Rio de Janeiro, from January 2003 to December 2012.

METHODS

The data were collected from medical records and included the fractured bones, etiology, gender, and age of the patients. A total of 202 cases were identified, and 159 were included in the study (129 men and 30 women).

RESULTS

The mandible was the most commonly injured bone (90 cases, 73 men and 17 women) with a mean age of 33.7 years old (±15.2), and traffic accidents (75 cases) were shown to be the major cause.

CONCLUSION

In the city of Rio de Janeiro, young men in their fourth decade of life are prone to trauma to their facial bones, especially the mandible, and they are most commonly caused by traffic accidents.

Hospital morbidity in a medium-sized city: differentials between men and women

Objective

characterize the hospital morbidity of adults living in the city of Maringá, PR, Brazil, between 2000 and 2011, focusing on the differential between men and women.

Method

this descriptive study was developed based on data from the Hospital Information System of the Unified Health System in order to investigate the association between groups of hospitalization causes and the average length of hospitalization per gender, in three-year periods.

Results

the main groups of hospitalization causes for men were: mental disorders, lesions and circulatory diseases; and, among women: tumors, circulatory and genitourinary diseases. Mental disorders and lesions, tumors, circulatory and genitourinary diseases were significantly associated with the female and male genders across the study period. Although not significant, the mean length of hospitalization dropped across the four three-year periods, and only showed a significant difference between men and women in the second triennium.

Conclusion

differences in the hospital morbidity profile between men and women underline the need for specific health and nursing actions, especially in primary health care, with a view to reducing hospitalizations due to the main groups of causes in the city.

[Deaths from violent causes among adolescents and young adults in two cities of the Southern Cone: Córdoba (Argentina) and Porto Alegre (Brazil), 1990-2010]

The scope of this paper is to analyze and compare the evolution of deaths from violent causes among adolescents and young adults in the cities of Cordoba (Argentina) and Porto Alegre (Brazil). It also seeks to establish if the results are consistent with those reported in previous national and local research. Based on official data, specific mortality rates (by sex, age and cause) are calculated for the 1990-92 and 2008-10 periods. In general, violent causes play a significant part in the total number of deaths especially among young men and as they get older. In line with the reality of the country, in Córdoba both non-traffic-related and also traffic-related deaths are most frequent. On the other hand, in Porto Alegre (where the level of deaths from violent causes is higher), homicides and traffic accidents are the most common cause of death. Beyond the actions taken so far, it is necessary to redouble efforts to counter the problem in question, both in the recording of information for decision-making and in regard to the decisions when they are put into practice.

O desafio de compreender a consequência fatal da violência em dois municípios brasileiros

Buscou-se compreender os homicídios por meio da abordagem sistêmica complexa aplicando-se o Modelo Ecológico (ME), que envolve condições individuais e relacionais dos sujeitos e do contexto. Foram realizados dois estudos de caso triangulando dados quantitativos e qualitativos. Os municípios selecionados, Paulista, Pernambuco, e Jaraguá do Sul, Santa Catarina, apresentaram comportamentos opostos em relação às taxas de homicídios entre 1980 e 2007. Na análise qualitativa, descortinou-se, em cada dimensão do modelo ecológico: individual - baixa escolaridade e uso de drogas; relacional violência intrafamiliar e uso de drogas por membros da família; comunitário e social - trabalho e desemprego; educação pública - segurança pública; tráfico de drogas e religiosidade. Conclui-se que os homicídios envolvem a combinação de vulnerabilidades, precariedades e rupturas de vínculos na dimensão individual e social, passíveis de enfrentamento em uma perspectiva inclusiva, interdisciplinar e intersetorial.