Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil.
Lancet. 2011 Jun 4;377(9781):1962-75. doi: 10.1016/S0140-6736(11)60053-6. Epub 2011 May 9.
Although there are signs of decline, homicides and traffic-related injuries and deaths in Brazil account for almost two-thirds of all deaths from external causes. In 2007, the homicide rate was 26·8 per 100,000 people and traffic-related mortality was 23·5 per 100,000. Domestic violence might not lead to as many deaths, but its share of violence-related morbidity is large. These are important public health problems that lead to enormous individual and collective costs. Young, black, and poor men are the main victims and perpetrators of community violence, whereas poor black women and children are the main victims of domestic violence. Regional differentials are also substantial. Besides the sociocultural determinants, much of the violence in Brazil has been associated with the misuse of alcohol and illicit drugs, and the wide availability of firearms. The high traffic-related morbidity and mortality in Brazil have been linked to the chosen model for the transport system that has given priority to roads and private-car use without offering adequate infrastructure. The system is often poorly equipped to deal with violations of traffic rules. In response to the major problems of violence and injuries, Brazil has greatly advanced in terms of legislation and action plans. The main challenge is to assess these advances to identify, extend, integrate, and continue the successful ones.
尽管存在下降迹象，但在巴西，凶杀和与交通相关的伤害和死亡占所有外部原因导致死亡的近三分之二。2007 年，凶杀率为每 10 万人 26.8 人，与交通相关的死亡率为每 10 万人 23.5 人。家庭暴力可能不会导致那么多人死亡，但它在与暴力相关的发病率中所占比例很大。这些都是重要的公共卫生问题，会导致巨大的个人和集体成本。年轻、黑人、贫困的男性是社区暴力的主要受害者和肇事者，而贫困的黑人妇女和儿童是家庭暴力的主要受害者。区域差异也很大。除了社会文化决定因素外，巴西的许多暴力行为与酒精和非法药物的滥用以及枪支的广泛可获得性有关。巴西交通相关发病率和死亡率高与交通系统选择的模式有关，该模式优先考虑道路和私人汽车使用，而没有提供足够的基础设施。该系统在处理违反交通规则的行为方面往往装备不足。针对暴力和伤害的主要问题，巴西在立法和行动计划方面取得了重大进展。主要挑战是评估这些进展，以确定、扩大、整合和继续成功的措施。
