Soares Filho Adauto Martins, Duarte Elisabeth Carmen, Merchan-Hamann Edgar
Secretaria de Vigilância em Saúde, Ministério da Saúde. Esplanada dos Ministérios Bloco G/Térreo, Asa Sul. 70058-900, Brasília, DF, Brasil.
Faculdade de Medicina, Universidade de Brasília (UnB). Brasília, DF, Brasil.
Cien Saude Colet. 2020 Mar;25(3):1147-1156. doi: 10.1590/1413-81232020253.19872018. Epub 2018 Jul 21.
The scope of this study is to analyze the trends and distribution of homicide mortality rates (HMR) according to the population size of Brazilian municipalities between 2000 and 2015. It is an ecological study of deaths recorded in the Mortality Information System, with HMR standardized by the direct method and 95% confidence interval. HMR in Brazil grew 6% (to 29.1/100,000) in the period, with an increase in small municipalities (83%; 12.7 to 23.2/100,000) and mediumsized cities (52%; 19.7% to 30.1/100,000); which is true for both sexes, different ages, regions and firearm-related events. HMR decreased in major cities (19%; 40.6% to 32.9/100,000) and the Southeast region (55%; 45.6% to 20.6/100,000). The relative risk (RR) of small and medium-sized cities in relation to large cities is already greater than or close to 1 among women (RR 0.99; 1.03), people aged 60 years or older (RR 1.43; 1.36) and homicides by other means (RR 1.16; 1.18). The cities of São Paulo and Rio de Janeiro contributed the most to the reduction of HMR, especially in large cities (-37.6 and -22.3 homicides/100,000 inhabitants). Small and medium-sized municipalities have consistent trends of an increase in HMR even considering population subgroups.
本研究的范围是分析2000年至2015年期间巴西各市镇人口规模对应的杀人死亡率（HMR）的趋势和分布情况。这是一项对死亡信息系统中记录的死亡情况进行的生态学研究，HMR采用直接法标准化，并计算95%置信区间。在此期间，巴西的HMR增长了6%（达到29.1/10万），其中小市镇（增长83%；从12.7/10万增至23.2/10万）和中等城市（增长52%；从19.7/10万增至30.1/10万）有所上升；无论男女、不同年龄、不同地区以及与枪支相关的事件，情况均如此。大城市（下降19%；从40.6/10万降至32.9/10万）和东南部地区（下降55%；从45.6/10万降至20.6/10万）的HMR有所下降。在女性（相对风险RR为0.99；1.03）、60岁及以上人群（RR为1.43；1.36）以及其他手段导致的杀人案件（RR为1.16；1.18）中，中小城市相对于大城市的相对风险已经大于或接近1。圣保罗市和里约热内卢市对HMR的降低贡献最大，尤其是在大城市中（分别减少-37.6和-22.3起杀人案件/10万居民）。即使考虑人口亚组，中小市镇的HMR也呈现出持续上升的趋势。
