Andrade Alice Barone de, Azeredo Catarina Machado, Peres Maria Fernanda Tourinho
Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Graduação em Nutrição, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil.
Rev Bras Epidemiol. 2020;23:e200039. doi: 10.1590/1980-549720200039. Epub 2020 Jun 1.
The isolated negative impacts of community violence and family violence on individuals' self-rated health (SRH) are known, but there is little evidence on the combined effect of these two types of interpersonal violence.
To analyze the association between exposure to community violence/by strangers and family violence/by acquaintances and negative SRH, distinguishing the type of violence suffered and also considering its cumulative exposure.
Epidemiological cross-sectional study developed with data from the National Health Survey (PNS) 2013. Crude multinominal logistic regression models were performed and adjusted to test the association of variables.
All types of violence analyzed were associated with negative SRH. Isolated community/unknown interpersonal violence was associated with SRH as regular (odds ratio - OR = 1.38) and bad (OR = 1.79). Exposure to family violence/by acquaintances was associated with regular (OR = 1.52) and bad (OR = 2.70) self-assessment. Concomitant exposure to the two types of violence was associated with regular (OR = 4.00) and bad (OR = 7.81) health assessments, with this association being of greater magnitude than those for isolated violence.
The cumulative effect of exposure to family/known and community/unknown violence enhances the negative assessment of health status. Health professionals must be aware of the multivitaminization and its impact on the health of victims who access health services.
社区暴力和家庭暴力对个人自评健康（SRH）的单独负面影响是已知的，但关于这两种人际暴力综合影响的证据很少。
分析遭受社区暴力/来自陌生人的暴力和家庭暴力/来自熟人的暴力与负面自评健康之间的关联，区分所遭受的暴力类型，并考虑其累积暴露情况。
利用2013年国家健康调查（PNS）的数据开展流行病学横断面研究。进行了粗多项逻辑回归模型分析并进行调整，以检验变量之间的关联。
所分析的所有暴力类型均与负面自评健康相关。单独的社区/未知人际暴力与自评健康为一般（优势比 - OR = 1.38）和较差（OR = 1.79）相关。遭受家庭暴力/来自熟人的暴力与一般（OR = 1.52）和较差（OR = 2.70）的自我评估相关。同时遭受两种暴力与一般（OR = 4.00）和较差（OR = 7.81）的健康评估相关，且这种关联的程度大于单独暴力的关联程度。
遭受家庭/熟人暴力和社区/未知暴力的累积影响会增强对健康状况的负面评估。卫生专业人员必须意识到这种多重暴力及其对寻求医疗服务的受害者健康的影响。
