拉丁美洲青少年及青年成人凶杀率的差异及其与城市特征的关联：SALURBAL研究
Variation in youth and young adult homicide rates and their association with city characteristics in Latin America: the SALURBAL study.
作者信息
de Lima Friche Amélia Augusta, Silva Uriel Moreira, Bilal Usama, Sarmiento Olga L, de Salles Dias Maria Angélica, Prado-Galbarro Francisco Javier, Briceño-León Roberto, Alazraqui Marcio, Diez-Roux Ana V, Caiaffa Waleska Teixeira
机构信息
Observatory for Urban Health in Belo Horizonte, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Department of Speech, Language and Hearing Sciences, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
出版信息
Lancet Reg Health Am. 2023 Mar 20;20:100476. doi: 10.1016/j.lana.2023.100476. eCollection 2023 Apr.
BACKGROUND
Latin America and the Caribbean (LAC) is one of the most urbanized and violent regions worldwide. Homicides in youth (15-24 years old, yo) and young adults (25-39yo) are an especially pressing public health problem. Yet there is little research on how city characteristics relate to homicide rates in youth and young adults. We aimed to describe homicide rates among youth and young adults, as well as their association with socioeconomic and built environment factors across 315 cities in eight LAC countries.
METHODS
This is an ecological study. We estimated homicide rates in youth and young adults for the period 2010-2016. We investigated associations of homicide rates with sub-city education and GDP, Gini, density, landscape isolation, population and population growth using sex-stratified negative binomial models with city and sub-city level random intercepts, and country-level fixed effects.
FINDINGS
The mean sub-city homicide rate per 100,000 in persons aged 15-24 was 76.9 (SD = 95.9) in male and 6.7 (SD = 8.5) in female, and in persons aged 25-39 was 69.4 (SD = 68.9) in male and 6.0 (SD = 6.7) in female. Rates were higher in Brazil, Colombia, Mexico and El Salvador than in Argentina, Chile, Panama and Peru. There was significant variation in rates across cities and sub-cities, even after accounting for the country. In fully adjusted models, higher sub-city education scores and higher city GDP were associated with a lower homicide rate among male and female (rate ratios (RR) per SD higher value in male and female, respectively, 0.87 (CI 0.84-0.90) and 0.90 (CI 0.86-0.93) for education and 0.87 (CI 0.81-0.92) and 0.92 (CI 0.87-0.97) for GDP). A higher city Gini index was associated with higher homicide rates (RR 1.28 (CI 1.10-1.48) and 1.21 (CI 1.07-1.36) in male and female, respectively). Greater isolation da was also associated with higher homicide rates (RR 1.13 (CI 1.07-1.21) and 1.07 (CI 1.02-1.12) in male and female, respectively).
INTERPRETATION
City and sub-city factors are associated with homicide rates. Improvements to education, social conditions and inequality and physical integration of cities may contribute to the reduction of homicides in the region.
FUNDING
The Wellcome Trust [205177/Z/16/Z].
背景
拉丁美洲和加勒比地区（LAC）是全球城市化程度最高且暴力事件频发的地区之一。青少年（15 - 24岁）和青年成年人（25 - 39岁）中的杀人案件是一个尤为紧迫的公共卫生问题。然而，关于城市特征如何与青少年和青年成年人的杀人率相关的研究却很少。我们旨在描述拉丁美洲和加勒比地区八个国家315个城市中青少年和青年成年人的杀人率，以及它们与社会经济和建成环境因素之间的关联。
方法
这是一项生态学研究。我们估算了2010 - 2016年期间青少年和青年成年人的杀人率。我们使用具有城市和次城市层面随机截距以及国家层面固定效应的性别分层负二项模型，研究了杀人率与次城市教育、国内生产总值（GDP）、基尼系数、人口密度、景观隔离度、人口及人口增长之间的关联。
结果
在15 - 24岁人群中，每10万人的次城市平均杀人率男性为76.9（标准差 = 95.9），女性为6.7（标准差 = 8.5）；在25 - 39岁人群中，男性为69.4（标准差 = 68.9），女性为6.0（标准差 = 6.7）。巴西、哥伦比亚、墨西哥和萨尔瓦多的杀人率高于阿根廷、智利、巴拿马和秘鲁。即使在考虑了国家因素之后，城市和次城市之间的杀人率仍存在显著差异。在完全调整模型中，次城市教育得分较高和城市GDP较高与男性和女性杀人率较低相关（男性和女性每标准差较高值的率比（RR）分别为，教育：0.87（95%置信区间0.84 - 0.90）和0.90（95%置信区间0.86 - 0.93）；GDP：0.87（95%置信区间0.81 - 0.92）和0.92（95%置信区间0.87 - 0.97））。较高的城市基尼指数与较高的杀人率相关（男性和女性的RR分别为1.28（95%置信区间1.10 - 1.48）和1.21（95%置信区间1.07 - 1.36））。更高的隔离度也与更高的杀人率相关（男性和女性的RR分别为1.13（95%置信区间1.07 - 1.21）和1.07（95%置信区间1.02 - 1.12））。
解读
城市和次城市因素与杀人率相关。改善教育、社会状况、不平等现象以及城市的物理整合可能有助于减少该地区的杀人案件。
资金来源
惠康信托基金会[205177/Z/16/Z]
Zotero 插件