Matzopoulos Richard, Prinsloo Megan R, Mhlongo Shibe, Marineau Lea, Cornell Morna, Bowman Brett, Mamashela Thakadu A, Gwebushe Nomonde, Ketelo Asiphe, Martin Lorna J, Dekel Bianca, Lombard Carl, Jewkes Rachel, Abrahams Naeemah
Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa.
Division of Public Health Medicine, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
PLOS Glob Public Health. 2023 Nov 22;3(11):e0002595. doi: 10.1371/journal.pgph.0002595. eCollection 2023.
South Africa has an overall homicide rate six times the global average. Males are predominantly the victims and perpetrators, but little is known about the male victims. For the country's first ever study on male homicide we compared 2017 male and female victim profiles for selected covariates, against global average and previous estimates for 2009. We conducted a retrospective descriptive study of routine data collected through postmortem investigations, calculating age-standardised mortality rates for manner of death by age, sex and province and male-to-female incidence rate ratios with 95% confidence intervals. We then used generalised linear models and linear regression models to assess the association between sex and victim characteristics including age and mechanism of injury (guns, sharp and blunt force) within and between years. 87% of 19,477 homicides in 2017 were males, equating to seven male deaths for every female, with sharp force and firearm discharge being the most common cause of death. Rates were higher among males than females at all ages, and up to eight times higher for the age group 15-44 years. Provincial rates varied overall and by sex, with the highest comparative risk for men vs. women in the Western Cape Province (11.4 males for every 1 female). Male homicides peaked during December and were highest during weekends, underscoring the prominent role of alcohol as a risk factor. There is a massive, disproportionate and enduring homicide risk among South African men which highlights their relative neglect in the country's prevention and policy responses. Only through challenging the normative perception of male invulnerability do we begin to address the enormous burden of violence impacting men. There is an urgent need to address the insidious effect of such societal norms alongside implementing structural interventions to overcome the root causes of poverty, inequality and better control alcohol and firearms.
南非的总体凶杀率是全球平均水平的六倍。男性主要是受害者和犯罪者，但对于男性受害者却知之甚少。在该国首次针对男性凶杀案的研究中，我们将2017年男性和女性受害者的特征与选定的协变量进行了比较，并与全球平均水平以及2009年的先前估计值进行了对比。我们对通过尸检调查收集的常规数据进行了回顾性描述性研究，计算了按年龄、性别和省份划分的死亡方式的年龄标准化死亡率以及男性与女性的发病率比值，并给出95%的置信区间。然后，我们使用广义线性模型和线性回归模型来评估性别与受害者特征（包括年龄和伤害机制，如枪支、锐器和钝器）在不同年份之间以及同一年份内的关联。2017年19477起凶杀案中，87%的受害者为男性，即男女死亡比例为7比1，锐器伤和枪击是最常见的死亡原因。各年龄段男性的凶杀率均高于女性，15至44岁年龄组的男性凶杀率高达女性的八倍。各省的凶杀率总体上以及按性别划分都有所不同，西开普省男性与女性的相对风险最高（每1名女性对应11.4名男性）。男性凶杀案在12月达到峰值，且在周末最高，这凸显了酒精作为一个风险因素的突出作用。南非男性面临着巨大、不成比例且持久的凶杀风险，这突出表明他们在该国的预防和政策应对中相对被忽视。只有通过挑战男性不会受到伤害的规范性观念，我们才能开始应对影响男性的巨大暴力负担。迫切需要解决此类社会规范的潜在影响，同时实施结构性干预措施，以消除贫困、不平等的根源，并更好地控制酒精和枪支。
