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Association between firearms and mortality in Brazil, 1990 to 2017 : a global burden of disease Brazil study.
(2020) Malta, Deborah Carvalho; Soares Filho, Adauto Martins; Pinto, Isabella Vitral; Minayo, Maria Cecília de Souza; Lima, Cheila Marina de; Machado, Ísis Eloah; Teixeira, Renato Azeredo; Morais Neto, Otaliba Libânio; Ladeira, Roberto Marini; Merchan-Hamann, Edgar; Souza, Maria de Fátima Marinho de; Vasconcelos, Cíntia Honório; Vidotti, Carlos Cezar Flores; Cousin, Ewerton; Glenn, Scott; Bisignano, Catherine; Chew, Adrienne; Ribeiro, Antônio Luiz Pinho; Naghavi, Mohsen
Background: Brazil leads the world in number of firearm deaths and ranks sixth by country in rate of firearm deaths per 100,000 people. This study aims to analyze trends in and burden of mortality by firearms, according to age and sex, for Brazil, and the association between these deaths and indicators of possession and carrying of weapons using data from the global burden of diseases, injuries, and risk factors study (GBD) 2017. Methods: We used GBD 2017 estimates of mortality due to physical violence and self-harm from firearms for Brazil to analyze the association between deaths by firearms and explanatory variables. Results: Deaths from firearms increased in Brazil from 25,819 in 1990 to 48,493 in 2017. Firearm mortality rates were higher among men and in the 20–24 age group; the rate was 20 times higher than for women in the same age group. Homicide rates increased during the study period, while mortality rates for suicides and accidental deaths decreased. The group of Brazilian federation units with the highest firearm collection rate (median = 7.5) showed reductions in the rate of total violent deaths by firearms. In contrast, the group with the lowest firearm collection rate (median = 2.0) showed an increase in firearm deaths from 2000 to 2017. An increase in the rate of voluntary return of firearms was associated with a reduction in mortality rates of unintentional firearm deaths (r = −0.364, p < 0.001). An increase in socio-demographic index (SDI) was associated with a reduction in all firearm death rates (r = −0.266, p = 0.008). An increase in the composite index of firearms seized or collected was associated with a reduction in rates of deaths by firearm in the subgroup of females, children, and the elderly (r = −0.269, p = 0.005). Conclusions: There was a change in the trend of firearms deaths after the beginning of the collection of weapons in 2004. Federation units that collected more guns have reduced rates of violent firearm deaths.
Implementation of the life in Traffic Program in 31 Brazilian municipalities.
(2020) Santos, Taciana Mirella Batista dos; Machado, Elaine Leandro; Mandacarú, Polyana Maria Pimenta; Costa, Dário Alves da Silva; Cardoso, Clareci Silva; Friche, Amélia Augusta de Lima; Tobias, Gabriela Camargo; Guimarães, Rafael Alves; Aquino, Érika Carvalho de; Morais Neto, Otaliba Libânio; Caiaffa, Waleska Teixeira
Introduction: The Life in Traffic Program (LTP) was launched in Brazil in 2010, aiming to promote road safety interventions capable of reducing deaths and serious injuries resulting from traffic collisions. The LTP methodology was based on four steps: intersectoral articulation, data quali fication and integration, integrated actions of road safety, and monitoring of actions. Objective: To determine the degree of implementation of the program in 31 Brazilian municipalities. Method: Formal and normative evaluations were adopted, in two phases. In the first one, the content of 28 indicators uniquely developed to evaluate the LTP implementation was verified by a panel of experts composed of 29 program coordinators in the Brazilian municipalities. A Likert scale was used, followed by a comparison of the interquartile range (IQR). In the second phase, the degree of implementation was evaluated based on baseline and follow-up interview applied in 2015 and 2017, defined through a system of scores, with weights differentiated for each indicator, according to the level of importance assigned by the experts, thus constituting the matrix of analysis and judgment. Results: Thirty municipalities participated in the 2015 evaluation and 26, in 2017. The indicators of implementation achieved high degree of consensus among the experts, suggesting adequacy of the instrument. Regarding the implementation, the LTP was partially or totally implemented in 84.6% of the 31 Brazilian municipalities. Municipalities in the North region (71.8%) had the highest degree of implementation, followed by South (71.2%), Central West (68.5%), Northeast (62.4%), and Southeast (58.8%). Monitoring of actions implemented was the LTP methodology step with the lowest performance detected among them.