Deborah Carvalho Malta, Adauto Martins Soares Filho, Isabella Vitral Pinto, Maria Cecília de Souza Minayo, Cheila Marina Lima, Ísis Eloah Machado, Renato Azeredo Teixeira, Otaliba Libânio Morais Neto, Roberto Marini Ladeira, Edgar Merchan-Hamann, Maria de Fatima Marinho de Souza, Cíntia Honório Vasconcelos, Carlos Cezar Flores Vidotti, Ewerton Cousin, Scott Glenn, Catherine Bisignano, Adrienne Chew, Antonio Luiz Ribeiro, Mohsen Naghavi
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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).</p><p><strong>Conclusions: </strong>There was a change in the trend of firearms deaths after the beginning of the collection of weapons in 2004. 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引用次数: 11
摘要
背景:巴西在枪支死亡人数方面居世界首位，在每10万人的枪支死亡率方面居各国第六。本研究旨在利用2017年全球疾病负担、伤害和风险因素研究(GBD)的数据，分析巴西按年龄和性别分列的枪支死亡趋势和死亡负担，以及这些死亡与拥有和携带武器指标之间的关联。方法:我们使用GBD 2017年对巴西枪支造成的身体暴力和自残死亡率的估计，分析枪支死亡与解释变量之间的关系。结果:巴西的枪支死亡人数从1990年的25819人增加到2017年的48493人。男性和20-24岁年龄组的枪支死亡率较高;这一比例是同年龄段女性的20倍。在研究期间，凶杀率上升，而自杀和意外死亡的死亡率下降。枪支收缴率最高的巴西联邦单位组(中位数= 7.5)显示，枪支造成的暴力死亡总数有所下降。相比之下，2000年至2017年，枪支收集率最低的群体(中位数= 2.0)的枪支死亡人数有所增加。自愿归还枪支率的增加与非故意枪支死亡死亡率的降低有关(r = -0.364, p < 0.001)。社会人口指数(SDI)的增加与所有枪支死亡率的降低相关(r = -0.266, p = 0.008)。缴获或收缴枪支综合指数的增加与女性、儿童和老年人亚组中枪支死亡率的下降有关(r = -0.269, p = 0.005)。结论:2004年开始收集武器后，火器死亡趋势发生了变化。收集更多枪支的联邦单位降低了枪支暴力死亡率。
Association between firearms and mortality in Brazil, 1990 to 2017: a global burden of disease Brazil study.
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.
期刊介绍：
Population Health Metrics aims to advance the science of population health assessment, and welcomes papers relating to concepts, methods, ethics, applications, and summary measures of population health. The journal provides a unique platform for population health researchers to share their findings with the global community. We seek research that addresses the communication of population health measures and policy implications to stakeholders; this includes papers related to burden estimation and risk assessment, and research addressing population health across the full range of development. Population Health Metrics covers a broad range of topics encompassing health state measurement and valuation, summary measures of population health, descriptive epidemiology at the population level, burden of disease and injury analysis, disease and risk factor modeling for populations, and comparative assessment of risks to health at the population level. The journal is also interested in how to use and communicate indicators of population health to reduce disease burden, and the approaches for translating from indicators of population health to health-advancing actions. As a cross-cutting topic of importance, we are particularly interested in inequalities in population health and their measurement.
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