Facial Injuries and the Gender Issue: Expressions of Violence in a Metropolitan Region of Northeastern Brazil

Cavalcante, Gigliana Maria Sobral; Bernardino, Ítalo de Macedo; Nóbrega, Lorena Marques da; Ferreira, Raquel Conceição; Ferreira e Ferreira, Efigênia; d’Avila, Sérgio

doi:10.1590/0103-6440202003005

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Article • Braz. Dent. J. 31 (5) • Sep-Oct 2020 • https://doi.org/10.1590/0103-6440202003005 copy

Facial Injuries and the Gender Issue: Expressions of Violence in a Metropolitan Region of Northeastern Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The aims of this investigation were to describe the profile of men and women victims of violence and identify factors associated with the severity of facial trauma. A retrospective study was carried out from 762 records of victims attended at the Institute of Legal Medicine and Dentistry located in a metropolitan region of Northeastern Brazil. The dependent variable was type of facial trauma suffered by victims. Independent variables were the sociodemographic characteristics of victims, characteristics of aggressors and circumstances of violence. Descriptive, bivariate (c2 test) and multivariate statistics were made through logistic regression. Level of significance was set at p < 0.05. The mean age of victims was 29.78 years (SD=13.33). Based on the final regression model, male subjects [odds ratio (OR)=2.22, 95% CI=1.08-4.57, p=0.030], assaulted by other male subjects (OR=4.88; 95% CI=1.12-21.26; p=0.035) through instrument (OR=6.67; 95% CI=2.85-15.60; p<0,001) or mixed aggressions (OR=4.34; 95% CI=1.44-13.02; p=0.009) were more likely to exhibit facial bone fractures or dentoalveolar fractures. The findings highlight that men and women present important victimization differentials in relation to interpersonal violence and facial trauma. Victim’s gender, aggressor’s gender and mechanism of aggression may exert influence on facial trauma patterns.

Key Words:
violence; gender and health; maxillofacial injuries.

Variables	n	%
Victim’s gender [762]
Female	408	53.5
Male	354	46.5
Victim’s age group [748]
≤ 9 years	15	2.0
10-19 years	141	18.9
20-29 years	290	38.8
30-39 years	151	20.2
40-49 years	94	12.6
50-59 years	32	4.3
≥ 60 years	25	3.3
Victim’s marital status [738]
Single, widowed or separated	474	64.2
Married or stable union	264	35.8
Victim’s schooling level [602]
Illiterate	45	7.5
≤ 4 years of study	291	48.3
5-8 years of study	68	11.3
9-11 years of study	142	23.6
≥ 12 years of study	56	9.3
Aggressor’s gender [724]
Female	182	25.1
Male	526	72.7
Both	16	2.2
Relation between aggressor and victim [728]
Partner	108	14.8
Ex-partner	72	9.9
Family	72	9.9
Known person	306	42.0
Strange person	170	23.4
Type of violence [734]
Intra-family violence	162	22.1
Community violence	572	77.9
Mechanism of aggression [701]
Aggression using physical force	635	90.6
Aggression using instruments	39	5.6
Mixed aggression	27	3.9
Type of maxillofacial trauma [762]
Soft tissue injury	708	92.9
Dentoalveolar fracture	22	2.9
Bone fracture	32	4.2

Independent variables	Facial trauma				Total		p value
	Fracture		Soft tissue injuries		Total		p value
	n	%	n	%	n	%
Victim’s gender							< 0.001*
Female	15	3.7	393	96.3	408	100.0
Male	39	11.0	315	89.0	354	100.0
Victim’s age group							0.095
≤ 9 years	1	6.7	14	93.3	15	100.0
10-19 years	7	5.0	134	95.0	141	100.0
20-29 years	17	5.9	273	94.1	290	100.0
30-39 years	9	6.0	142	94.0	151	100.0
40-49 years	12	12.8	82	87.2	94	100.0
50-59 years	5	15.6	27	84.4	32	100.0
≥ 60 years	3	12.0	22	88.0	25	100.0
Victim’s marital status							0.308
Single, widowed or separated	30	6.3	444	93.7	474	100.0
Married or stable union	22	8.3	242	91.7	264	100.0
Victim’s schooling level							0.943
Illiterate	4	8.9	41	91.1	45	100.0
≤ 4 years of study	18	6.2	273	93.8	291	100.0
5-8 years of study	5	7.4	63	92.6	68	100.0
9-11 years of study	8	5.6	134	94.4	142	100.0
≥ 12 years of study	4	7.1	52	92.9	56	100.0
Aggressor’s gender							0.067
Female	6	3.3	176	96.7	182	100.0
Male	42	8.0	484	92.0	526	100.0
Both	2	12.5	14	87.5	16	100.0
Relation between aggressor and victim							0.044*
Partner	5	4.6	103	95.4	108	100.0
Ex-partner	2	2.8	70	97.2	72	100.0
Family	1	1.4	71	98.6	72	100.0
Known person	26	8.5	280	91.5	306	100.0
Strange person	17	10.0	153	90.0	170	100.0
Type of violence							0.029*
Intra-family violence	5	3.1	157	96.9	162	100.0
Community violence	46	8.0	526	92.0	572	100.0
Mechanism of aggression							< 0.001*
Aggression using physical force	28	4.4	607	95.6	635	100.0
Aggression using instruments	21	24.4	65	75.6	86	100.0
Mixed aggression	5	18.5	22	81.5	27	100.0

Variables	Bivariate Analysis		Multivariate Analysis
Variables	OR _Non-adjusted (CI 95%)	p value	OR _Adjusted† (CI 95%)	p-value
Victims’s sociodemographic characteristics (Block 1)
Victims’s gender
Female	1.00		1.00
Male	3.24 (1.76-5.99)	<0.001*	2.22 (1.08-4.57)	0.030*
Victim’s age group
≤ 9 years	1.00		-	-
10-19 years	0.73 (0.08-6.38)	0.777	-	-
20-29 years	0.87 (0.11-7.03)	0.897	-	-
30-39 years	0.89 (0.10-7.52)	0.913	-	-
40-49 years	2.05 (0.25-17.02)	0.507	-	-
50-59 years	2.59 (0.28-24.40)	0.405	-	-
≥ 60 years	1.91 (0.18-20.22)	0.591	-	-
Victim’s marital status
Single, widowed or separated	1.00		-	-
Married or stable union	1.35 (0.76-2.38)	0.309	-	-
Victim’s schooling level
Illiterate	1.00		-	-
≤ 4 years of study	0.68 (0.22-2.10)	0.498	-	-
5-8 years of study	0.81 (0.21-3.21)	0.768	-	-
9-11 years of study	0.61 (0.18-2.14)	0.441	-	-
≥ 12 years of study	0.79 (0.19-3.34)	0.747	-	-
Aggressor’s characteristics (Block 2)
Aggressor’s gender
Female	1.00		1.00
Male	2.55 (1.06-6.09)	0.036*	4.88 (1.12-21.26)	0.035*
Both	4.19 (0.77-22.72)	0.097	7.20 (0.84-61.87)	0.072
Relation between aggressor and victim
Partner	1.00		-	-
Ex-partner	0.59 (0.11-3.12)	0.533	-	-
Family	0.29 (0.03-2.54)	0.263	-	-
Known person	1.91 (0.72-5.11)	0.196	-	-
Strange person	2.29 (0.82-6.40)	0.114	-	-
Circumstances of violence (Block 3)
Type of violence
Intra-family violence	1.00		-	-
Community violence	2.75 (1.07-7.03)	0.035*	-	-
Mechanism of aggression
Aggression using physical force	1.00		1.00
Aggression using instruments	9.63 (4.42-20.98)	<0.001*	6.67 (2.85-15.60)	< 0.001*
Mixed aggression	4.93 (1.74-13.97)	0.003*	4.34 (1.44-13.02)	0.009*

Variables	OR (CI 95%)	p value†
Main effect
Victim’s gender	3.24 (1.76-5.99)	<0.001(a)
Interaction effects
Victim’s gender *Victim’s age group		0.001(a)
Male *≤ 9 years	1
Male *10-19 years	2.25 (0.79-6.42)
Male *20-29 years	3.03 (1.40-6.54)
Male *30-39 years	2.89 (1.08-7.77)
Male *40-49 years	5.74 (2.28-14.42)
Male *50-59 years	6.24 (1.87-20.83)
Male * ≥ 60 years	5.69 (1.47-21.92)
Victim’s gender *Victim’s marital status		0.008(a)
Male *Single, widowed or separated	1
Male *Married or stable union	2.33 (1.25-4.34)
Victim’s gender *Victim’s schooling level		0.341
Male * Illiterate	1
Male * ≤ 4 years of study	2.11 (0.97-4.59)
Male * 5-8 years of study	2.37 (0.75-7.51)
Male * 9-11 years of study	1.58 (0.56-4.46)
Male * ≥ 12 years of study	1.50 (0.33-6.85)
Victim’s gender *Aggressor’s gender		0.001(a)
Male * Female	1
Male * Male	3.31 (1.78-6.13)
Male * Both	5.15 (0.57-46.68)
Victim’s gender *Relationship between aggressor and victim		0.004(a)
Male *Partner	1
Male *Ex-partner(b)	-
Male * Family	0.98 (0.12-7.69)
Male * Known person	3.69 (1.84-7.40)
Male * Strange person	2.89 (1.39-6.02)
Victim’s gender *Type of violence		<0.001(a)
Male *Intra-family violence	1
Male *Community violence	3.69 (1.98-6.88)
Victim’s gender *Mechanism of aggression		<0.001(a)
Male *Aggression using physical force	1
Male *Aggression using instruments	19.32 (8.18-45.60)
Male *Mixed aggression	10.24 (3.33-31.48)

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[1] Correspondence: Sérgio d’Avila, Avenida das Baraúnas, n. 351, 58429-500 Campina Grande, PB, Brasil. Tel: +55-83-3315-3326. e-mail: davila2407@hotmail.com