Factors associated with homicide in Manaus, Amazonas, Brazil, 2014

cross-sectional study, with data from the Mortality Information System (SIM); homicide rates and odds ratio (OR) were estimated, comparing to other external causes, for 2014; logistic regression was used.

RESULTS:

of the 1,657 violent deaths, 913 were due to homicide; homicide rate was of 55.8/100 thousand inhabitants (95%CI 52.1;59.7); odds ratio was higher among males (OR 3.4; 95%CI 2.3;5.1) when compared with females; among single (OR 1.6; 95%CI 1.1;2.5) and widowed individuals (OR 4.1; 95%CI 1.1;15.6), when compared with married individuals; at night/early hours (OR 2.1; 95%CI 1.6;2.9) and in the afternoon (OR 1.7; 95%CI 1.2;2.4), when compared with the morning period; the probability was higher among individuals under 35 years, with less schooling.

CONCLUSION:

homicide mortality in Manaus was high, especially among males and young individuals with less schooling.

Keywords:
Homicide; Violence; Odds Ratio; Cross-Sectional Studies

Selected state capitals and Brazil	SHMR/100 thousand inhabitants	95%CI^a
Fortaleza ^b	110.3	107.7;113.0
Manaus ^c	60.3	59.8;64.0
Rio de Janeiro	36.0	34.3;37.7
São Paulo	25.4	24.4;26.5
Florianópolis ^d	19.3	16.6;22.4
Brasil	42.6	42.3;42.9

Victims characteristics	Homicides ^a		Other external causes^b
	N	%	N	%
	913	55.0	744	45.0
Age group (in years)
15-24	351	38.9	236	31.7
25-39	394	43.7	237	31.8
40-59	130	14.4	165	22.2
≥60	26	2.9	106	14.2
Sex
Female	56	6.1	140	18.8
Male	856	93.9	604	81.2
Ethnicity/skin color
White	56	6.3	70	9.5
Black	6	0.7	9	1.2
Asian	1	0.1	3	0.4
Brown	825	92.8	659	88.9
Indigenous	1	0.1	-	-
Marital status
Married	52	5.9	101	13.7
Single	816	92.3	605	82.2
Divorced	8	0.9	10	1.4
Widowed	5	0.6	11	1.5
Other	3	0.3	9	1.2
Education level (years of schooling)
0-3	176	19.5	169	22.9
4-7	465	51.5	280	37.9
8-11	235	26.0	233	31.6
≥12	27	3.0	56	7.6
Place of occurrence
Hospital	352	38.5	356	47.8
Other health facilities	41	4.5	41	5.6
Household	52	5.7	131	17.6
Public place	420	46.0	163	21.9
Other	48	5.3	53	7.1
Time of occurrence
Morning	108	12.8	180	25.3
Afternoon	168	19.8	155	21.8
Night/early hours	570	67.4	377	52.9
Weekdays of occurrence
Monday	119	13.0	104	14.0
Tuesday	100	10.9	82	11.0
Wednesday	123	13.5	93	12.5
Thursday	115	12.6	88	11.8
Friday	122	13.4	121	16.3
Saturday	153	16.8	121	16.3
Sunday	181	19.8	135	18.1
Autopsy
No	328	35.9	316	42.5
Yes	585	64.1	428	57.5

Type of weapon used	Place of occurrence ^a
	Public place		Household		Other		Total
	N	%	N	%	N	%	N	%
Male
Firearm	296	88.1	16	4.8	24	7.1	336	69.3
Sharp object	71	74.7	17	17.9	7	7.4	95	19.6
Other assaults	22	73.3	4	13.4	4	13.3	30	6.2
Non-specified	16	66.7	3	12.5	5	20.8	24	4.9
Female
Firearm	9	64.3	3	21.4	2	14.3	14	40.0
Sharp object	2	22.2	5	55.6	2	2.2	9	25.7
Other assaults	4	36.4	2	18.2	3	27.3	9	25.7
Non-specified	-	-	2	66.7	1	33.3	3	8.6
Both sexes
Firearm	305	87.1	19	5.4	26	7.4	350	67.3
Sharp object	73	70.2	22	21.2	9	8.6	104	20.0
Other assaults	26	66.7	6	15.4	7	17.9	39	7.5
Non-specified	16	59.2	5	18.5	6	22.3	27	5.2

Victims characteristics	OR ^a (95%CI) ^b	p value (LR-test) ^c	OR ^d ( 95%CI) ^b	p value (LR-test) ^c
Age² (in years)	0.969 (0.976;0.988)	<0.001	0.999 (0.998;1.001)	<0.718
Marital status
Married	1.0	<0.001	1.0	0.029
Single	2.6 (1.8;3.7)		1.6 (1.1;2.5)
Divorced	1.6 (0.6;4.2)		2.1 (0.7;6.5)
Widowed	0.9 (0.3;2.7)		4.1 (1.1;15.6)
Other	0.6 (0.2;2.5)		0.3 (0.1;1.5)
Sex
Female	1.0	<0.001	1.0	<0.001
Male	3.5 (2.6;4.9)		3.4 (2.3;5.1)
Time of occurrence
Morning	1.0	<0.001	1.0	<0.001
Afternoon	1.8 (1.3;2.5)		1.7 (1.2;2.4)
Night/early hours	2.5 (1.9;3.3)		2.1 (1.6;2.9)
Education level (years of schooling)
≥12	1.0	<0.001	1.0	<0.019
0-3	2.2 (1.3;3.6)		3.8 (1.5;9.9)
4-7	3.4 (2.1;5.6)		2.3 (0.9;5.6)
8-11	2.1 (1.3;3.4)		1.3 (0.5;3.3)
Ethnicity/skin color
White	1.0	0.019	1.0	0.478
Black + brown	1.6 (1.1;2.2)		0.9 (0.5;1.3)
Place of occurrence
Hospitals and other health facilities	1.0	<0.001	1.0	<0.001
Public place	2.6 (2.1;3.3)		2.0 (1.5;2.6)
Household	0.4 (0.3;0.6)		0.3 (0.2;0.5)
Other	0.9 (0.6;1.4)		0.7 (0.4;1.2)
Age ² (in years) versus Education level (years of schooling)
Age versus 0-3 years of schooling	-		0.99 (0.97;0.99)	0.023
Age versus 4-7 years of schooling			0.99 (0.93;1.01)
Age versus 8-11 years of schooling	-		0.98 (0.94;1.02)

Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil SRTVN Quadra 701, Via W5 Norte, Lote D, Edifício P0700, CEP: 70719-040, +55 61 3315-3464, Fax: +55 61 3315-3464 - Brasília - DF - Brazil
E-mail: ress.svs@gmail.com

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[1] Correspondence: Jesem Douglas Yamall Orellana - Rua Terezina, No. 476, Adrianópolis, Manaus-AM, Brasil. CEP: 69057-070 E-mail: jesem.orellana@fiocruz.br