This thematic issue of Revista Brasileira de Epidemiologia analyzes different databases that depict the challenge of violence and accidents in the Brazilian context. These events constitute some of the main Public Health problems in the country, with a strong effect on the public health system (Sistema Único de Saúde - SUS), and are responsible for more than 150 thousand deaths a year, in addition to lives lost prematurely, disability, loss of quality of life, and significant economic impacts. Violence and accidents represent huge obstacles, affecting vulnerable populations, those with low schooling and income, young people, women, black individuals, and widening social inequalities. We highlight that over half of the homicides are committed against young people aged 15 to 29 years, and, among these victims, approximately three-quarters are black.
This thematic issue covers the analysis of different surveys and information systems, including the Surveillance System for Violence and Accidents (Sistema de Vigilância de Violências e Acidentes - VIVA), established in 2006 by the Secretariat of Health Surveillance (Secretaria de Vigilância em Saúde - SVS) of the Ministry of Health (MoH). VIVA became an important tool for understanding the magnitude, distribution, and trend of these events. The data analyzed herein derive from two components: VIVA Survey, conducted periodically at the front door of emergency departments, and VIVA Continuous, based on the notification of domestic, sexual, and other interpersonal or self-inflicted violence in health services, registered in the Notifiable Diseases Information System (Sistema de Informação de Agravos de Notificação - SINAN). Between 2011 and 2017, these notifications totaled more than 1.5 million records.
The articles presented here show analyses of cases related to violence and accidents in vulnerable populations: “Wounded adolescences: a portrait of firearm violence reported in Brazil” reveals the daily tragedy of having more than half of the firearm-related notifications in VIVA involving adolescents. Another article, “Violence against adolescents: analysis of health sector notifications,” analyzes the VIVA database on adolescents. The National Adolescent Student Health Survey (Pesquisa Nacional de Saúde dos Escolares - PeNSE) is assessed in an article about the “Risk and protective factors related to domestic violence against Brazilian adolescents,” presenting the factors associated with domestic violence in this age group. Another study describes the “Profile of notification of violence against Lesbian, Gay, Bisexual, Transvestite and Transsexual people recorded in the National Information System on Notifiable Diseases,” contributing to the investigation of vulnerable and discriminated populations; an “Analysis of notifications of intimate partner violence against women” is also presented. Older adults are covered in the article “Profile of care for violence against the elderly in urgency and emergency services.”
Other VIVA analyses bring the characteristics of “Aggressions in urgency and emergency care in Brazilian capitals,” as well as the “Profile of cases due to burn attended in emergency care units.” This thematic issue also has three studies addressing road traffic based on data from the Mortality Information System (Sistema de Informações sobre Mortalidade - SIM). An analysis reveals the increasing “Female motorcycle mortality in Brazilian municipalities;” after assessing VIVA records, the article “Helmet use and injury severity among crashed motorcyclists in Brazilian state capitals” shows the importance of this life-saving equipment; lastly, the third study, “Temporal trend in the prevalence of indicators related to driving a motor vehicle after alcohol consumption, between 2007 and 2018,” points out that abusive alcohol consumption before driving decreased in Brazil; nonetheless, driving after consuming any amount of alcohol remains a frequent practice, and constant surveillance and actions from authorities are necessary.
Finally, data from the Surveillance of Risk and Protective Factors for Chronic Diseases by Telephone Survey (Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico - Vigitel) allowed “An evaluation of Primary Health Care from the users’ perspective: reflections on the usage of the Primary Care Assessment Tool-Brazil in telephone surveys.” This article shows the opportunity of using Vigitel to assess primary care in the country.
The 2030 Agenda for Sustainable Development Goals included several indicators related to violence as targets: halve the number of deaths from road traffic accidents; provide access to safe and sustainable transport systems; expand public transport; eliminate violence against women and girls; reduce by one-third the rates of femicide and homicide of children, adolescents, young people, black individuals, indigenous people, women, and LGBT individuals; reduce illicit financial and arms flows, among others11. Grupo de Trabalho da Sociedade Civil para Agenda 2030 do Desenvolvimento Sustentável. Relatórios Luz: síntese e completo de 2017 [Internet]. Grupo de Trabalho da Sociedade Civil para Agenda 2030 do Desenvolvimento Sustentável. [acessado em 15 out. 2017]. Disponível em: Disponível em: https://gtagenda2030.org.br/
https://gtagenda2030.org.br/... . These indicators represent commitments to the present and the future; however, what has been observed in Brazil recently are attempts to destroy these rights, including discussions about the age of criminal responsibility, attacks on the anti-firearm law, facilitating access to weapons, and poverty growth due to both austerity policies and reduced investment in social programs22. Rasella D, Basu S, Hone T, Paes-Sousa R, Ocké-Reis CO, Millett C. Child morbidity and mortality associated with alternative policy responses to the economic crisis in Brazil: A nationwide microsimulation study. PLoS Med 2018; 15(5): e1002570. https://doi.org/10.1371/journal.pmed.1002570
We expect that this compilation can contribute to expanding knowledge and improving the understanding of the impact of violence on the health of the general population, especially the most vulnerable groups, as well as encourage reflection and intersectoral actions seeking health promotion and peace culture and ensuring the non-violation of rights and the search for peaceful and inclusive societies by 2030.
- 1Grupo de Trabalho da Sociedade Civil para Agenda 2030 do Desenvolvimento Sustentável. Relatórios Luz: síntese e completo de 2017 [Internet]. Grupo de Trabalho da Sociedade Civil para Agenda 2030 do Desenvolvimento Sustentável. [acessado em 15 out. 2017]. Disponível em: Disponível em: https://gtagenda2030.org.br/
- 2Rasella D, Basu S, Hone T, Paes-Sousa R, Ocké-Reis CO, Millett C. Child morbidity and mortality associated with alternative policy responses to the economic crisis in Brazil: A nationwide microsimulation study. PLoS Med 2018; 15(5): e1002570. https://doi.org/10.1371/journal.pmed.1002570
- Publication in this collection
03 July 2020
- Date of issue