Experience of neighbourhood violence and mental distress in Brazilian favelas: a cross-sectional household survey

Cruz, Marcelo Santos; Silva, Eliana Sousa; Jakaite, Zivile; Krenzinger, Miriam; Valiati, Leandro; Gonçalves, D.M.; Ribeiro, Eduardo; Priebe, Stefan

doi:10.1016/j.lana.2021.100067

Cited by 8 publications

(11 citation statements)

References 48 publications

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“…Participants in lower SES classes reported more problems for all EQ-5D dimensions and presented higher rates of chronic conditions, smoking, and lower educational levels. Individuals with lower SES are typically exposed to unhealthy living conditions characterized by the lack of sanitation and clean water, presence of disease vectors [ 16 – 19 ] and impaired access to public health [ 20 , 21 ] which results in a negative impact in all EQ-5D dimensions [ 22 – 24 ]. These individuals also present a worse perception of their own health as demonstrated in studies that assessed the association between low income or unemployment with HRQOL [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Health inequity assessment in Brazil: is EQ-5D-3L sensible enough to detect differences among distinct socioeconomic groups?

Tura,

da Costa,

Lordello

et al. 2024

Health Qual Life Outcomes

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Background Multidimensional health-related quality of life (HRQOL) instruments, such as the EQ-5D, are increasingly used to assess inequalities in health. However, it is necessary to explore the ability of these instruments to capture differences between population groups, especially in low/middle-income countries. This study aimed to investigate whether the EQ-5D-3L instrument can detect differences in HRQOL between groups of different socioeconomic status (SES) in Brazil. Methods Data collection occurred during the Brazilian EQ-5D-3L valuation study and included respondents aged 18 to 64 years enrolled in urban areas. SES was aggregated into three categories: “higher” (A and B), “intermediate” (C) and “lower” (D and E). EQ-5D-3L index was calculated considering the Brazilian value set. A mixed-effects regression model was estimated with random effects on individuals and marginal effects on SES, sex, and educational attainment. Odds ratios for the chance of reporting problems for each EQ-5D dimension were estimated by logistic regression. Results A total of 9,148 respondents were included in the study. Mean age was 37.80 ± 13.13 years, 47.4% were men and the majority was ranked as classes B or C (38.4% and 50.7%, respectively). Participants in lower SES classes reported increasingly poorer health compared to individuals in higher classes. The mean EQ-5D-3L index decreased as SES deteriorates being significantly higher for classes A and B (0.874 ± 0.14) compared to class C (0.842 ± 0.15) and classes D and E (0.804 ± 0.17) (p < 0.001). The same was observed for the mean EQ-VAS scores (84.0 ± 13.8 in classes A and B, 81.0 ± 17 in class C and 78.3 ± 18.7 in class C [p < 0.001]). The multivariate analysis confirmed that SES is an independent factor that effects EQ-5D-3L index measures. Participants in intermediate and lower SES classes have a statistically significant lower EQ-5D-3L index compared to participants in classes A and B, regardless of age, sex, and educational attainment. Conclusion In a Brazilian population sample, the EQ-5D-3L instrument was able to detect important differences between groups with distinct socioeconomic statuses (SES). The EQ-5D-3L is useful for exploring inequities in health.

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Section: Discussionmentioning

confidence: 99%

Health inequity assessment in Brazil: is EQ-5D-3L sensible enough to detect differences among distinct socioeconomic groups?

Tura,

da Costa,

Lordello

et al. 2024

Health Qual Life Outcomes

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“…Neighborhood violence is a serious social problem affecting societies worldwide. A study of 1,211 residents living in Brazilian favelas revealed that people who experience more violence have higher levels of mental health symptoms and a poorer quality of life, thus lower levels of well-being [26]. Another study conducted with college students tending at an urban historically black college/university (HBCU) reported that minority college students were more likely to experience PTSD as a result of community violence and overpolicing [27].…”

Section: Neighborhood Violencementioning

confidence: 99%

Social, Cultural, and Economic Determinants of Well-Being

2022

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Individual well-being is influenced by a number of economic and social factors that include income, mental health, physical health, education, social relationships, employment, discrimination, government policies, and neighborhood conditions. Well-being involves both physical and mental health as part of a holistic approach to health promotion and disease prevention. The well-being of a society’s people has the potential to impact the well-being and productivity of the society as a whole. Though it may be assessed at the individual level, well-being becomes an important population outcome at the macro level and therefore represents a public health issue.

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“…Reducing lethal and non-lethal violence is target 16.1 and eliminating all violence against women and girls is target 5.2 of the United Nations’ Sustainable Development Goals (SDGs) [ 1 , 2 ]. Lethal violence accounts for 1.3% of Years of Life Lost worldwide, [ 3 , 4 ] and non-lethal violence can also have severe consequences [ 5 – 8 ]. For instance, non-lethal violence increases the risk of mental disorders (anxiety, depression, and others) [ 5 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Lethal violence accounts for 1.3% of Years of Life Lost worldwide, [ 3 , 4 ] and non-lethal violence can also have severe consequences [ 5 – 8 ]. For instance, non-lethal violence increases the risk of mental disorders (anxiety, depression, and others) [ 5 , 9 , 10 ]. Non-lethal violence affects specific demographic groups more, such as women, younger individuals, and people experiencing racial discrimination (such as Afrodescendants and ethnic minorities) [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Gender inequalities in violence victimization and depression in Brazil: results from the 2019 national health survey

Mrejen

Rosa

et al. 2023

Int J Equity Health

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Background Violence is a worldwide public health challenge and has been linked to depression in many settings. Depression is higher in women and differential exposure to violence is a potential risk factor – especially in countries with high-levels of violence. This paper provides a comprehensive characterization of the association between violence victimization and depression in Brazil, focusing on sex/gender inequalities. Methods We used data from the 2019 wave of the National Health Survey (PNS) in Brazil to assess whether respondents had depression (using PHQ-9) and if they were victims of violence, differentiating by the type of violence, the frequency of victimization, and the primary aggressor. We used logit models to assess the association between victimization and the likelihood of having depression. We predicted probabilities of being depressed, considering the interaction between violence victimization and sex/gender, to analyze the differences between men and women. Results Rates of violence victimization and depression were higher among women than among men. The odds of being depressed were 3.8 (95%CI: 3.5–4.2) times higher among victims of violence than among non-victims, and 2.3 (95%CI: 2.1–2.6) times higher among women than among men, adjusting for socioeconomic factors. For any given income level, racial/ethnic or age group, victims of violence who were women had the highest predicted probabilities of being depressed – e.g., 29.4% (95%CI: 26.1–32.8) for lower-income women, 28.9% (95%CI: 24.4–33.2) for black women, and 30.4% (95%CI: 25.4–35.4) for younger women that suffered violence. Over one in three women that suffered multiple types of violence, experienced violence more frequently, or where the aggressor was an intimate partner or another family member were predicted to have depression. Conclusions Being a victim of violence was strongly associated with higher risk of depression in Brazil, with women more likely to be both victims of violence and develop depression. Frequent, sexual, physical or psychological violence, and intimate partners or family member perpetrators were major risk factors for depression and should be a public health priority.

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Experience of neighbourhood violence and mental distress in Brazilian favelas: a cross-sectional household survey

Cited by 8 publications

References 48 publications

Health inequity assessment in Brazil: is EQ-5D-3L sensible enough to detect differences among distinct socioeconomic groups?

Health inequity assessment in Brazil: is EQ-5D-3L sensible enough to detect differences among distinct socioeconomic groups?

Social, Cultural, and Economic Determinants of Well-Being

Gender inequalities in violence victimization and depression in Brazil: results from the 2019 national health survey

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