Uneven state distribution of homicides in Brazil and their effect on life expectancy, 2000–2015: a cross-sectional mortality study

Abstract

ObjectiveTo determine cause-specific and age-specific contributions to life expectancy changes between 2000 and 2015, separately by state and sex in Brazil, with a focus on homicides.DesignRetrospective cross-sectional demographic analysis of mortality.Setting and populationBrazilian population by age, sex and state from 2000 to 2015.Main outcome measureUsing mortality data from the Brazilian Mortality Information System and population estimates from the National Statistics Office, we used death distribution methods and the linear integral decomposition model to estimate levels and changes in life expectancy. We also examine how multiple causes of death, including those attributable to homicides and amenable/avoidable mortality, contributed to these changes from 2000 to 2015.ResultsBetween 2000 and 2015, life expectancy in Brazil increased from 71.5 to 75.1 years. Despite state-level variation in gains, life expectancy increased in almost all states over this period. However across Brazil, homicide mortality contributed, to varying degrees, to either attenuated or decreased male life expectancy gains. In Alagoas in 2000–2007 and Sergipe in 2007–2015, homicides contributed to a reduction in life expectancy of 1.5 years, offsetting gains achieved through improvements due to medically amenable causes. In the period 2007–2015, male life expectancy could have been improved by more than half a year in 12 of Brazil’s states if homicide mortality had remained at the levels of 2007.ConclusionsHomicide mortality appears to offset life expectancy gains made through recent improvements to mortality amenable to medical services and public health interventions, with considerable subnational heterogeneity in the extent of this phenomenon. Efforts combating the causes of homicides can increase life expectancy beyond what has been achieved in recent decades.

An Unrelenting Epidemic of Violence: Trends of Homicide Mortality in Mexico, 1998–2020

“…Homicide mortality for males was higher than for females in all age groups, as in other homicide studies worldwide 9,38–40 and in Mexico. 17,41,42 Premature homicide mortality in 2020 was more than eight times higher for men compared to women in Mexico, while the global homicide rate for the male population is roughly four times the rate for females.…”

Gender-related and non-gender-related female homicide in Porto Alegre, Brazil, from 2010 to 2016

“…Black men from the urban periphery with criminal records [20]. At the national level, there was a migration of crime from large urban centers to other regions of the country, where social inequality, access to firearms, drug trafficking, and alcohol and drug abuse contributed to Brazil presenting a mortality risk ten times higher than that of developed countries [5,7]. In the study area, the increase in female homicides followed that of male homicides, with clearer trends in adolescents aged 15 to 19 years, predominantly those of non-White color and linked to criminal activities.…”

“…A study of 24 countries in the region revealed that this type of violence affects 14% to 60% of the female population of childbearing age (15-49 years). Other studies have shown a relationship between increased urban violence and elevated gender violence, especially where great socioeconomic inequality and the influence of organized crime and drug trafficking exist [5,7,38]. In Brazil, the prevalence is that one in seven women (14%-17%) may be a victim of intimate partner violence at some point in life [4].…”

“…In Latin America, high overall homicide mortality rates are related to high unemployment rates, participation in criminal activities, and easy access to firearms [4,5]. There is also a higher concentration of deaths among women aged 15 to 29 years [6].…”

“…There is also a higher concentration of deaths among women aged 15 to 29 years [6]. In Brazil, life expectancy is compromised by the high risk of death from male and female homicides [5]. A study that analyzed homicide mortality in women aged 10 years or over in different Brazilian regions from 1980 to 2014 revealed an average rate of 5.13 deaths per 100,000 women.…”