Transcript The impact of firearm on public health in Brazil Small Arms Survey

The impact of firearm
on public health in Brazil
Luciana Phebo, MD, MPH
ISER
Small Arms Survey
Method
• Source:
– Mortality Information System (MIS), MOH
– Hospitalization Information System (HIS), MOH
– Census, IBGE
• Categories for firearm injuries and deaths
– ICD 9th and 10th version
– Intentional, unintentional injuries and death
– Unknown intention - correction
International Comparison
International Comparison (Firearm deaths and homicides - absolute numbers and rates)
Year of
Firearm Death Firearm Homicide Number of deaths % of homicides
reference Rate /100 000
Rate /100 000
by firearm
committed by
firearms
Colombia
2002
55,7
51,77
22 827
86%
From: Centro de Referencia Nacional sobre Violência – Colômbia, 2002)
South Africa
2002
26,8
26
11 709
54%
25,3
1 641
71%
64%
From: South African Police Service (SAPS) -2002
El Salvador
2001
25,8
From: PNUD, Armas de fuego y Violencia , 2003
Brazil
2002
21,8
20,8
38 088
2000
10,4
3,9
28 663
From: DATASUS
United States
From: HELP Network, 2000 and CDC
64%
Injury Deaths (%), Brazil 2002
Other
external
causes
44.0%
N=126.550
Firearm s
30.1%
Motor
vehicle
25.9%
Timeline of Firearm Death Rate in Brazil
25.0
21.8
22.5
20.2
20.0
18.5 18.7
19.2
17.1 16.9 17.3
17.5
14.2 14.0 14.4 14.1
15.0
11.6
12.5
12.1
10.8
9.6
10.0
10.0
8.5
7.2
7.5
5.0
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
0
1984
0.0
1983
2.5
1982
Rate per 100.000 inhab.
15.7
14.9
Firearm Death rates
Unidades da Federação
Taxas de PAF - 2000
0 - 5.4
5.4 - 16.74
16.74 - 32.44
32.44 - 58.79
58.79 - 149.48
(1980)
(1991)
(2000)
Firearm death rate, per sex and age group, Brazil, 2002
120
103.1
100
Male
80
Female
71.2
57.7
60
40
37.1
34.6
22.6
20
0.5 0.3
4.4
1.3
4.7
5.3
3.7
2.8
1.6
2.6
0
up to 9
years
10-14
15-19
20-29
30-39
40-49
50-59
60-69
9.1
0.5
70 or
more
Causes of Death (natural and external causes)
in (%), 15-19 year old males, Brazil 2002
N= 15,764
Natural
Causes
26.3%
Motor
Vehicle
14.8%
Other
External
Causes
19.9%
Firearm s
39.1%
Causes of death, 15-19 year old males,
in (%), Municipality of Rio de Janeiro, 2002
N= 886
External
cause of
death
20%
Motor
vehicle
injuries
8%
Natural
cause of
death
14%
Firearm
58%
Firearm death rate, per race/color Brazil 2002
Rates per 100.000 inhab.
35
30
25
20
15
10
5
0
1997
White
1998
1999
Black
2000
2001
Mulatto
2002
Firearm injury by intent, Brazil 2002
Firearm death
N=38,088
Unintentional
injuries
Accidents
Suicides
3.6%
0.8%
Unknown
Intentionalit
intent
y unknow
5.6%
Firearm wound admissions by intent
N=19,519
Unintentional
injuries
Accidents
32,7%
Hom icides
90.0%
Unknown
Assault /
homicide
attempt
61,5%
Intentionalit
yintent
unknown
3,0%
Suicide
attempt
2,8%
Firearm wound admissions, by intent and age group,
Brazil 2002
3,5%
Unknow n intent
36,8%
45 years old or +
3, 5%
Unintentional injuries
56,2%
3,0%
Suicide attem pt
32,2%
35-44 years old
2, 7%
Hom icide attem pt
62,1%
2,3%
30,7%
25-34 years old
3, 1%
63,9%
2,9%
30,8%
15-24 years old
2, 6%
63,6%
5,7%
0-14 years old
54,3%
1, 8%
38,2%
0%
5%
10%
15%
20%
25%
30%
Firearm wound admissions, 0 to 14 years old, Brazil, 2002
N=1.078
Unknown
Intentionalit
intent
y unknown
6%
Homicide
attempt
38%
Unintentional
injuries
Accidents
54%
Suicide
attempt
2%
Homicides, by method, Brazil 2002
N= 56,795
Others
15.5%
Physical
aggression
0.8%
Other type
of
w eapons
19.8%
Assaults and Homicides Attempts, by method,
2002
Firearm
N=12.004
63.9%
Others
17,3%
Firearm
30,4%
Physical
aggression
14,3%
Other type
of weapons.
38,0%
Suicide method distribution, Brazil 2002
N=7,726
Other
11.5%
Fall
2.7%
Firearm
17.7%
Suicide attempt method, Brazil 2002
N=546
Poisining
15.9%
Other
19,8%
Hanging
52.2%
Firearm
5,2%
Fall
0,5%
Hanging
0,4%
Poisoning
74,1%
Firearm and motor vehicle hospitalization,
by length of stay (days), Brazil 2002
Motor vehicle
6
Firearm
7
0
1
2
3
4
5
6
7
8
Lethality proportion, by intent, Brazil 2002
Firearm
unintentional
Firearm
unitencional
6,9
Firearm unknown cuase
7,1
Firearm suicide attempt
13,4
Firearm assault
9,9
Firearm
8,9
Motor vehicle
4,4
0
2
4
6
8
10
12
14
16
Discussion
• Stray bullets
• Firearm types
Challenges
• Firearm injury surveillance (police, health,
coroners)
• Survey about prevalence of firearm
The use of data
• Disarmament Statute
• Popular referendum
• Buy back campaign evaluation
• www.vivario.org.br
Gracias
Thank you
Obrigada