ABSTRACT
INTRODUCTION: Sexual violence has emerged in the health field with changes in the epidemiological profiles of populations. METHODOLOGY: An ecological study with 5,565 Brazilian municipalities between 2010 and 2014. A descriptive analysis of the variables (Population rate of sexual violence reporting, household income per capita and HDI) and their stratification by quintile was performed. In order to explore the factors associated with changes in social inequalities regarding the rate of reporting of sexual violence, the Slope Index of Inequality and Relative Index of Inequality were adopted. An Equiplot was constructed for the outcome on each independent variable. RESULTS: The mean rate of reports of sexual violence in Brazil was 4.38 reports/100,000 inhabitants for the period. There was an increase in the rate of sexual violence and improvement in socioeconomic conditions. There was a higher rate of reporting in the quintile with better living conditions. An increase in the inequality of the rate of sexual violence as a function of household income and the HDI was observed. Several factors seem to influence the increase of reports of sexual violence in the country, among them the improvement in the living conditions of the population and greater moral sensitivity to violence. However, there is still a disparity in reporting among municipalities according to their socioeconomic status. CONCLUSION: The lack of public policies on social equity in health has interfered with reports of sexual violence in the country and has widened health inequities.
Subject(s)
Health Status Disparities , Sex Offenses/trends , Social Determinants of Health/trends , Socioeconomic Factors , Brazil/epidemiology , Cities/epidemiology , Female , Humans , Linear Models , Male , Mandatory Reporting , Sex Offenses/statistics & numerical data , Social Conditions/trends , Time FactorsABSTRACT
RESUMO: Introdução: A violência sexual tem despontado no cenário da saúde com as mudanças nos perfis epidemiológicos das populações. Metodologia: Estudo ecológico com 5.565 municípios brasileiros entre 2010 e 2014. Realizou-se análise descritiva das variáveis (taxa populacional de notificação de violência sexual, renda domiciliar per capita e índice de desenvolvimento humano - IDH) e suas estratificações por quintil. Para explorar os fatores associados às mudanças nas desigualdades sociais na taxa de notificação de violência sexual, foram adotados o coeficiente angular de desigualdade e o índice relativo de desigualdade. Construiu-se equiplot para o desfecho em cada variável independente. Resultados: A taxa média de notificações de violência sexual no Brasil foi de 4,38 notificações/100 mil habitantes para o período. Houve incremento na taxa de violência e melhoria nas condições socioeconômicas. Observou-se maior taxa de notificações no quintil com melhores condições de vida, bem como aumento na desigualdade da taxa de notificações de violência sexual em função da renda domiciliar e do IDH. Diversos fatores parecem influenciar o aumento das notificações de violência sexual no país. Entre eles, destacam-se a melhoria nas condições de vida da população e a maior sensibilidade moral à violência, contudo ainda há disparidade de notificações entre os municípios de acordo com sua condição socioeconômica. Conclusão: A falta de políticas públicas de equidade social em saúde tem interferido nas notificações de violência sexual no país e ampliado as iniquidades em saúde.
ABSTRACT: Introduction: Sexual violence has emerged in the health field with changes in the epidemiological profiles of populations. Methodology: An ecological study with 5,565 Brazilian municipalities between 2010 and 2014. A descriptive analysis of the variables (Population rate of sexual violence reporting, household income per capita and HDI) and their stratification by quintile was performed. In order to explore the factors associated with changes in social inequalities regarding the rate of reporting of sexual violence, the Slope Index of Inequality and Relative Index of Inequality were adopted. An Equiplot was constructed for the outcome on each independent variable. Results: The mean rate of reports of sexual violence in Brazil was 4.38 reports/100,000 inhabitants for the period. There was an increase in the rate of sexual violence and improvement in socioeconomic conditions. There was a higher rate of reporting in the quintile with better living conditions. An increase in the inequality of the rate of sexual violence as a function of household income and the HDI was observed. Several factors seem to influence the increase of reports of sexual violence in the country, among them the improvement in the living conditions of the population and greater moral sensitivity to violence. However, there is still a disparity in reporting among municipalities according to their socioeconomic status. Conclusion: The lack of public policies on social equity in health has interfered with reports of sexual violence in the country and has widened health inequities.
Subject(s)
Humans , Male , Female , Sex Offenses/trends , Socioeconomic Factors , Health Status Disparities , Social Determinants of Health/trends , Sex Offenses/statistics & numerical data , Social Conditions/trends , Time Factors , Brazil/epidemiology , Linear Models , Cities/epidemiology , Mandatory ReportingABSTRACT
OBJECTIVES: Assessing the prevalence of sexual violence in Brazil and its association with individual and contextual factors. METHODS: A multilevel analysis performed with cross-sectional data from 2010. The adjusted prevalence ratio was estimated through Poisson multilevel modelling. Cross-level interactions were evaluated by the inclusion of interaction terms between socio-economic variables from the two levels. RESULTS: Sexual violence is more prevalent in federal units that presented lower years of schooling expectancy at 18 years old (PR 1.27; CI95% 1.09-1.48), lower per capita income (PR 1.23; CI95% 1.05-1.43), lower HDI (PR 1.17; CI95% 1.01-1.37), higher proportion of poverty vulnerability (PR 1.18; CI95% 1.02-1.38), higher proportion of unemployment (PR 1.68; CI95% 1.45-1.96) and higher proportion of people who neither work nor study (PR 1.26; CI95% 1.08-1.46). Higher prevalence of sexual violence was associated with lower Gini index and greater coverage of primary health services. In analysing the tendency demonstrated a strong contextual effect between the Brazilian federative units in relation to sexual violence CONCLUSIONS: The strategy to reduce sexual violence in Brazil must be integrated with other social policies, considering both individual risk factors and macro-social determinants.
