Nancy Cardia

[Decline in homicide rates in Sao Paulo, Brasil: a descriptive analysis].

OBJECTIVE To describe homicide mortality in the municipality of São Paulo according to type of weapon, sex, race or skin color, age, and areas of socioeconomic inequalities, between 1996 and 2008. METHOD For this ecological time-series study, data about deaths in the municipality of São Paulo were collected from the municipal program for improvement of mortality information, using International Classification of Diseases, 10th revision (ICD-10) codes. Homicide mortality rates (HMR) were calculated for the overall population and specifically for each sex, race or skin color, age range, type of weapon, and occurrence in social deprivation/affluence areas. HMR were adjusted for age using the direct method. The percentage age of variation in HMR was calculated for the study period. For areas of socioeconomic inequalities, the relative risk of death from homicide was calculated. RESULTS HMR fell 73.7% between 2001 and 2008. A reduction in HMR was observed in all groups, especially males (-74.5%), young men between 15 and 24 years of age (-78.0%), and residents in areas of extreme socioeconomic deprivation (-79.3%). The reduction occurred mostly in firearm homicide rates (-74.1%). The relative risk of death from homicide in areas of extreme socioeconomic deprivation, as compared to areas with some degree of socioeconomic deprivation, was 2.77 in 1996, 3.9 in 2001, and 2.13 in 2008. In areas of high socioeconomic deprivation, the relative risk was 2.07 in 1996 and 1.96 in 2008. CONCLUSIONS To understand the reduction in homicide rates in the municipality of São Paulo, it is important to take into consideration macrodeterminants that affect the entire municipality and all population subgroups, as well as micro/local determinants that have special impact on homicides committed with firearms and on subgroups such as the young, males, and residents of areas of high socioeconomic deprivation.

Homicídios, desenvolvimento socioeconômico e violência policial no Município de São Paulo, Brasil

OBJECTIVE To analyze the association between police violence and homicide mortality rates taking into consideration the effect of contextual variables. METHODS This was an environmental, cross-sectional study that included the 96 census districts in the City of São Paulo. The association between the variables was analyzed using Spearmans rank correlation and simple and multiple regression analysis. RESULTS Univariate analysis revealed a strong and significant association between homicide mortality coefficients and all the indicators of socioeconomic development and police violence. After controlling for potential confounding factors, the association between police violence and homicide mortality coefficients remained strong and significant. This significance was lost only after control for the size of the resident population. CONCLUSION The results indicate that police action that violates basic human rights is not the right answer to urban violence. The combination of homicides from interpersonal violence and deaths from police violence results in negative socialization and promotes further violence.OBJETIVO: Analisar a associacao entre violencia policial e coeficientes de mortalidade por homicidio, considerando o efeito de variaveis contextuais. METODOS: Estudo ecologico de corte transversal considerando os 96 distritos censitarios do Municipio de Sao Paulo. A associacao entre as variaveis foi determinada atraves de correlacao de Spearman e de analise de regressao linear simples e multipla. RESULTADOS: Nas analises univariadas, encontramos associacao forte e significativa entre os coeficientes de mortalidade por homicidio e todos os indicadores de desenvolvimento socioeconomico e violencia policial. Apos controle dos potenciais confundidores, a associacao entre a violencia policial e os coeficientes de mortalidade por homicidio manteve-se forte e significativa. Apenas com o controle para o tamanho da populacao residente a associacao perdeu a significância estatistica. CONCLUSAO: Os resultados indicam que uma acao policial centrada na violacao de direitos humanos basicos nao parece ser a resposta correta para o enfrentamento da violencia urbana. A combinacao de homicidios que resultam de violencia interpessoal com mortes por violencia policial representa uma situacao de socializacao negativa, favorecendo ainda mais violencia.

HOMICIDE RATES AND HUMAN RIGHTS VIOLATIONS IN S?O PAULO, BRAZIL: 1990 to 2002

®he growth of violence in urban areas in Brazil (and in a number of Latin American cities) cannot be properly understood and prevented without recognizing that large sectors of those urban populations have little access to many social and economic rights. This article hopes to shed some light on the impact that this deprivation of rights has on the growing rate of violent crime-in particular, homicide-in areas of Brazil. According to available statistics, homicides are often concentrated in urban areas where social and economic rights are limited; however, not all such areas have high homicide rates. This article therefore explores what combinations of poor access to rights result in increased homicide rates. As other variables-exposure to violence, poor social capital, and the abusive use of force by law enforcement agents-are seen to have a role, they are included in this analysis. Nancy Cardia is Coordinator of Knowledge Transfer and ViceCoordinator of Nuicleo de Estudos da Violencia (NEV), Universidade de S?o Paulo (USP); S?rgio Adorno is Scientific Coordinator of the NEV/USP, Professor of Sociology at the School of Philosophy, Languages and Human Sciences, USP; and Frederico Z. Poleto is a graduate student in mathematics and statistics at USP. Please address all correspondence to the authors at ncardia@usp.br.

The assessment of the readiness of five countries to implement child maltreatment prevention programs on a large scale

This study aimed to systematically assess the readiness of five countries - Brazil, the Former Yugoslav Republic of Macedonia, Malaysia, Saudi Arabia, and South Africa - to implement evidence-based child maltreatment prevention programs on a large scale. To this end, it applied a recently developed method called Readiness Assessment for the Prevention of Child Maltreatment based on two parallel 100-item instruments. The first measures the knowledge, attitudes, and beliefs concerning child maltreatment prevention of key informants; the second, completed by child maltreatment prevention experts using all available data in the country, produces a more objective assessment readiness. The instruments cover all of the main aspects of readiness including, for instance, availability of scientific data on the problem, legislation and policies, will to address the problem, and material resources. Key informant scores ranged from 31.2 (Brazil) to 45.8/100 (the Former Yugoslav Republic of Macedonia) and expert scores, from 35.2 (Brazil) to 56/100 (Malaysia). Major gaps identified in almost all countries included a lack of professionals with the skills, knowledge, and expertise to implement evidence-based child maltreatment programs and of institutions to train them; inadequate funding, infrastructure, and equipment; extreme rarity of outcome evaluations of prevention programs; and lack of national prevalence surveys of child maltreatment. In sum, the five countries are in a low to moderate state of readiness to implement evidence-based child maltreatment prevention programs on a large scale. Such an assessment of readiness - the first of its kind - allows gaps to be identified and then addressed to increase the likelihood of program success.

O medo da polícia e as graves violações dos direitos humanos

A consolidacao democratica no Brasil ainda se depara com alguns desafios oriundos do regime autoritario. O advento da democracia coincidiu com uma grave crise economica e com a reducao da capacidade do Estado de intervir na oferta de servicos. O desempenho policial durante a transicao democratica ao contrario de melhorar so se deteriorou. A violencia e a arbitrariedade tambem nao desapareceram mas cresceram com a ineficiencia. A imagem que o publico tinha da policia durante a ditadura nao se reestruturou mas continuou a ser negativa. Essa imagem ruim e causada tanto pelo fraco desempenho e pela violencia e arbitrariedade da policia quanto pela falta de controles externos da policia, ou seja, de canais institucionais para as pessoas poderem registrar suas queixas sobre o comportamento policial. Assim, as pessoas ficam entre a necessidade por seguranca publica que deveria ser fornecida pela policia e a descrenca ou mesmo medo que sentem por ela. Eis entao a grande ambiguidade do sentimento das pessoas com relacao a policia: elas tendem a nao acreditar na policia mas isso nao se traduz por demandas de melhora no desempenho ou de controle sobre essa instituicao. Muito pelo contrario, a desconfianca caminha lado a lado com a concordância do comportamento arbitrario da policia. O objetivo deste trabalho e exatamente examinar essas contradicoes.

Evolução dos homicídios e indicadores de segurança pública no Município de São Paulo entre 1996 a 2008: um estudo ecológico de séries temporais

The scope of this paper was to analyze the association between homicides and public security indicators in Sao Paulo between 1996 and 2008, after monitoring the unemployment rate and the proportion of youths in the population. A time-series ecological study for 1996 and 2008 was conducted with Sao Paulo as the unit of analysis. Dependent variable: number of deaths by homicide per year. Main independent variables: arrest-incarceration rate, access to firearms, police activity. Data analysis was conducted using Stata.IC 10.0 software. Simple and multivariate negative binomial regression models were created. Deaths by homicide and arrest-incarceration, as well as police activity were significantly associated in simple regression analysis. Access to firearms was not significantly associated to the reduction in the number of deaths by homicide (p>0,05). After adjustment, the associations with both the public security indicators were not significant. In Sao Paulo the role of public security indicators are less important as explanatory factors for a reduction in homicide rates, after adjustment for unemployment rate and a reduction in the proportion of youths. The results reinforce the importance of socioeconomic and demographic factors for a change in the public security scenario in Sao Paulo .

Fall in homicides in the city of São Paulo: an exploratory analysis of possible determinants

Throughout the first decade of the 2000s the homicide mortality rate (HMR) showed a significant reduction in the state and the city of São Paulo (MSP). The aim of this study is to describe the trend of HMR, socio-demographic indicators, and the investment in social and public security, and to analyze the correlation between HMR and independent variables in the MSP between 1996 and 2008. An exploratory time series ecological study was conducted. The following variables were included: HMR per 100,000 inhabitants, socio-demographic indicators, and investments in social and public security. The moving-averages for all variables were calculated and trends were analyzed through Simple Linear Regression models. Annual percentage changes, the average annual change and periodic percentage changes were calculated for all variables, and the associations between annual percentage changes were tested by Spearmans correlation analysis. Correlations were found for the proportion of youth in the population (r = 0.69), unemployment rate (r = 0.60), State budget for education and culture (r = 0.87) and health and sanitation (r = 0.56), municipal (r = 0.68) and State (r = 0.53) budget for Public Security, firearms seized (r = 0.69) and the incarceration rate (r = 0.71). The results allow us to support the hypothesis that demographic changes, acceleration of the economy, in particular the fall in unemployment, investment in social policies and changes in public security policies act synergistically to reduce HMR in São Paulo. Complex models of analysis, incorporating the joint action of different potential explanatory variables, should be developed.

Regimes espaciais: dinâmica dos homicídios dolosos na cidade de São Paulo entre 2000 e 2008

OBJETIVO: Identificar a existencia de padroes espaco-temporais na ocorrencia de homicidios dolosos no Municipio de Sao Paulo (MSP) e discutir o valor analitico de levar em conta tais padroes ao elaborar estudos que tratam da dinâmica e dos fatores associados a incidencia dos homicidios dolosos. METODOS: Realizou-se um estudo ecologico e longitudinal, tendo como unidades de analise 13 205 setores censitarios e os 96 distritos censitarios que congregam esses setores na capital paulista. Foram estudados todos os homicidios dolosos registrados no municipio entre 2000 e 2008 e calculadas as taxas brutas de homicidios dolosos por 100 000 habitantes para cada setor censitario, assim como as taxas bayesianas globais e locais. Para verificar a possibilidade de identificar diferentes padroes de distribuicao espacial dos homicidios, foram utilizadas as tecnicas BoxMap e o indice de Moran. RESULTADOS: Nao houve uma tendencia homogenea e sistematica dos homicidios ao longo da ultima decada na capital paulista. Ao inves disso, foram identificados sete padroes de distribuicao espacial, ou seja, sete regimes espaciais, para a ocorrencia de homicidios dolosos, considerando as taxas dentro de cada setor censitario e nos setores adjacentes. Esses regimes de distribuicao espacial nao estavam contidos nos limites dos setores e distritos censitarios do municipio. CONCLUSOES: Os resultados mostraram a importância de analisar a distribuicao espacial dos fenomenos sociais sem restricao de fronteiras politico-administrativas.

World report on violence and health

WHO Violence cuts short the lives of millions of people across the world each year, and damages the lives of millions more. It knows no boundaries of geography, race, age or income. It strikes at children, young people, women and the elderly. It finds its way into homes, schools and the workplace. Men and women everywhere have the right to live their lives and raise their children free from the fear of violence. We must help them enjoy that right by making it clearly understood that violence is preventable, and by working together to identify and address its underlying causes.

Home Visitation Programs for Early Child Development: Experiences in Latin America and the Caribbean

Research over recent decades has shown that promoting good care for children in the very early stages of their development has extensive effects throughout the life cycle. As a result, over the years several programs and policies have been designed to improve the lives of children from 0 to 6 years. In this chapter, we present a perspective from Latin America on programs that seek to promote good care in early stages of child development. The programs reviewed, whether in Chile, Cuba, Ecuador, Colombia, Argentina, Peru, or Brazil, rely in some measure on home visitation methodology and target areas of high social vulnerability, assisting families who, for various reasons, have difficulties reaching other assistance networks. We present information about the programs’ goals, procedures, and when evaluations are available, their results.