Stela Nazareth Meneghel

Profile of gender violence by intimate partners

OBJECTIVE To investigate the prevalence and profile of gender violence (physical, psychological, and sexual) perpetrated against women by current or former intimate partners. METHODS This is a cross-sectional study carried out at a primary healthcare unit in the city of Porto Alegre, Southern Brazil. Our sample comprised 251 women aged 18-49 years who attended the healthcare unit between October and November 2003. Data were collected by means of a questionnaire and double-entered into a electronic spreadsheet. We carried out univariate and bivariate analyses and the chi-square test. RESULTS The prevalence of the three types of violence were: psychological (55%, 95% CI: 49-61), physical (38%; 95% CI: 32-44), and sexual (8%; 95% CI: 5-11). Variables significantly associated with the three types of violence included womans age (psychological: p=0.004), womans schooling (psychological and physical; p=0.012 and 0.023, respectively), partners schooling (p=0.004, 0.000), social class (p=0.006, 0.000), years with partner (p=0.006, 0.005), partners occupation (p=0.015, 0.001), number of pregnancies (p=0.018, 0.037), and prevalence of minor psychiatric disorders (p=0.000, 0.000). CONCLUSIONS The present study found high prevalences of gender violence perpetrated by intimate partners among the users of a primary healthcare unit. Such units play an important role in preventing violence against women.

Epidemiological aspects of suicide in Rio Grande do Sul, Brazil

OBJECTIVE To describe epidemiological aspects of suicide mortality in a 10-year time series. METHODS Suicide deaths reported in the state of Rio Grande do Sul (RS), Brazil, were put together as historical time series based on data from the Ministry of Health Mortality Reporting System for the period 1980 to 1999. Suicides were grouped according to the WHO criteria and analyzed using standard demographic variables. RESULTS Suicide rates (proportional mortality and mortality rates) in RS during the study period were the highest in Brazil. The standardized rates grew from around 9 per 100,000 in the 1980s to 11 per 100,000 in 1999. This increase in mortality was attributed mainly to male mortality rates that grew from 14 per 100,000 to the current 20 per 100,000. The male:female ratio increased from 3 to 5. The highest ratios were seen among the elderly although this ratio has been increasing in young adults as well. Widows, widowers and farmers/fishers had the highest mortality rates. CONCLUSIONS The study highlights suicide as a collective health problem in RS and shows aspects that could contribute to preventive action.

The relationship between family violence and teenage aggressiveness

The following is an exploratory study on family violence in two different schools, public and the other private, Porto Alegre, Rio Grande do Sul. Seventy-six families were interviewed, 36 with adolescents classified as aggressive by teachers and 40 with non-aggressive adolescents. Total number of subjects was 213. Physical and severe violence, frequent or occasional, was present in more than half of the sample: 41 reports - 53.9%. A third of the cases occurred in the private school (37%), with twice as many in the public school (63%). However, rates of severe or frequent episodes were similar in both schools. The relationship between violent behavior by teenagers and physical punishment by parents was significant. That is, aggressive adolescents were punished more than non-aggressive ones (odds ratio = 4.3). Prevalence of physical abuse was higher in the older, male teenager group, in the presence of sibling aggression, and in low-income and dysfunctional families. The study shows that physical abuse is more present in society than we would like to imagine.

The impact of women's groups on gender vulnerability

This study evaluated the impact of workshops on health and gender conducted through extension programs under Universidade do Vale do Rio dos Sinos (UNISINOS) in the city of S o Leopoldo, Rio Grande do Sul, Brazil. The method was based on participatory research and action-based research. Womens groups were organized in two locations in the city. The first group was attended by 14 women, with a total of 6 meetings. The second received 18 women and held a total of 11 meetings. The themes discussed and experienced were: relations between parents and children, gender stereotypes and roles, conjugality, limits to abusive behaviors, body and sexuality, and empowerment to deal with violence. Thirteen women who attended the second group changed their behavior patterns, looking for jobs, going back to school, improving their body image, and reassessing situations involving violence. The group of researchers approached the S o Leopoldo Womens Forum and helped strengthen a support network, as well as increasing the visibility of specific policies and the planning and implementation of public policies for women.

Rotas críticas de mulheres em situação de violência: depoimentos de mulheres e operadores em Porto Alegre, Rio Grande do Sul, Brasil

This qualitative study aims to describe the trajectories of female victims of gender violence in Porto Alegre, Rio Grande do Sul State, Brazil. The methodology included in-depth interviews with women and staff, attempting to map the critical paths of women when they made the decision to seek professional help. We interviewed 21 women victims of gender violence and 25 professionals, including law enforcement officials, health and social workers, and nongovernmental organizations. The womens trajectories in the services were mapped, identifying facilitating factors and obstacles in the process of breaking with gender violence. The victims reported: pressure by professional staff to return to their marriages and police inefficiency in providing protection. The discourse of law enforcement officials and health and social workers showed a range of different concepts regarding violence, medicalization of violence, and network fragmentation.

Técnicas educacionales en el tratamiento de la diabetes

This study focused on an educational program for type 2 diabetics and monitoring of the following variables: blood glucose, weight, body mass index (BMI), blood pressure, and self-care of feet since the initial diagnosis over a 5-year period. This was an exploratory study from 1996 to 2000. The study was carried out with 189 patients diagnosed as type 2 diabetics, divided into two groups: compliant patients (n = 101) and non-compliant (n = 88), the latter having participated for less than 2 years. The methodology consisted of an educational intervention aimed at health and self-care. The variables used were: blood glucose, weight, BMI, and systolic and diastolic arterial pressure. The differences between baseline and final values showed a decrease for all variables in the compliant group and for blood glucose and arterial pressure (AP) for the non-compliant group. Regarding diet control, medication, physical exercise, and prevention of diabetic foot, there was a general improvement, demonstrating the importance of preventive measures for health.

Femicídios: homicídios femininos no Brasil

OBJETIVO: Analisar a mortalidade feminina por agressao segundo indicadores sociodemograficos e de saude. METODOS: Estudo ecologico sobre a mortalidade feminina por agressao ocorrida no Brasil de 2003 a 2007. Os dados de 19.459 obitos foram obtidos do Sistema de Informacoes sobre Mortalidade. Os coeficientes padronizados de mortalidade feminina por agressao foram relacionados (teste de correlacao de Pearson) com 28 indicadores socioeconomicos, demograficos e de saude. Foi realizada regressao linear multipla com variaveis que apresentaram p < 0,20 e excluidas as variaveis que apresentaram multicolinearidade. RESULTADOS: O coeficiente padronizado de mortalidade foi de 4,1 obitos/100.000 mulheres no periodo. Apos o ajuste, tres variaveis permaneceram significativas e associadas a mortalidade feminina por agressao: taxa de natalidade (p = 0,072), percentual de evangelicos (p = 0,019) e coeficiente de mortalidade por agressao no sexo masculino (p < 0,001). O modelo possui uma capacidade de predicao do desfecho de 69% (r² = 0,699). Espirito Santo, Pernambuco, Mato Grosso, Rio de Janeiro, Rondonia, Alagoas, Mato Grosso do Sul, Roraima e Amapa apresentaram os maiores coeficientes no periodo. CONCLUSOES: A mortalidade feminina por agressao no Brasil foi elevada e nao homogenea entre as regioes. Entre as variaveis associadas ao evento, destaca-se a mortalidade masculina por agressao, indicando a importância da reducao da violencia estrutural como protecao das mulheres contra a violencia.

Suicide rates in the State of Rio Grande do Sul, Brazil: association with socioeconomic, cultural, and agricultural factors

Rio Grande do Sul State has the highest suicide rates in Brazil. Previous studies have suggested a possible role of agricultural activities, especially tobacco farming, where pesticide use is intensive. An ecological study was designed to assess associations between age-adjusted suicide rates based on death certificates and socioeconomic and agricultural factors. Suicide rates in males and females were inversely associated with schooling level and directly associated with divorce/marital separation. Rates for men were higher in areas where traditional Protestant religious were more prevalent, and rates for women were lower in areas with a higher proportion of single-inhabitant households. Multivariate analyses showed no associations between increased suicide rates and any of the agricultural variables. These results confirm the role of socioeconomic determinants of suicide, but do not support the hypothesis of a specific role of agricultural practices.

Racial inequalities in access to women's health care in southern Brazil

The aim of this population-based cross-sectional study was to investigate access by 20 to 60 year-old women--both black and white--to early detection (pap-smear) exams for breast and cervical cancer in two towns--São Leopoldo and Pelotas--in Rio Grande do Sul State, southern Brazil. Estimates of the association between race/color and access to Pap-smear and breast exams were adjusted for income, education, economic class and age. Of the 2,030 women interviewed, 16.1% were black and 83.9%, white. Black women were significantly less likely to have had a Pap-smear and/or breast exam than white women. Racial inequalities in access to cancer early detection exams persisted after controlling for age and other socioeconomic factors. Racial differentials in access to early detection (Pap-smear) exams for breast and cervical cancers might result from racial and socioeconomic inequalities experienced by black women in access to reproductive health care services and programs.

Uso de métodos contraceptivos entre mulheres com vida sexual ativa em São Leopoldo, Rio Grande do Sul, Brasil

In 2003, a population-based cross-sectional study was conducted in the urban area of Sao Leopoldo, Rio Grande do Sul, Brazil. The sample included 867 sexually active women from 20 to 60 years of age. The objective was to describe the use of contraceptive methods. Data were collected using a standardized questionnaire. The study analyzed the prevalence of contraceptive use and socioeconomic variables in women reporting an active sex life (84.5%), stratified by age groups. Some 627 (61.1%) women reported use of contraceptive methods. In the 20-49-year old group, 48.8% reported using oral contraceptives, 18.7% tubal ligation, 17.3% condoms, and 7.3% IUDs. In the 50-60-year old group, the most widely used method was tubal ligation (79.6%). Regarding tubal ligation, the schooling variable showed a linear trend, that is, women with less schooling showed a higher prevalence. Prevalence of oral contraception was higher in low-income women.