Padrões de violência contra idosos: análise pelo sistema de vigilância de violências e acidentes

Abstract

Violence against the elderly is an important public health problem, with implications for quality of life, individual and population health. Due to the aging of the Brazilian population and social inequalities, added to the family situation and the psychosocial context, the different types of violence can occur, in greater quantity, against the elderly. In 2006, the Ministry of Health developed the Violence and Accident Surveillance System (VIVA), with two components: Surveillance by Survey, carried out in selected urgency and emergency services in the country, and Continuous Surveillance, through the System of Diseases Notification (SINAN). Its purpose is to monitor and provide information to tackle violence in the country. The objective of the study is to describe the patterns of care in urgent and emergency services and notifications for violence against elderly people in Brazil. This is a cross-sectional study, with data on violence against the elderly recorded in VIVA, referring to 2017. Any person aged 60 or over was considered elderly, as established in the Elderly Statute. A descriptive analysis of the characteristics of the victim, of the violence and of the probable aggressor was carried out according to sex, age group and education, and Pearson's χ2 test was used to compare the groups. Then, the Simple Correspondence Analysis was carried out to assess the main relationships between the characteristics studied and to assess the main patterns of violence against the elderly. The results of the VIVA SURVEY showed that the majority of the victims were elderly people, between 60 and 69 years old, with low education, of non-white race/skin color, residents of the Northern Region of the country, who suffered, above all, physical violence. The Simple Correspondence Analysis showed four patterns of violence, and, when considering the victim's gender, they were related to violence by force/beatings and contusion injuries for women. For men, the associations were injury by cutting, on public area and by stranger aggressor. When considering the age group, the group of elderly people from 60 to 69 years old showed an association with the variable's race/skin color, high education, male aggressor and with suspected alcohol consumption. Among the elderly, there was a relationship with race/skin color non-white, low education, other violence and occurrence at home. In the SINAN component, 17,311 cases or suspected violence against the elderly were reported. Of the total, 50.4% are of white race/skin color, 42.3% are married and 17.2% have disabilities/disorders. The majority (76.9%) of the occurrences were at the residence and physical violence was the main type, responsible for 62.8% of notifications and repetition violence was reported by 49.5%. Regarding the aggressor, 62.0% are men and 62.8% of the violence was committed by two or more aggressors. Simple Correspondence Analysis was performed according to the victim's sex, obtaining four different patterns for men and women. The results show differences in relation to sex: among women, the occurrences were mainly at home, committed by a family aggressor or intimate partner, while the occurrences among men were, mainly, on the public area, committed by a stranger person and with suspected consumption of alcohol for both components. The present study showed that physical violence was the main type of aggression against the elderly. Regarding the VIVA SURVEY, most of the victims were male and most of the occurrences were on the public area. In SINAN, most of the victims were female and the place of occurrence was the residence. In the patterns of violence, different patterns are evident when considering the sex of the elderly, the occurrence of physical violence among the youngest and due to neglect/abandoned among the most fragile and elderly, and also the violence committed by the daughter. In addition to these, the incompleteness of the variables, especially education and suspicion of alcohol consumption, and low frequency of notifications in the Northeast Region in the SINAN registrations, stands out. It is essential to increase actions to tackle violence against the elderly in Brazil, through effective policies aimed at improving living conditions and structural changes that reduce inequalities and end all types of discrimination, such as gender and age and the promotion of a culture of peace in all age groups.