Análise da tendência de mortalidade por homicídios entre adolescentes residentes em um grande centro urbano: Projeto BH Viva, 2002 a 2020.

Abstract

Introduction: Homicide mortality among adolescents constitutes a public health problem with severe social and economic repercussions. Violence is associated with factors such as social inequality and unplanned urbanization, disproportionately affecting young people in vulnerable areas. Objective: To describe the profile of homicide mortality rates among adolescents aged 10 to 19 years and analyze the temporal trend in Belo Horizonte/MG, from 2002 to 2020. Methods: An ecological study with time series analyses was conducted to investigate homicide mortality among adolescents aged 10 to 19 years, using data from the BH-Viva Project, developed by the Belo Horizonte Urban Health Observatory (OSUBH). Homicide deaths were classified according to Chapter XX of the International Statistical Classification of Diseases and Related Health Problems (ICD-10), titled "External Causes of Morbidity and Mortality" (codes X60-Y89). Subsequently, the association between mortality rates and age group, place of residence, and year effect was estimated using a series of log-linear Negative Binomial regression models. To confirm the robustness of the results, sensitivity analyses were conducted using the Poisson distribution. A significance level of 5% was adopted in this study. Statistical analyses were performed using Stata 17.0. Results: During the study period, Belo Horizonte recorded 2,073 homicide deaths among adolescents. The cumulative rate for the period was 35.71 homicides per 100,000 inhabitants in Belo Horizonte, with 29.82 homicides per 100,000 inhabitants in the formal city and 92.80 homicides per 100,000 inhabitants in favelas and urban communities. There was an overall downward trend in the risk of homicides over the years analyzed (RR=0.94; 95% CI=0.92–0.95), with higher risk observed among older adolescents (RR=14.18; 95% CI=11.48–17.51) and in favelas and urban communities (RR=3.11; 95% CI=2.64–3.67). The reduction was greater in favelas and urban communities (8% per year) compared to the formal city (5% per year). Adolescents aged 15 to 19 years residing in favelas and urban communities had an approximately 44 times higher risk of being homicide victims than adolescents aged 10 to 14 years living in the formal city. Despite the downward trend over the years, with a more pronounced decrease in favelas and urban communities, it was found that mortality rates remain high, with significant differences according to place of residence. Conclusion: The reduction in homicide mortality rates among adolescents in Belo Horizonte reflects progress during the study period, possibly related to the interventions of the BH-Viva Project and other local initiatives. However, further investigations are needed to confirm this relationship. The persistence of high mortality rates in vulnerable areas underscores the urgent need for comprehensive public policies aimed at social equity and the protection of adolescents in vulnerable situations, addressing the social determinants of violence in an integrated manner.