Academic journal article Iranian Journal of Public Health

Characterization of Morbidity from Interpersonal Violence in Brazilian Children and Adolescents

Academic journal article Iranian Journal of Public Health

Characterization of Morbidity from Interpersonal Violence in Brazilian Children and Adolescents

Article excerpt

Introduction

The World Health Organization (WHO) defines violence as the intentional use of physical force or power, real or threatened, against oneself, another person, or a group or community that results (or resulted, or is likely to result) in injury, death, psychological harm, maldevelopment or deprivation (1). Violence is understood as a social and historical phenomenon that follows the entire experience of man (2). The occurrence of these events may be associated with factors such as age, low educational level, alcohol consumption and acculturation practices, often emphasized by alcohol consumption and acceptance of violence (3).

Worldwide, these injuries during childhood and adolescence have an important impact on the individual and population (4). In Europe, every year, over 40,000 children die from injuries, and for all of them, there are thousands of victims who live with varying degrees of disabilities or physical and psychological sequelae (4). Fatal injuries represent a small fraction of the problem. Non-fatal violence compromises the health of million people worldwide (5).

In Brazil, violence has been one of the most prominent causes of morbidity and mortality (6). From January 2008 to October 2012, there were 39,798 cases of aggression to children and adolescents, 24,734 of them in the age group 15-19 years. The most affected were males, corresponding to 79.21% of cases (7).

Records of cases of violence among children and adolescents have increased every year (8). Many of the victims are marked by the effects of violence in their homes, schools or communities (9). For challenging the authority of parents, adolescents can provoke violent responses. In comparison, infants and young children are more likely to be victims due to their disability and physical frailty, helplessness and defiant behavior (8).

The Brazilian Criminal Procedure Code establishes that when the offense leaves trace, the corpus delicti examination becomes mandatory. The corpus delicti examination is the verification of the existence of crime, done by experts directly, or through other evidence, when traces, although material, disappear. The issue of an expert report attests the materiality of the offense, exhibits a reasoned conclusion with all relevant observations to what was verified, discussing on life-threats and severity and extent of injury in the context of body injuries (10).

The maxillofacial region occupies the most prominent position in the human body, making it vulnerable to the occurrence of lesions (11). In many cases of violence in children and adolescents, face, head and mouth are involved (12-14).

The consequences produced by violence have a broad dimension (5), because in addition to affecting individual and collective health, it also has consequences to other sectors, such as increased cost of emergency services, assistance and rehabilitation, with more onerous expenses than those of conventional medical procedures (15). Approximately 3.3% of the Gross Domestic Product (GDP) are used with the direct costs of violence. This percentage rises when indirect expenditures and transfers of resources are included (16).

Therefore, violence cannot be understood solely as a public health issue, but also as a public health problem, because it affects the individual and the collectivity, which requires prevention and confrontation based on specific policies and organization of practices and specific services (2).

Considering the impact that violence generates to the lives of children and adolescents, this study aimed to characterize morbidity due to violence in this population occurred between 2008 and 2011 in Campina Grande, Paraiba, Brazil.

Material and Methods

Study Design

A cross-sectional study was conducted through the analysis of medical reports of corpus delicti examinations and respective police reports (PR) of children and adolescents non-fatal victims from external causes reported at the Center for Forensic Medicine and Dentistry of Campina Grande, Paraiba, Brazil. …

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