Violência urbana e saúde

O artigo problematiza a conformação da “violência urbana” no país e sua centralidade nas percepções e vivências cotidianas da população, elegendo como caso específico o município de São Paulo. Considera-se a categoria da “violência urbana” em suas diferentes perspectivas, ou seja, como representação e problema social, bem como objeto de interesse de diferentes campos de saber e de intervenção, com destaque para o campo da saúde públicaThe article discusses the conformation of urban violence in the country and its central role in everyday perceptions and experiences of the population; and draws particularly on the case of the city of São Paulo. The category of urban violence is considered from its different perspectives, namely as representation and social problem as well as a growing interest in different fields of knowledge and intervention, especially in the field of public healt

Social Disorganization and Urban Homicide Rates: A Spatial-Temporal Analysis in São Paulo, Brazil 2000 to 2015

This study aims to contribute to understanding urban spatial and temporal patterns of social disorganization and homicide rates in São Paulo, Brazil (2000–2015). Using exploratory spatial data analysis and spatial panel regression techniques, we describe spatial-temporal patterns of homicide rates and assess to what extent social disorganization can explain between-district variation in homicide trajectories. The results showed some variation in the pattern of homicide decline across districts, and less disorganized communities experienced earlier, more linear declines. However, we found no evidence to suggest that changes in social disorganization are associated with differences in the decline in homicide rates

Vitimização fatal de crianças no espaço público em decorrência da violência interpessoal comunitária: um diagnóstico da magnitude e contextos de vulnerabilidade na América Latina

Desde a década de 1990 a América Latina é reconhecida como uma das áreas mais violentas do mundo. A violência, na região, é endêmica e as taxas de mortalidade por homicídio são extremamente elevadas. A vitimização de crianças não é exceção. O objetivo deste texto é sistematizar informações existentes sobre a vitimização fatal de crianças no espaço público em decorrência da violência interpessoal comunitária nos países da América Latina. Os resultados encontrados permitem afirmar que este é um problema grave na região, que envolve fatores de elevada complexidade. Embora existam diferenças importantes entre os países, um conjunto de fatores permite explicar os altos níveis de violência encontrados. A presença do crime organizado e as gangues, a violência policial, crianças em situação de rua, migração e conflitos armados emergem em um cenário de pobreza e desigualdade que, juntos, tornam as crianças particularmente vulneráveis à violência comunitária com desfecho letal

Patterns of health-related behaviours among adolescents: a cross-sectional study based on the National Survey of School Health Brazil 2012.

OBJECTIVES: The aim of this study was to analyse the clustering of multiple health-related behaviours among adolescents and describe which socio-demographic characteristics are associated with these patterns. DESIGN: Cross-sectional study. SETTING: Brazilian schools assessed by the National Survey of School Health (PeNSE, 2012). PARTICIPANTS: 104 109 Brazilian ninth-grade students from public and private schools (response rate=82.7%). METHODS: Exploratory and confirmatory factor analyses were performed to identify behaviour clustering and linear regression models were used to identify socio-demographic characteristics associated with each one of these behaviour patterns. RESULTS: We identified a good fit model with three behaviour patterns. The first was labelled 'problem-behaviour' and included aggressive behaviour, alcohol consumption, smoking, drug use and unsafe sex; the second was labelled 'health-compromising diet and sedentary behaviours' and included unhealthy food indicators and sedentary behaviour; and the third was labelled 'health-promoting diet and physical activity' and included healthy food indicators and physical activity. No differences in behaviour patterns were found between genders. The problem-behaviour pattern was associated with male gender, older age, more developed region (socially and economically) and public schools (compared with private). The 'health-compromising diet and sedentary behaviours' pattern was associated with female gender, older age, mothers with higher education level and more developed region. The 'health-promoting diet and physical activity' pattern was associated with male gender and mothers with higher education level. CONCLUSIONS: Three health-related behaviour patterns were found among Brazilian adolescents. Interventions to decrease those negative patterns should take into account how these behaviours cluster together and the individuals most at risk

O conceito de saúde mental

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Association between self-control and health risk behaviors: a cross-sectional study with 9th grade adolescents in São Paulo.

BACKGROUND: Self-control (SC) has been consistently found associated with diverse health risk behaviors (HRBs), but little research refers to low- and middle-income countries. Furthermore, there is evidence that some HRBs tend to aggregate, however studies with the specific purpose of addressing the relation between SC and multiple health risk behaviors (MHRBs) are rare. The objective of this study is to analyze these associations and provide evidence to help filling these gaps. METHODS: A sample of 2106 9th grade students from the city of São Paulo responded a self-administered questionnaire in 2017. We tested the association of SC measured as an ordinal variable with four levels (higher, high, medium and low) with six HRBs (binge drinking, marijuana use, smoking, high consumption of ultra-processed food, sedentary behavior and bullying perpetration), in both separated and aggregated forms (MHRBs), controlling for potential confounders. Binary logistic regression was used to test the association between exposure (SC) and single outcomes. In order to analyze the association of SC with MHRBs, multinomial logistic regression was employed. RESULTS: SC was associated with five of six HRBs investigated and with MHRBs. The effect size of the association of SC and MHRBs increased in a steep pattern with accumulation of more HRBs. CONCLUSION: Low self-control is associated with most HRBs investigated and the magnitude of the association increases when more than two or three HRBs are accumulated. There seems to be a group of adolescents in a position of pronounced vulnerability for MHRBs. This should be considered when designing public policy and prevention programs. In contexts of limited or scarce resources and public funds, interventions focusing the most vulnerable groups, instead of universal interventions, should be considered

The role of social support in reducing the impact of violence on adolescents' mental health in São Paulo, Brazil.

OBJECTIVES: We investigated whether perceived social support among adolescent students moderated the association between violence exposure and internalising symptoms in São Paulo city, Brazil. METHODS: We tested the stress-buffering model using data from the cross-sectional school-based, survey São Paulo Project on the Social Development of Children and Adolescents. Internalising symptoms were measured using an adapted version of the Social Behaviour Questionnaire; serious victimisation, being bullied once/week, school violence and community violence, friend and teacher support were scales adapted by the research team; the Alabama Parenting Questionnaire measured parenting style. Linear mixed-effects models were used to quantify moderation effects of (i) social support between violence exposure and internalising symptoms and (ii) gender between violence exposure and internalising symptoms across schools. RESULTS: Across schools, being bullied once/week, school violence, and community violence were associated with a significant (p<0.001) increase in internalising symptoms (e.g., bullied b = 5.76, 95% CI 2.26, 9.26; school violence b = 0.48, 95% CI 0.30, 0.67; community violence b = 0.36; 95% CI 0.22, 0.50). Males exposed to all types of violence had significantly lower (p<0.01) internalising symptoms compared to females (e.g., serious victimisation: b = -1.45; 95% CI -2.60, -0.29; school violence b = -0.27; 95% CI -0.30, -0.24; community violence b = -0.23; 95% CI -0.25, -0.20). As a main effect, social support was associated with a significant (p<0.01) decrease in internalising symptoms across schools (e.g., positive parenting b = -2.42; 95% CI -3.12, -1.72; parent involvement b = -2.75; 95% CI -3.32, -2.17; friend support b = -1.05; 95% CI -1.74, -0.34; teacher support b = -0.90; 95% CI -1.58, -0.22). Social support did not moderate the association between violence exposure and internalising symptoms. CONCLUSIONS: Adolescent students in São Paulo exposed to violence have a higher likelihood of internalising symptoms, compared to those who are not. Support from parents, friends, and teachers, independent of violence, appear to be protective against internalising symptoms, pointing to potential programmes that could improve adolescent mental health

Assessing the measurement invariance and antecedents of legal cynicism in São Paulo, Zurich, and Montevideo

Introduction This paper accomplishes two goals. First, we assesses the measurement invariance of legal cynicism among adolescents in São Paulo, Brazil, Montevideo, Uruguay, and Zurich, Switzerland. Second, we evaluate a series of social and individual antecedents that are expected to influence legal cynicism across contexts. Methods This paper first evaluates the measurement invariance of legal cynicism using Multigroup Confirmatory Factor Analysis with three randomized clustered samples of adolescents in Zurich (n = 1447), São Paulo (n = 2680) and Montevideo (n = 2204). Second, we assessed the correlates for legal cynicism in each city using structural equation modelling techniques. Results The results demonstrated metric invariance, but not scalar invariance among adolescents in São Paulo, Zurich, and Montevideo. We were able to establish partial measurement invariance for legal cynicism in São Paulo and Zurich, and therefore proceeded with the comparison of latent means and antecedents. The results show that on average legal cynicism is higher in Zurich, but that the size and strength of antecedents were similar across cities. Low self-control was by far the strongest correlate of legal cynicism. Conclusions Overall, our results suggest that current operationalizations of legal cynicism may not be rooted in social structural context and experiences with legal authorities, but rather reflect how individuals interpret legal boundaries and dispositions towards rule-breaking. Researchers must reconsider how legal cynicism fits into models of legal socialization, and whether developmental models of self-control may help us understand the origins and nature of legal cynicism, as it is currently measured

A vulnerabilidade dos jovens à morte violenta: um estudo de caso no contexto dos “Crimes de Maio”

This article discusses the life story of a young resident of a suburb of Sao Paulo executed in the context of “Crimes of May” which occurred in 2006. We used the conceptual framework of vulnerability in order to understand the different elements involved in his victimization. This concept provides a broad and dynamic perspective that considers the susceptibility of potentially threatening events as dependent not only on individual aspects, but also on relationa processes and contextual elements, avoiding stigmatizing effects. The analysis emphasizes the uncertainty and the situation of social limiarity of the young population with the “world of crime”; cases of police violence directed at particular groups of people, and the situation of impunity. These elements occupy a central role in youth vulnerability to lethal violence, making it necessary to consider all the above mentioned elements for the development of preventive actions, inclusive in the health sector.Este artigo aborda a história de um jovem morador de um bairro periférico de São Paulo sumariamente executado no contexto dos “Crimes de Maio” ocorridos em 2006. Utiliza-se do arcabouço conceitual da vulnerabilidade como forma de compreender os diferentes elementos envolvidos na sua vitimização. Esse conceito proporciona uma perspectiva ampla e dinâmica que considera a suscetibilidade a um determinado evento enquanto dependente não só de aspectos individuais, mas também relacionais e contextuais, evitando efeitos estigmatizantes. A análise desenvolvida enfatiza a incerteza social juvenil e a situação de liminaridade em relação ao “mundo do crime”; os processos de violência policial que recaem sobre determinadas parcelas da população, bem como a situação de impunidade. Tais elementos ocupam hoje uma posição central na conformação da vulnerabilidade de jovens à violência letal, o que torna necessária sua problematização para o desenvolvimento de ações de prevenção, inclusive no setor da saúde

Graves violações de direitos humanos e desigualdade no município de São Paulo

OBJECTIVE:To analyze the profile of gross human rights violations, and the relationship between these violations and socioeconomic and demographic indicators. METHODS:Cross-sectional ecological study of 96 census districts of the city of São Paulo (Southeastern Brazil) in the year 2000. The data used came from the gross human rights violations database maintained by the Núcleo de Estudos de Violência (Center for the Study of Violence) at the Universidade de São Paulo. This database contains information on all the cases of summary executions, lynching and police violence reported on the written press. Socioeconomic and demographic data were obtained from the 2000 Census carried out by the Instituto Brasileiro de Geografia e Estatística (Brazilian Institute of Geography and Statistics). A descriptive analysis of the data was carried out, and the association between the dependent variable - gross human rights violations (number of police violence victims, lynching episodes and summary executions) -, and different socioeconomic and demographic variables was tested. In order to test this association the Spearman's correlation test was used. RESULTS: The correlations between gross human rights violations and the socioeconomic and demographic indicators were statistically significant, except for the urbanization rate and the hospital beds per 1000 inhabitants. The strongest correlations were found between the dependent variable and the following variables: size of the resident population (r=0,693), proportion of youths aged from 15 to 24 years (r=0,621), and proportion of household heads with no education or with up to three years of schooling (r=0,590). CONCLUSIONS: Gross human rights violations more markedly occur in the population with the worst living conditions. Therefore, in a scenario in which inequality in attaining social and economic rights is directly superposed to the violation of civil rights, the violence cycle is intensified and perpetuated.OBJETIVO: Analizar el perfil de graves violaciones de derechos humanos y su asociación con aspectos socioeconómicos y demográficos. MÉTODOS: Estudio ecológico, de corte transversal, teniendo como unidad de análisis los 96 distritos censarios del municipio de Sao Paulo, SP, para el año de 2000. Fue utilizado el banco de datos sobre graves violaciones de derechos humanos, del Núcleo de Estudos da Violência de la Universidade de São Paulo, que contiene informaciones sobre todos los casos de ejecuciones sumarias, linchamiento y violencia policial notificados en la prensa escrita. Datos socioeconómicos y demográficos fueron obtenidos del Censo 2000 de la Fundação Instituto Brasilero de Geografía e Estatística. Fue evaluada la asociación entre la variables dependiente-graves violaciones de derechos humanos (compuesta por el número de víctimas de violencia policial, linchamientos y ejecuciones sumarias)- y variables socioeconómicas y demográficas por medio de la prueba de correlación de Spearman. RESULTADOS: Las correlaciones entre las violaciones de derechos y los indicadores socioeconómicos y demográficos fueron estadísticamente significativos, excepto con relación a la tasa de urbanización y relación de lecho hospitalario por 1000 habitantes. Las correlaciones más fuertes fueron encontradas entre graves violaciones de derechos y tamaño de la población residente (r= 0,693), proporción de jóvenes de 15 a 24 años en la población (r= 0,621) y proporción de jefes de familia sin instrucción o con hasta tres años de escolaridad (r= 0,590). CONCLUSIONES: Graves violaciones de derechos humanos afectan más incisivamente a la población que presenta peores condiciones de vida. De este modo, se perpetúa un cuadro en el que la desigualdad en la efectividad de los derechos sociales y económicos se sobrepone directamente a la violación de los derechos civiles, intensificando un ciclo de violencia.OBJETIVO: Analisar o perfil de graves violações de direitos humanos e sua associação com aspectos socioeconômicos e demográficos. MÉTODOS: Estudo ecológico, de corte transversal, tendo como unidade de análise os 96 distritos censitários do município de São Paulo (SP) para o ano de 2000. Foi utilizado o banco de dados sobre graves violações de direitos humanos, do Núcleo de Estudos da Violência da Universidade de São Paulo, que contém informações sobre todos os casos de execuções sumárias, linchamento e violência policial noticiados na imprensa escrita. Dados socioeconômicos e demográficos foram obtidos do Censo 2000 da Fundação Instituto Brasileiro de Geografia e Estatística. Foi testada a associação entre a variável dependente - graves violações de direitos humanos (composta pelo número de vítimas de violência policial, linchamentos e execuções sumárias) - e variáveis socioeconômicas e demográficas por meio do teste de correlação de Spearman. RESULTADOS: As correlações entre as violações de direitos e os indicadores socioeconômicos e demográficos foram estatisticamente significantes, exceto em relação à taxa de urbanização e relação de leito hospitalar por 1000 habitantes. As correlações mais fortes foram encontradas entre graves violações de direitos e tamanho população residente (r=0,693), proporção de jovens de 15 a 24 anos na população (r=0,621) e proporção de chefes de família sem instrução ou com até três anos de escolaridade (r=0,590). CONCLUSÕES: Graves violações de direitos humanos atingem mais incisivamente a população que apresenta piores condições de vida. Desse modo, perpetua-se um quadro em que a desigualdade na efetivação dos direitos sociais e econômicos se sobrepõe diretamente à violação dos direitos civis, intensificando um ciclo de violência