Trend and distribution of the homicide mortality rate in accordance with the size of the population of Brazilian municipalities-2000 and 2015

Abstract

The scope of this study is to analyze the trends and distribution of homicide mortality rates (HMR) according to the population size of Brazilian municipalities between 2000 and 2015. It is an ecological study of deaths recorded in the Mortality Information System, with HMR standardi-zed by the direct method and 95% confidence in-terval. HMR in Brazil grew 6% (to 29.1/100,000) in the period, with an increase in small municipalities (83%; 12.7 to 23.2/100,000) and medium-sized cities (52%; 19.7% to 30.1/100,000); which is true for both sexes, different ages, regions and firearm-related events. HMR decreased in ma-jor cities (19%; 40.6% to 32.9/100,000) and the Southeast region (55%; 45.6% to 20.6/100,000). The relative risk (RR) of small and medium-sized cities in relation to large cities is already greater than or close to 1 among women (RR 0.99; 1.03), people aged 60 years or older (RR 1.43; 1.36) and homicides by other means (RR 1.16; 1.18). The cities of São Paulo and Rio de Janeiro contributed the most to the reduction of HMR, especially in large cities (-37.6 and-22.3 homicides/100,000 inhabitants). Small and medium-sized municipalities have consistent trends of an increase in HMR even considering population subgroups.