463 FREE THEMES DOI: 10.1590/1413-81232018232.00072016 ------Homicide, Injury, Assault, Violence, Violence, Assault, Homicide, Injury, An ecological aimed at analyz study An

Spatial analysis area. We calculated the municipal rates using the municipal calculated rates We area. the crit For population IBGE. estimates from we obtained estimates of the number ical areas, of households multiplied the a factor equal to by household density in the corresponding average a decrease was There in homicidecensus tract. and a rise rates in actual harm bodily in Itaboraí. an increased was also that there risk found of We injurybodily in critical with areas the worst liv suggestinging conditions, the existence of social inequalities certain that make social spaces more incidents to vulnerable violent involving injuries. words Key conducted in Itaboraí, in the years 2010 to 2011. in the years 2011. 2010 to conducted in Itaboraí, entireThe municipality used was study the in covering critical and non-criticalThe data areas. the Public System for the Information came from The ter state. SecurityJaneiro de in Rio Institute ritories identified were referring and defined by to The snow studies on illegal occupations of areas. balling method used was the social for recognition The morphologicalof poor conditions. differen tiation marked of urban standards and housing and georeferenced, were areas The locations. the and or geographically located were the problems their to correspondingganized according critical Abstract Abstract and actualing homicide harm bodily rates was Murder and actual bodily harm in Itaborai, : Brazil: and actual bodily harmItaborai, in Murder scales analysis at different 2 2

1 1 2 Laboratório de Departamento de Estudos Departamento Estudos de Fiocruz. RJ Janeiro de Rio Fiocruz. Brasil. [email protected] 2 Grandes de Monitoramento ENSP, Empreendimentos, de Saúde Pública (ENSP), (ENSP), Pública Saúde de Brasil 4036/7º, Av. Fiocruz. 21040-210 Manguinhos. RJ Brasil. Janeiro de Rio 1 e Saúde Violência sobre Nacional Escola Careli, Jorge Paulo Chagastelles Sabroza Sabroza Chagastelles Paulo Pinto Liana Wernersbach Edinilsa Ramos de Souza Edinilsa Ramos de Praça Levy Ferreira Heitor da Luz Eliane Santos 464 et al.

Souza ER Introduction As a methodological alternative to access the different living conditions of the populations, The implementation of a major commercial ecological studies on specific areas were used as enterprise such as the Rio Petrochemical Com- units of analysis and they were compared with plex, Complexo Petroquímico do Rio de Janeiro/ each other to identify socio-spatial inequalities COMPERJ in the eastern region of Rio de Janei- and health conditions4-7. ro has brought about major socioenvironmental Barcellos et al.6 working in a similar theoreti- transformations1. In order to check the hetero- cal vein concerning the methodological resource geneity of the areas and its relations with the of space stated: health situation, epidemiological monitoring of if the disease is a manifestation of the individ- the commercial enterprise is taking place. In the ual, the health situation is a manifestation of the ambit of this monitoring, we analyzed the inci- place. The places inside of a city or region, are the dents of actual bodily harm and murders in the result of an accumulation of historical, environ- municipality of Itaboraí and in specific areas in mental and social situations that promote particu- this municipality that presented poor sanitary, lar conditions for the production of diseases. living and economic conditions which we called They highlighted the importance of the “de- critical areas2,3. velopment of indicators that can detect and re- The search for inter-relations between liv- flect conditions that present health risks based ing conditions and health is not a recent search; on the environmental and socially adverse con- pioneers in this area produced studies on the ditions”6, for the diagnosis of the differences in above in the 19th century. Subsequently with the health situations. advent of the “bacteriological era”, such studies In general, the studies described as “ecolog- increased in intensity and there was a marked ical”, use indicators that come from censuses or increase in the 1950s “emphasizing the relations health reports that, due to how they have been between health levels and socioeconomic factors, obtained, end up limiting the construction of the principally in relation to the theme of health and territorial units to be analyzed8,9. development”4. In the ambit of the Plan for Epidemiological The studies are theoretically based on the Monitoring of the Process for the Implementa- presence of inequality in health for certain pop- tion of COMPERJ2, there were two with com- ulation groups, which is a reflection of the differ- plementary ones that employed methodological ent living conditions demonstrated in the classic tools to investigate the influence of the popula- research findings produced by Villermé and En- tion’s living conditions in the municipalities cov- gels. According to Paim4, these studies provide an ered by the research in relation to worsening peo- explanation for the health conditions. ple’s health for those that were being monitored. based on the relations between the development The first consists of the socioeconomic strat- of productive forces connected to industrialization ification of the boroughs and census sectors in and the social processes such as: urbanization, the the municipalities of Itaboraí, and agrarian question, migrations and the formation grouped in Local Surveil- of the so-called reserve army of labor, meaning the lance Units (UVL). This was done in accordance population surplus exposed to poverty and serious with the indices composed of urban installations health problems. and social structures in order to cross reference Based on this assumption, this idea is very the information on the notification of assaults well summarized by Castellanos7 (apud Paim4), and deaths. The UVLs are territorial units for that: analysis created based on an agglomeration of each individual, family, community and pop- census sectors. The Demographic Census from ulation group in every moment of their existence, IBGE10 is the primary database that has demo- have necessities and risks that are characteristic to graphic and socioeconomic information in the them, based on their age, sex and on other individ- country that is in accordance with the criteria ual attributes such as geographical and ecological of contiguity and similarity in relation to indi- locality, culture, level of education or economic-so- cators comprising living conditions and urban cial standing which translates itself into health infrastructure created for the Epidemiological problems/peculiar diseases and which can either be Monitoring of the Process of Implementation for favorable to them or, to a greater or lesser extent, COMPERJ. Lastly the UVLs were mapped onto make their being an fulfilled individual difficult -in the boroughs of the municipalities through the cluding realizing social projects. analysis of images. 465 Ciência & Saúde Coletiva, 23(2):463-470, 2018

The second idea that this paper is based on, Itaboraí between 2010 and 2011. These acts were consists in the identification of the critical areas chosen as they are characterized by: violence that are localities that have the worse living con- against someone, their gravity and because they ditions in the ambit of the municipalities that are indicators for social violence11,12. In addition were covered and monitored and in the checking to this, the offence of actual bodily harm has of the distribution of assaults in these areas. been registered the most amount of times by the The search for another perspective for the police. recognition of living conditions comes from our The information relative to actual bodily concordance with criticism in the use of social harm and murders came from the Information indicators obtained through the aggregation of System for the Public Security Institute in state data on the population. These indicators have as of Rio de Janeiro. It was taken from the police re- an assumption, the internal homogeneity of the ports made at the police stations which had been territorial units, but according to Barcellos7, placed on the system. these assumptions are false, being the result of Two spatial scale analysis were used: the mu- a simplification of structure and dynamics in the nicipality and its parts and three analysis units. geographic space. Various studies have shown that These included the municipality, critical areas there is not always a linear and direct correlation and the localities without critical areas in the between poverty and poor health conditions. In same municipality. some cases, to the contrary, areas with higher num- The critical territories were initially identified bers may increase the risks of health of their resi- through the review of studies on urban condi- dents. tions in the municipality (including the Direc- The acceptance of this hypothesis easily takes tor’s Plan for the Municipality of Itaboraí and us to the conclusion that these areas would not be the Strategic Municipal Plan for Informal Urban homogenous as assumed by the aggregated analysis Settlements - PEMAS) principally those referring methodology (ecological speaking), but extremely to the existence and location of illegal occupa- differentiated internally. tions and through the social recognition of the Thus, in relation to the panorama provided worse conditions using the snowballing13 method. by the secondary data referring to living condi- Thus, the areas were identified by the research- tions and health at territorial scales in the mu- ers through field work in the identified localities nicipality in Itaboraí, the intention was to bring based on dialogs with: technicians from the city together another perspective given through the council, residents in illegal occupations indicated search for information with technicians from the by the technicians and residents of other areas city councils in the municipalities and field work, in the municipality indicated by the residents of for the recognition of living conditions in the lo- these occupations. cal ambit. This means the intention was to ana- Later on, in the study, we went to these lo- lyze the relations between living conditions and calities to conduct physical recognitions and to health conditions based on two complementary outline the geographical limits through the pro- scales: municipal and the other based on small cess of morphological differentiation of urban local units of analysis called critical areas. standards of living in the localities to which the In this way, the present study presents itself as researchers were taken by the participants. These an attempt, in the face of the challenge, to bring areas were georeferenced. to light some of the silenced internal differenc- Geographical localization was done for the es in the midst of homogenization owing to the investigated incidents based on the variable pub- construction of social indicators for municipal lic places placed on the databases used. The data territorial units, to refine the analysis of possi- was organized by the names of roads and sub- ble correlations between living conditions and sequently classified in accordance with its corre- health conditions in the local units in the munic- sponding critical area. ipality of Itaboraí. To calculate the municipal rates, population estimates from IBGE10 were used and for popula- tion estimates in the critical areas, the number of Methodology habitations was calculated with a multiplication by a factor equal to the average household densi- The purpose of this ecological study was to an- ty in the corresponding sector census. alyze the rates of murders (fatal aggression) and The murder and actual bodily harm rates were actual bodily harm (none fatal aggression) in calculated for the municipality as a whole. This 466 et al.

Souza ER covered the critical areas and the rest of the lo- oraí went back to cultivating oranges15, in part, calities in the municipality without critical areas. as a response to the expansion of the market and In relation to the comparison of rates between thanks to the development of the cities of Niterói years and areas, the incidents under analysis may and Rio de Janeiro. be considered as being subject to random varia- The construction and paving of the highways tions and in this way, requires the calculation of was also an important factor that had a dynamic confidence intervals14. Where the numerator rate economic impact on the population of this re- was less than 100 incidents, we used the Poisson gion. Amongst them were the highways: RJ-104, distribution for calculating the confidence inter- BR-493 and BR-116. It is worth mentioning that vals of 95%. For the rest of the cases, the normal in 1970 there was the occurrence of a major event distribution of probability was used. In the com- that drastically changed the whole social and eco- parison of rates whose numerator was less than nomic dynamism in the region accelerating the 100, a superposition of the intervals of confi- process of urbanization and principally impact- dence, indicated that the observed difference was ing on the municipality of Itaboraí. This was the not statistically significant. For cases in which the construction of the Rio-Niterói bridge that was numerator of the rates was greater than 100, we opened in 197416. calculated a test statistic of z and this was consid- The pottery industry also played an import- ered not to be significant when |z| <1.9614. ant role in the economy of this municipality. It was boosted by the arrival of the royal family to A brief description of the municipality Brazil. However, this economic activity started to of Itaboraí decline in the 1970s resulting in the down turn of industrial production17. This municipality is located in the state of Rio During the 90s there was a serious citriculture de Janeiro on the north-east part of the Guanaba- crisis which was the municipality’s main activity, ra bay. It is a part of the Metropolitan Region of due to pests. This factor produced major losses in Rio de Janeiro encompassing the hydro-graphic the rural economy of Itaboraí with the transfor- basin of the Caceribu River. It has an area that mation of the district of Tanguá in the munici- is approximately 428.6 km². To the north, it pality (taking with it the greater part of the rural borders the municipalities of Guapimirim and output of Itaboraí) and it caused a significant fall Cachoeiras de Macacu. To the south, it borders in agricultural activity in the municipality. Maricá. To the west, it borders São Gonçalo and The recent analysis of the characterization of Baia de Guanabara and to the east it borders Tan- the economic activity in the municipality showed guá (the old district of Itaboraí that became in- that the municipality is strongly based on the ter- dependent in 1995). Its territory is divided into tiary sector and services which makes up 62.0% eight districts: Itaboraí, Porto das Caixas, Itambi, of the GDP. This sector has grown and attracted Sambaetiba, Visconde de Itaboraí, Cabuçu, Ma- new companies such as electrical domestic and nilha and Pachecos. furnisher stores and a chain of snack bars. The According to the Census data for 201010, its secondary sector in the economy can also be high- total population was 218,008 inhabitants of lighted with particular reference to civil construc- whom, 98.8% resided in the urban areas. Wom- tion and the transformation of industries, each of en were the predominant sex making up 51.3% which has been contributing up to 9% of the mu- of the total population. Also, according to the nicipal’s GDP. It should also be highlighted that to aforementioned Census10, 57.7% of the popula- corroborate the findings of the fall in agricultural tion was aged between 20 to 59 years old and only activity, a notable fact in the primary sector is that 10.3% were over 60. The population was over- it has not reached 1.0% of the GDP17. whelming made up of young people. In terms of territorial occupation, the critical In the first decades of the 19th century with areas correspond to 4.1% of the total territory the expansion of the coffee plantation, Itaboraí occupied in the municipality of Itaboraí and in acquired a level of importance and relevance for this area 7.4% of the inhabitants live there. having a route for the soldiers that brought cof- fee from Cantagalo, Cordeiro and going towards the Macacu river and taking it to Results Porto das Caixas and then on to Rio de Janeiro. However, from 1950s the production of coffee In 2010, the rate of murders in the critical areas was hit by a crisis and the municipality of Itab- (48.7/100.000 inhabitants, 8 incidents) was 13% 467 Ciência & Saúde Coletiva, 23(2):463-470, 2018

greater than what was observed in the munici- 41.6% greater than a rate in the localities without pality as a whole (43.1/100.000 inhabitants, 94 critical areas (495.4/100.000 inhabitants, 1014 incidents), and 14.3% greater than the rate in cases). The comparison of the rates between the the localities without critical areas (42.6/100.000 areas for the year 2010 showed that there was inhabitants, 86 incidents). In 2011, the rate for no significant difference. For the following year these incidents in critical areas (48/100.000 in- however, the differences observed were statisti- habitants, 8 incidents) was 53.8% greater than cally significant. the rate in the municipality (31.2 per 100.000 In the period, we observed increases in the inhabitants, 69 incidents) and when compared rates in three units of analysis, with there being to the rate in the territory without critical areas greater intensity in the critical areas (21.3%) (29.8/100.000, 61 incidents) the difference was compared to whole of the municipality (15.5%) even greater (61.1%) as shown in Graphic 1. The and the non-critical areas (4.6%). We noted a sta- differences observed however, were not statisti- tistically significant difference only for the mu- cally significant. nicipal rates. It is important to highlight the absolute num- bers, as the rate of murders fell between 2010 to 2011 in the units of analysis and in the localities Discussion without critical areas, but they remained practi- cally the same in the critical areas. In the munic- The present study sought to obtain new indica- ipality, the rate fell by 27.6% and in the localities tors for the analysis of violence that can identify without critical areas the fall was 30%. However, intra-territorial heterogeneity and thus demon- we did not see any significant statistical differ- strate the existence of distinct vulnerabilities ence between the rates. determined by the different socioeconomic life In Graphic 2 in 2010 the rate of actual bodily conditions. The findings suggest the existence harm in the critical areas (577.9/100.000 inhab- of social inequalities resulting from precarious itants, 95 incidents) was 20% greater than what living conditions that make certain social spaces was observed in the municipality as a whole more vulnerable to violent incidents4-7,18. (481.5/100.000 inhabitants, 1050 incidents), and In the analysis presented here, we observed 22% greater than the rate in the localities with- the reduction in the rate of murders and the in- out critical areas (473.6/100.00 inhabitants, 955 crease in the rate of actual bodily harm in the incidents). In the following year, the difference municipality of Itaboraí; showing a possible was even more accentuated: the critical areas pre- change in the pattern of aggressive acts that were sented a rate of (701.3/100.000 inhabitants, 117 occurring which may indicate that they became cases) 26.1% greater than that in the municipal- less serious. This is something that requires a ity (556.1/100.000 inhabitants, 1231 cases) and deeper study. One way of checking this hypothe-

120.00 Municipality Critical areas 100.00 Non-critical areas

80.00

60.00

40.00

20.00 43.10 48.66 42.65 31.17 47.95 29.80

Murder rate/100.000 inhabitants Murder 0.00 2010 2011 year

Graphic 1. Annual rate of murders (per 100,000 inhabitants) in critical areas, non-critical areas and the municipality of Itaboraí with the respective rate of CI95%, 2010 and 2011. 468 et al. Souza ER

Municipality Critical areas 900.00 Non-critical areas 800.00 700.00 600.00 500.00 400.00 300.00 481.45 577.89 473.59 556.11 701.31 495.42 200.00 100.00 0.00 Bodily harm rate/100,000 inhabitants 2010 2011 year

Graphic 2. Annual rate of actual bodily harm (per 100,000 inhabitants) in critical areas, non-critical areas and the municipality of Itaboraí with the respective rate of CI95%, 2010 and 2011.

sis would be to analyze the dynamic generators of poverty stricken populations for having high the murders and actual bodily harm incidents as, levels of violence. On the contrary, these popu- for example, the involvement of incidents with lations have principally been the victims of these narcotrafficking having a common criminality forms of violence that occur in the territories element or with crimes of passion such as aggres- where they live. These areas are marked by pre- sion against women, amongst others. carious socioeconomic living conditions and so- The national journals have been showing cial instruments, but the principal lost is that of falls in the mortality rates for murders in the the protection for the residents and the guarantee large Brazilian metropolises19,20 and increases in of their citizenship rights. cities around the capitals metropolitan regions – In the years that were analyzed, even when such as is the case for Itaboraí just like the cities there was a fall in the rate of murders in the mu- in the outskirts of the states and in the border nicipality and in the non-critical areas, we ob- regions21-25. It would be important to monitor served an increase in this rate in critical areas. whether the occurrence of a decline in the rates When there was an increase in the rate of actual observed in the municipality studied was consis- bodily harm in the three areas, it was intense in tent. And, this being the case, to identify if and the critical territories. This, once again, showed how this fall is related to the arrival of COMPERJ that these last areas are more vulnerable to these in the municipality and to the control of certain violent incidents. violent events as also with the increase of other Barcellos18 highlighted that the degree of de- types of aggression which was the case for actual tail from the information depends on the scale bodily harm. In this study, we checked that the of geographical analysis chosen and this choice falls observed in the rates of murders were not is not arbitrary. His definition advocates the best statistically significant. way of reaching the objectives of the study and The violence shown here through lethal ag- to respond to the question in the research. This gression and non-lethal aggression, appeared to has implications in just a part of the information show not just differences amongst the areas that that was analyzed since it is impossible to consid- were analyzed but we also noted a greater intensi- er all of the existing elements on any given geo- ty of the violence for those with poor living con- graphical scale as well as the recognition of the ditions. In this way in 2011, what can be noted geographical elements that ought to be includ- was the existence of a greater risk of non-fatal ed or excluded in the study. For this reason, it is aggression in the critical territories characterized necessary to take care when studying associations by a lack of urban infrastructure. However, in amongst the risks of one particular and complex agreement with some authors26,27, it is important health problem that has many causes as is the to explain that we do not want to incriminate case for violence and isolated variables28. 469 Ciência & Saúde Coletiva, 23(2):463-470, 2018

Final Considerations doñez1, in 2010, this municipality attracted 50 thousand new residents totaling approximately The methods and indicators used to analyze the 300 thousand inhabitants. The prediction was acts of violence are not always sufficiently specif- that in ten years-time the population would reach ic and precise to detect inter and intra-regional one million. Also, according to these authors, a differences, that many times are necessary to un- study by the Federação das Indústrias in the state derstand these aggressive acts. of Rio de Janeiro (Firjan) made the prediction This study has shown that it is possible to that COMPERJ would attract between 320 and obtain more detailed knowledge on creating a 700 industries to the municipality in the next five methodology and working with smaller scale years. COMPERJ generated six thousand jobs in analysis. However, it should be highlighted that 2010 and in 2011 it was hoped that it would gen- this was the initial contribution and that any erate approximately 10 thousand jobs. In the area enhancements to the method here, needs to be of commerce, 160 new jobs were created in 2009. done with a view to refining it. The city is experiencing a property explosion There is a possibility that sub-registers exist with an increase of 20% in the value of property in the number of violent incidents that were an- which has not stopped increasing. This is a reflec- alyzed, bearing in mind that not all of the mur- tion of the migratory flow. However, only a third ders and principally not all of the actual bodily of the population has access to a sewage system harm acts that were registered by the police, can and basic sanitation. be taken as an under-estimation of the rates. In It falls to the public authorities to act pro- the same way, there may be inaccuracies in the actively with the objective of improving the so- population estimates, principally those related cio-sanitary conditions in its most poverty strick- to the critical areas that were based on counting en territories with a view to reducing the effects the number of households multiplied by the av- of unplanned economic growth. This situation of erage density of households from the census data a lack of state intervention has already occurred where the critical areas were situated. This num- in other areas in Rio de Janeiro that went through ber may have increased as the population went similar experiences and its adverse effects are well down in these areas, causing either a reduction in known. the risk or its increase. Another important step ought to be looked at which is to analyze a larger historical series which may demonstrate a consistency or not in the re- sults that were found. In any case is necessary to conduct a deeper analysis of this area as according to Gracie et al.28, Collaborations spatial studies affect the results that are obtained because each space on the scale used, has its own ER Souza, HLF Praça and ES Luz came up with attributes. A geographical scale on using a certain the idea as well as analyzed and wrote the paper. unit of aggregated data, can show clear associa- PC Sabroza came up with the methodology used tions that are not visible on other geographical in the article. LW Pinto analyzed the data and scales. Thus, the same indicator can be positively wrote the text. or negatively correlated with an incidence of a violent act, for example, depending on the geo- graphical scale used. Therefore, as recommended Acknowledgments by the authors, it is important to combine, visu- alize and analyze the data on different scales and The authors would like to thank Ivani Henrique decide which geographical scale should be used. Rodrigues Vieira Junior and Heise Parede de Do not forget that it should be compatible with Souza for their contribution in locating the vi- the studied phenomenon. However, this choice is olent incidents that were analyzed. They would never an easy one. also like to thank: Rafael Pereira, Rossana Souza, The municipality of Itaboraí and its critical Alexandre San Pedro Siqueira, Jefferson Pereira areas are suffering from the influences of socio- Caldas dos Santos, Fábio Lemgruber and Vinícius economic and demographic transformations re- Mesquita Rosenthal for their contribution in the sulting from the installation of the Petrochemi- development of the methodology used in this cal Pole COMPERJ. According to Rosa and Or- study. 470 et al.

Souza ER References

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