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      Homicídios intencionais de mulheres com notificação prévia de violência Translated title: Homicidios intencionales de mujeres con notificación previa de violencia Translated title: Intentional homicides of women with prior notification of violence

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          Abstract

          Resumo Objetivo Descrever o perfil das mulheres vítimas de homicídios intencionais e com notificação prévia de violência. Métodos Trata-se de um estudo transversal, realizado no estado de Pernambuco, no período de 2012 a 2016. Foi empregado o relacionamento probabilístico entre todas as notificações de violência contra mulher, registradas no Sistema de Informação de Agravos de Notificação, e os homicídios de mulheres, registrados no Sistema de Informações sobre Mortalidade. Resultados Identificou-se 121 homicídios que tinham notificações prévias de violência. As mulheres eram solteiras (88,9%), negras (91,7%) e com menos de sete anos de estudo (80,9%). A agressão física foi o tipo de violência mais notificado (65,8%), ocorrida na residência (66,7%) e cometida por parceiro/ex-parceiro íntimo (51,9%). O disparo de arma de fogo foi o principal meio utilizado (44,6%) e o óbito ocorreu em estabelecimento de saúde (41,3%). Mulheres com notificação prévia de violência tiveram risco 65,9 vezes maior de homicídio, quando comparadas com a população geral de mulheres. Conclusão Descrever o perfil das mulheres vítimas de homicídios, com notificação de violência prévia, pode contribuir para a formulação de políticas públicas de proteção e prevenção da violência contra mulher.

          Translated abstract

          Resumen Objetivo Describir el perfil de mujeres víctimas de homicidios intencionales con notificación previa de violencia. Métodos Se trata de un estudio transversal, realizado en el estado de Pernambuco, en el período de 2012 a 2016. Se empleó la relación probabilística entre todas las notificaciones de violencia contra la mujer registradas en el Sistema de Información de Agravios de Notificación y los homicidios de mujeres registrados en el Sistema de Información sobre Mortalidad. Resultados Se identificaron 121 homicidios que tenían notificaciones previas de violencia. Las mujeres eran solteras (88,9 %), negras (91,7 %) y con menos de siete años de estudios (80,9 %). La agresión física fue el tipo de violencia más notificado (65,8 %), ocurrida en la residencia (66,7 %) y cometida por la pareja/expareja íntima (51,9 %). El disparo de arma de fuego fue el principal medio utilizado (44,6 %) y la muerte ocurrió en un establecimiento de salud (41,3 %). Mujeres con notificación previa de violencia tuvieron un riesgo de homicidio 65,9 veces mayor, en comparación con la población general de mujeres. Conclusión Describir el perfil de mujeres víctimas de homicidios con notificación de violencia previa puede contribuir a la formulación de políticas públicas de protección y prevención de la violencia contra la mujer.

          Translated abstract

          Abstract Objective To describe the profile of women victims of intentional homicides and with prior notification of violence. Methods This is a cross-sectional study carried out in the state of Pernambuco from 2012 to 2016. Probabilistic relationship was used between all notifications of violence against women registered in the Information System for Notifiable Diseases, and the homicides of women, registered in the Mortality Information System. Results 121 homicides were identified with previous reports of violence. Women were single (88.9%), black (91.7%) and had less than seven years of study (80.9%). Physical aggression was the most reported type of violence (65.8%), occurring at home (66.7%) and committed by a partner/ex-intimate partner (51.9%). Firearm firing was the main method used (44.6%) and death occurred in a health facility (41.3%). Women with prior notification of violence had a 65.9 times higher risk of homicide when compared to the general population of women. Conclusion Describing the profile of women victims of homicides, with prior notification of violence, can contribute for formulating public policies for the protection and prevention of violence against women.

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          The health-systems response to violence against women.

          Health systems have a crucial role in a multisector response to violence against women. Some countries have guidelines or protocols articulating this role and health-care workers are trained in some settings, but generally system development and implementation have been slow to progress. Substantial system and behavioural barriers exist, especially in low-income and middle-income countries. Violence against women was identified as a health priority in 2013 guidelines published by WHO and the 67th World Health Assembly resolution on strengthening the role of the health system in addressing violence, particularly against women and girls. In this Series paper, we review the evidence for clinical interventions and discuss components of a comprehensive health-system approach that helps health-care providers to identify and support women subjected to intimate partner or sexual violence. Five country case studies show the diversity of contexts and pathways for development of a health system response to violence against women. Although additional research is needed, strengthening of health systems can enable providers to address violence against women, including protocols, capacity building, effective coordination between agencies, and referral networks. Copyright © 2015 World Health Organization. Published by Elsevier Ltd/Inc/BV. All rights reserved. Published by Elsevier Ltd. All rights reserved.
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            Racial and Ethnic Differences in Homicides of Adult Women and the Role of Intimate Partner Violence — United States, 2003–2014

            Homicide is one of the leading causes of death for women aged ≤44 years.* In 2015, homicide caused the death of 3,519 girls and women in the United States. Rates of female homicide vary by race/ethnicity ( 1 ), and nearly half of victims are killed by a current or former male intimate partner ( 2 ). To inform homicide and intimate partner violence (IPV) prevention efforts, CDC analyzed homicide data from the National Violent Death Reporting System (NVDRS) among 10,018 women aged ≥18 years in 18 states during 2003–2014. The frequency of homicide by race/ethnicity and precipitating circumstances of homicides associated with and without IPV were examined. Non-Hispanic black and American Indian/Alaska Native women experienced the highest rates of homicide (4.4 and 4.3 per 100,000 population, respectively). Over half of all homicides (55.3%) were IPV-related; 11.2% of victims of IPV-related homicide experienced some form of violence in the month preceding their deaths, and argument and jealousy were common precipitating circumstances. Targeted IPV prevention programs for populations at disproportionate risk and enhanced access to intervention services for persons experiencing IPV are needed to reduce homicides among women. CDC’s NVDRS is an active state-based surveillance system that monitors characteristics of violent deaths, including homicides. The system links three data sources (death certificates, coroner/medical examiner reports, and law enforcement reports) to create a comprehensive depiction of who dies from violence, where and when victims die, and factors perceived to contribute to the victim’s death ( 3 ). This report includes NVDRS data from 18 states during 2003–2014 (all available years). † Five racial/ethnic categories § were used for this analysis: white, black, American Indian/Alaska Native (AI/AN), Asian/Pacific Islander (A/PI), and Hispanic. Persons categorized as Hispanic might have been of any race. Persons categorized as one of the four racial populations were all non-Hispanic. Analyses were limited to female decedents aged ≥18 years. IPV-related deaths were defined as those involving intimate partner homicides (i.e., the victim was an intimate partner [e.g., current, former, or unspecified spouse or girlfriend] of the suspect), other deaths associated with IPV, including victims who were not the intimate partner (i.e., family, friends, others who intervened in IPV, first responders, or bystanders), or jealousy. Deaths where jealousy, such as in a lovers’ triangle, was noted as a factor were included only when they involved an actual relationship (versus unrequited interest). Violence experienced in the preceding month refers to all types of violence (e.g., robbery, assault, or IPV) that was distinct and occurred before the violence that killed the victim; there did not need to be any causal link between the earlier violence and the death itself (e.g., victim could have experienced a robbery by a stranger 2 weeks before being killed by her spouse). Rates were calculated using intercensal and postcensal bridged–race population estimates compiled by CDC’s National Center for Health Statistics and were age-adjusted to the 2010 standard U.S. population of women aged ≥18 years ( 4 ). Sociodemographic characteristics and precipitating circumstances across racial/ethnic groups were examined using chi-square and Fisher’s exact tests. Two-sided p-values 90% of these women being killed by their current or former intimate partner. Strategies to prevent IPV-related homicides range from protecting women from immediate harm and intervening in current IPV, to developing and implementing programs and policies to prevent IPV from occurring ( 5 ). IPV lethality risk assessments conducted by first responders have shown high sensitivity in identifying victims at risk for future violence and homicide ( 6 ). These assessments might be used to facilitate immediate safety planning and to connect women with other services, such as crisis intervention and counseling, housing, medical and legal advocacy, and access to other community resources ( 6 ). State statutes limiting access to firearms for persons under a domestic violence restraining order can serve as another preventive measure associated with reduced risk for intimate partner homicide and firearm intimate partner homicide ( 7 ). Approximately one in 10 victims of IPV-related homicide experienced some form of violence in the preceding month, which could have provided opportunities for intervention. Bystander programs, such as Green Dot, ¶ teach participants how to recognize situations or behaviors that might become violent and safely and effectively intervene to reduce the likelihood of assault ( 8 ). In health care settings, the U.S. Preventive Services Task Force recommends screening women of childbearing age for IPV and referring women who screen positive for intervention services.** Approximately 15% of female homicide victims of reproductive age (18–44 years) were pregnant or postpartum, which might or might not be higher than estimates in the general U.S. female population, requiring further examination. Approximately 40% of non-Hispanic black, AI/AN, and Hispanic female homicide victims were aged 18–29 years. Argument and jealousy were common precipitating factors for IPV-related homicides. Teaching safe and healthy relationship skills is an important primary prevention strategy with evidence of effectiveness in reducing IPV by helping young persons manage emotions and relationship conflicts and improve their problem-solving and communication skills ( 5 ). Preventing IPV also requires addressing the community- and system-level factors that increase the risk for IPV; neighborhoods with high disorder, disadvantage, and poverty, and low social cohesion are associated with increased risk of IPV ( 5 ), and underlying health inequities caused by barriers in language, geography, and cultural familiarity might contribute to homicides, particularly among racial/ethnic minority women ( 9 ). The findings in this report are subject to at least five limitations. First, NVDRS data are available from a limited number of states and are therefore not nationally representative. Second, race/ethnicity data on death certificates might be misclassified, particularly for Hispanics, A/PI, and AI/AN ( 10 ). Third, the female homicide victims in this dataset were more likely to be never married or single and less likely to have attended college than the general U.S. female population †† ; although this is likely attributable to the relatively younger age distribution of homicide victims in general, §§ this requires further examination. Fourth, not all homicide cases include detailed suspect information; in this analysis, 85.3% of cases included information on the suspect. Finally, information about male corollary victims of IPV-related homicide (i.e., other deaths associated with IPV, including male victims who were not the intimate partner) were not included in this analysis. Therefore, the full scope of IPV-related homicides involving women is not captured. The racial/ethnic differences in female homicide underscore the importance of targeting prevention and intervention efforts to populations at disproportionately high risk. Addressing violence will require an integrated response that considers the influence of larger community and societal factors that make violence more likely to occur. Summary What is already known about this topic? Homicide is one of the leading causes of death for women aged ≤44 years, and rates vary by race/ethnicity. Nearly half of female victims are killed by a current or former male intimate partner. What is added by this report? Homicides occur in women of all ages and among all races/ethnicities, but young, racial/ethnic minority women are disproportionately affected. Over half of female homicides for which circumstances were known were related to intimate partner violence (IPV). Arguments and jealousy were common precipitating circumstances among IPV-related homicides. One in 10 victims of IPV-related homicide were reported to have experienced violence in the month preceding their deaths. What are the implications for public health practice? Racial/ethnic differences in female homicide underscore the importance of targeting intervention efforts to populations at risk and the conditions that increase the risk for violence. IPV lethality risk assessments might be useful tools for first responders to identify women at risk for future violence and connect them with life-saving safety planning and services. Teaching young persons safe and healthy relationship skills as well as how to recognize situations or behaviors that might become violent are effective IPV primary prevention measures.
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              State Intimate Partner Violence–Related Firearm Laws and Intimate Partner Homicide Rates in the United States, 1991 to 2015

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                Author and article information

                Journal
                ape
                Acta Paulista de Enfermagem
                Acta paul. enferm.
                Escola Paulista de Enfermagem, Universidade Federal de São Paulo (São Paulo, SP, Brazil )
                0103-2100
                1982-0194
                2021
                : 34
                : eAPE00715
                Affiliations
                [3] Recife PE orgnameCentro Universitário Maurício de Nassau orgdiv1Centro de saúde Brasil
                [4] Recife PE orgnameSecretaria de Saúde do Recife Brasil
                [5] Recife PE orgnameFundação Joaquim Nabuco orgdiv1Diretoria de Pesquisas Sociais Brasil
                [1] Recife Pernambuco orgnameUniversidade Federal de Pernambuco Brazil
                [2] Recife PE orgnameFiocruz Pernambuco orgdiv1Instituto Aggeu Magalhães Brasil
                Article
                S0103-21002021000100463 S0103-2100(21)03400000463
                10.37689/acta-ape/2021ao00715
                f1129a7c-de41-42b8-a6f5-e1d963ed8b44

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 02 December 2020
                : 04 April 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 35, Pages: 0
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                SciELO Brazil


                Homicidio,Violencia contra la mujer,Registros de mortalidade,Estatísticas vitais,Sistemas de Informação em Saúde,Violência contra a mulher,Homicídio,Mortality registries,Vital statistics,Helath information systems,Violence against women,Homicide,Registros de mortalidad,Estadísticas vitales,Sistemas de información en salud

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