Violência doméstica, indicadores de vulnerabilidade socioespacial e traumas maxilofaciais: um estudo ecológico para identificar áreas de alto risco

Abstract

The aim of the present study was to determine the spatio-temporal distribution of cases of maxillofacial trauma resulting from domestic violence and to assess the influence of socio-spatial vulnerability indicators. Thus, an ecological study was carried out involving the analysis of cases of domestic violence treated at the Nucleus of Medicine and Legal Dentistry (NUMOL) of Campina Grande-PB, as well as population data extracted from the Brazilian Institute of Geography and Statistics (IBGE) referring to the socioeconomic, habitation and housing characteristics of the neighborhoods where the victims lived. The Geographic Information Systems (GIS) tool was applied for data integration. High resolution maps were built using QGIS software version 2.18.22 (QGIS Geographic Information System, Open Source Geospatial Foundation). Three types of spatio-temporal analysis techniques were performed: (i) trajectory analysis of the incidence of cases, using finite mixture modeling; (ii) spatial autocorrelation analysis; (iii) spatial regression analysis, to assess the influence of socio-spatial vulnerability conditions on the incidence of events. The level of significance was set at 5% (p ≤ 0.05). The results confirmed that there is a statistically significant heterogeneity in the distribution of events in the analyzed geographical space, with the concentration of records in certain neighborhoods. The trajectory analysis revealed different patterns of evolution in the rates of domestic violence and violence by intimate partners against women, with an increasing trend in the last year of observation in some neighborhoods. The Getis-Ord spatial autocorrelation indicator (Gi*) recognized statistically significant high-risk clusters in the East (p<0.05) and West (p<0.05), and low risk clusters in the North (p<0.05). The spatial regression models revealed that indicator 2 (socioeconomic status proxy) remained significantly associated with the incidence rates of maxillofacial trauma associated with domestic violence in general (β = 8.403; SE = 2.738; p<0.001) and with situations of intimate partner violence against women (β = 5.305; SE = 1.741; p = 0.002). Therefore, the results suggest an association between increased case reporting and high socio-spatial vulnerability, highlighting the need to develop local public policies for preventing and combating domestic violence.