In this month's Bulletin
Homicide accounts for nearly a third of deaths in young Brazilians between 15 and 19 years of age and is the leading cause of death in this age group. And the problem is escalating: between 1977 and 1994 the nationwide death rate due to homicide rose by 160% Several predisposing factors have been postulated, among them use of narcotics, alcohol and tobacco, having an unmarried mother, exposure to violence on television, high risk sexual behaviour, dropping out of school, and membership in a youth gang. In an attempt to identify risk factors that might be amenable to preventive action, Falbo et al. (pp. 2 7) conducted a case control study in Recife, one of Brazil's most violent cities. With a teenage homicide rate of 324 per 100 000 males about 30% higher than that of Afro American males in New York City it may even be one of the most violent cities in the world. The study compared data on a range of personal and social variables in 255 homicide victims under 20 years of age with the same variables in 255 ageand sex matched living neighbours of the victims. Data were obtained by questionnaire and personal interview. Of the victims, 95%were male and 97% had died of shot wounds, mostly to the head. The typical teenager at greatest risk of dying by homicide, the Recife study showed, has a police record and uses narcotic drugs. Teenagers who had completed their higher education, who had had a religious upbringing and whose father lived at home were at lowest risk. Social workers take note, the authors urge. They add that possession of firearms must also be a significant risk factor but was not picked up by the study because of gross underreporting by victims' families fearful of legal repercussions.
Bulletin of the World Health Organization