Deaths from homicides: a historical series

OBJECTIVE: to describe mortality from homicides in Itabuna, in the State of Bahia. METHOD: study with hybrid, ecological and time-trend design. The mortality coefficients per 1,000 inhabitants, adjusted by the direct technique, proportional mortality by sex and age range, and Potential Years of Life Lost were all calculated. RESULTS: since 2005, the external causes have moved from third to second most-common cause of death, with homicides being responsible for the increase. In the 13 years analyzed, homicides have risen 203%, with 94% of these deaths occurring among the male population. Within this group, the growth occurred mainly in the age range from 15 to 29 years of age. It was ascertained that 83% of the deaths were caused by firearms; 57.2% occurred in public thoroughfares; and 98.4% in the urban zone. In 2012, the 173 homicides resulted in 7,837 potential years of life lost, with each death causing, on average, the loss of 45.3 years. CONCLUSIONS: mortality by homicide in a medium-sized city in Bahia reaches levels observed in the big cities of Brazil in the 1980s, evidencing that the phenomenon of criminality - formerly predominant only in the big urban centers - is advancing into the rural area of Brazil, causing changes in the map of violent homicide in Brazil.


Introduction
Characterized as a phenomenon with complex and multifactorial causality, one can define violence as actions undertaken by one or more individuals and which cause physical or psychological harm to oneself or to others (1) . In this regard, it is deeply rooted in the social, economic and political structures, representing a risk for the process of human development, with potential threats to life and to health and the consequent possibility of death (2) .
Among the various forms of expression of violence, homicide is the most outrageous act, as it "definitively deprives the victim of all her rights", thus being an indicator for society's inability to develop and maintain non-lethal mechanisms for conflict resolution. Attention is drawn to mortality from homicides, fundamentally, because, in addition to occurring in large numbers, it mainly affects a young population. It is the principal cause of death in the age group between 15 and 44 years old, subverting the pattern present in first world countries, which is that deaths occur at the more advanced ages, being the main cause of potential years of life lost in this population (1)(2)(3) .
In Brazil, since the last decade, the concentration of homicides which previously was present in the major cities has spread to the interior of the country, as organized crime has sought new spaces. Besides the public safety institutions' difficulties in containing the process of the spread of violence into the interior of the country, urban degradation has contributed decisively to it, as poverty, social inequality, and poor access among the population to goods and basic services are problems which are no longer exclusive to the big cities (1) .
Research undertaken by the Ministry of Justice (MJ) and the NGO the Brazilian Forum on Public Safety, involving 266 municipalities with more than 100,000 inhabitants, in 2009, confirms that although it is spread throughout Brazil, violence is growing in the North and Northeast. This is a reflection of poor social indicators, few resources for applying to the public safety systems, and few preventive policies (4) .
It is in Bahia that one finds five of the 15 municipalities indicated by the above-mentioned study undertaken by the MJ, where the young Brazilians are most exposed to criminality, according to the Youth Vulnerability to Violence Index (IVJ-Violence) which takes into account socioeconomic data such as the number of assaults, educational level, access to the job market, income and housing (4) .
The most serious situation is that of the municipality of Itabuna, which occupies first place in the research's general ranking, evidencing that young males are increasingly involved as victims and authors of deaths by homicide. These deaths, in the urban spaces, are linked to impunity for infractions of the law and delinquency; to the exaggerated consumption of alcoholic drinks; to the use of, and trafficking in, drugs; to wide access to, and availability of, firearms; and to the absence of a political project for greater inclusion, which could be capable of reducing the social exclusion to which various segments of society are subject (1) .
This study aims to describe mortality from For many years, this municipality's economic basis was the cultivation of cocoa beans. Since the end of the 1980s, it has been facing a serious crisis due to the appearance of witch's broom disease*, which caused a marked drop in production. Currently, the city is seeking economic alternatives, with the help of commerce, industry, and the diversification of plantations, and is an important commercial hub for the State, being sited on the edges of the BR-101 and BR-415 intercity highways (5) . in the urban zone (6) . The municipality has the fifth  (7) . The specific mortality coefficients by age range were applied in relation to the respective populational contingents of the standard population. The number of deaths anticipated which could occur in each age range was obtained, should the standard population be exposed to the specific mortality coefficients which, divided by the standard population, resulted in the Mortality Coefficient by Standardized Cause (7) .
Considering that standardization for comparison effect is not appropriate for the age-specific Mortality Coefficients, they were compared in their raw state.  moved to second place, as shown in Figure 1, which shows the mortality coefficients by specific cause, standardized by age, by the direct technique, in accordance with the following age ranges: less than one year; 1 to 4 years; When one examines the distribution of the total of 2973 deaths from external causes, which took place in the period 2000 -2012, by specific types, it may be verified that 237 deaths, 8%, were recorded as "events in which the intention is unspecified" -that is, the information available was not sufficient to allow the distinction between it being an accident, a suicide, or a homicide.
In relation to proportional mortality, in 2012, homicides were responsible for 82.5% of deaths from external causes for which the intention was defined, presenting considerable growth since 2000, when they corresponded to 38.6% of deaths from these causes.       Costa FAMM, Trindade RFC, Santos CB.
in Brazil, with an estimated population of 9,968,485 inhabitants (11) , which corroborates the process of the spread of violence to the interior (i.e. areas and cities in rural regions) of Brazil and evidences that the shortcomings and inadequacies of the State and Public Safety Apparatus contribute to the attraction of criminality.
The predominance of mortality from homicide among young men found in this study was also observed in various other locales in Brazil. Some studies (1,12) relate the excess mortality among males to the higher probability of exposure to violence. In this population,  (13) .
Authors (1,11) contend that homicide of young people Even among the intentional elements, it is suicides which head mortality in these countries (3) .  (3) . The firearm was the weapon used most in the violent events which occurred in the municipality, for both sexes, a fact also observed by various authors (1,3) .
A recent study has demonstrated that Alagoas, Bahia, Ceará, Pará and Paraíba were the States which presented the highest rates of homicide by firearm in the year 2010 (13) .
The growth of 13% of the number of homicides with firearms is slightly superior to the global growth in Brazil, which was 11.2% in the decade 2000 -2010 (13) . These data contrast with those published by the Brazilian Institute for Applied Economic Research (IPEA) (14) , This predominantly rural crisis had direct influences on the urban zone. The populational and urban growth, in convergence with the economic crisis, led to high unemployment and the proliferation of poverty, social exclusion and criminality in the city (5,18) .

Conclusion
The