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Profile of female deaths by homicide in the city of Goiânia

Perfil de homicidio muerte de mujeres en la ciudad de Goiania

ABSTRACT

Objectives:

to identify the female homicide profile in the city of Goiânia.

Methods:

a cross-sectional, descriptive study that characterized female deaths by homicide from 2008 to 2015. They occurred in Goiânia, and registered in the Mortality Information System. Cases of homicide of women aged ≥ 10 years were eligible. Other causes of death were excluded. Descriptive statistical analysis with frequencies.

Results:

three hundred seventy-six women died from assault, with an increase in the percentage of deaths annually. Most of the victims were young (57.5%), single (78.8%), mixed-ethnicity (61.1%) and with low education (58.4%). The most frequent means of assault was firearm (64.0%). The health districts with the highest record of female deaths due to assault were southwest, center and northwest.

Conclusions:

the predominant profile of women victims of femicide was young, mixed-ethnicity, single, with low level of education and living in less favored regions.

Descriptors:
Gender-Based Violence; Violence Against Women; Homicide; Violence; Battered Women

RESUMEN

Objetivos:

identificar el perfil de homicidios femeninos en la cuidad de Goiânia.

Métodos:

estudio descriptivo transversal que caracterizó las muertes de mujeres por homicidios de 2008 a 2015, ocurridas en Goiânia, registradas en el Sistema de Información de Mortalidad. Los casos de homicidio de mujeres ≥ 10 años que vivían en Goiânia eran elegibles. Se excluyeron otras causas de muerte. Análisis estadístico descriptivo con frecuencias.

Resultados:

376 mujeres murieron por agresión, con un aumento en el porcentaje de muertes anuales. La mayoría de las víctimas eran jóvenes (57.5%), solteras (78.8%), mestizas (61.1%) y con baja educación (58.4%). El medio de agresión más frecuente fue con un arma de fuego (64.0%). Los distritos de salud con el mayor número de muertes de mujeres debido a la agresión fueron Suroeste, Centro y Noroeste, respectivamente.

Conclusiones:

el perfil predominante de mujeres víctimas de feminicidio era joven, morena, soltera, con bajo nivel educativo y viviendo en regiones menos favorecidas.

Descriptores:
Violencia de Género; Violencia contra la Mujer; Homicidio; Violencia; Mujeres Maltratadas

RESUMO

Objetivos:

identificar o perfil de homicídios femininos no município de Goiânia, Goiás.

Métodos:

estudo transversal, descritivo, que caracterizou os óbitos femininos por homicídios de 2008 a 2015, ocorridos em Goiânia, registrados no Sistema de Informação sobre Mortalidade. Foram elegíveis casos de homicídios de mulheres com idade ≥ 10 anos que residiam em Goiânia. Foram excluídas as outras causas de morte. Análise estatística descritiva com frequências.

Resultados:

376 mulheres morreram por agressão, observando-se um aumento da porcentagem de óbitos anualmente. A maioria das vítimas era jovens (57,5%), solteiras (78,8%), pardas (61,1 %) e de baixa escolaridade (58,4%). O meio de agressão mais frequente foi com arma de fogo (64,0%). Os distritos sanitários com maior registro de óbitos femininos por agressão foram Sudoeste, Centro e Noroeste, respectivamente.

Conclusões:

o perfil predominante das mulheres vítimas de feminicídio foi jovens, pardas, solteiras, com baixo nível de escolaridade e moradoras de regiões menos favorecidas.

Descritores:
Violência de Gênero; Violência contra a Mulher; Homicídio; Violência; Mulheres Maltratadas

INTRODUCTION

Violence against women is considered an important public health problem, due to the high prevalence of cases identified in several countries, especially those committed by intimate partners(11 World Health Organization. Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence[Internet]. World Health Organization; 2013[cited 2018 Jun 13]. Available from: https://apps.who.int/iris/bitstream/handle/10665/85239/9789241564625_eng.pdf;jsessionid=C2B1BC6807B33F0E72F3125851BBF935?sequence=1
https://apps.who.int/iris/bitstream/hand...
).

In North America, it is estimated that between 60% and 70% of female homicide in the United States and Canada are committed by intimate partners(11 World Health Organization. Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence[Internet]. World Health Organization; 2013[cited 2018 Jun 13]. Available from: https://apps.who.int/iris/bitstream/handle/10665/85239/9789241564625_eng.pdf;jsessionid=C2B1BC6807B33F0E72F3125851BBF935?sequence=1
https://apps.who.int/iris/bitstream/hand...
-22 Campbell JC, Glass N, Sharps PW, Laughon K, Bloom T. Intimate partner homicide: review and implications of research and policy. Trauma Violence Abuse. 2007;8(3):246-69. doi: 10.1177/1524838007303505.
https://doi.org/10.1177/1524838007303505...
). Other investigators suggest that the greatest risk of female homicide is by partners or ex-partners(33 Stöckl H, Devries K, Rotstein A. The global prevalence of intimate partner homicide: a systematic review. Lancet. 2013;382(9895):859-65. doi: 10.1016/S0140-6736(13)61030-2
https://doi.org/10.1016/S0140-6736(13)61...
). Similarly, in the United Kingdom, in 2009, 54% of female deaths and 5% of male deaths were committed by intimate partners(44 Smith K, Coleman K, Eder S, Hall P. Homicides, firearm offences and intimate violence 2009/10 (Crime in England and Wales). Home Office Statistical Bulletin[Internet]. 2011 [cited 2018 Jun 13]:118 Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/116483/hosb0212.pdf
https://assets.publishing.service.gov.uk...
). Another retrospective study carried out in 1999 and 2009 in South Africa found that about 50% of female homicide were committed by spouses(55 Abrahams N, Mathews S, Martin LJ, Lombard C, Jewkes R. Intimate partner femicide in South Africa in 1999 and 2009. PLoS Med [Internet]. 2013 [cited 2017 Aug 28];10(4):132-8 Available from: https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001412
https://journals.plos.org/plosmedicine/a...
).

Female deaths for which gender-based discrimination was the only reason they were named femicides in 1976 by Diana Russel(66 Russel DEH, Harmes R. Defining Feminicide and related concepts. In: Russel DEH, Harmes R, (eds.). Feminicide in global perspective. New York: Teacher’s College Press, 2001, 12-8 p.). Women deaths caused by gender conflicts represent the maximum expression of violence. Intimate partner physical violence against women was the main risk factor for femicide. These deaths result from situations of abuse at home, threats, sexual violence, and situations in which women have less power and resources than men(22 Campbell JC, Glass N, Sharps PW, Laughon K, Bloom T. Intimate partner homicide: review and implications of research and policy. Trauma Violence Abuse. 2007;8(3):246-69. doi: 10.1177/1524838007303505.
https://doi.org/10.1177/1524838007303505...
-33 Stöckl H, Devries K, Rotstein A. The global prevalence of intimate partner homicide: a systematic review. Lancet. 2013;382(9895):859-65. doi: 10.1016/S0140-6736(13)61030-2
https://doi.org/10.1016/S0140-6736(13)61...
).

With regard to female homicide, Brazil ranks fifth among 84 countries in the world(77 Waiselfisz JJ. Mapa da Violência 2015: homicídios de mulheres no Brasil[Internet]. 2015[cited 2017 Aug 28]. 79 p. Available from: https://www.mapadaviolencia.org.br/pdf2015/MapaViolencia_2015_mulheres.pdf.
https://www.mapadaviolencia.org.br/pdf20...
). From 2009 to 2011, 13,071 femicides were registered in the Brazilian Mortality Information System (Sistema de Informação de Mortalidade, abbreviated SIM, corresponding to U.S.’ National Vital Statistics System), which is equivalent to a crude mortality rate of 4.48 deaths per 100,000 women(88 Garcia LP, Freitas LRS, Silva GDM, Höfelmann DA. Estimativas corrigidas de feminicídios no Brasil, 2009 a 2011. Rev Panam Salud Publica [Internet]. 2015[cited 2017 Aug 28];37:251-7 Available from: https://www.scielosp.org/pdf/rpsp/2015.v37n4-5/251-257/pt
https://www.scielosp.org/pdf/rpsp/2015.v...
). Among the Brazilian states, the State of Goiás ranks sixth place, since 6.9 cases of femicide were registered per 100 thousand women(88 Garcia LP, Freitas LRS, Silva GDM, Höfelmann DA. Estimativas corrigidas de feminicídios no Brasil, 2009 a 2011. Rev Panam Salud Publica [Internet]. 2015[cited 2017 Aug 28];37:251-7 Available from: https://www.scielosp.org/pdf/rpsp/2015.v37n4-5/251-257/pt
https://www.scielosp.org/pdf/rpsp/2015.v...
).

In the last decades, several international and national public policies were created with the purpose of giving a different treatment to gender issues, including femicide. Among public policies, the creation of UN Women by the United Nations in 2010 stands out. This entity plays a global leadership role in the defense of women around the world. It seeks to expand global efforts to defend women’s human rights, placing gender equality as an important condition for achieving development(99 Organização das Nações Unidas. ONU Mulheres Brasil[Internet]. 2010[cited 2017 Aug 28]. Available from: http://www.onumulheres.org.br/onu-mulheres/sobre-a-onu-mulheres/
http://www.onumulheres.org.br/onu-mulher...
). In Brazil, Law 11.340 - known as Maria da Penha Law - came into force in 2006, which defines domestic and family violence against women as a crime, allowing offenders of women to be caught in the act or to have their preventive detention decreed(1010 Presidência da República (BR). Lei n. 11.340 de 7 de agosto de 2006. Lei Maria da Penha. Dispõe sobre a criação dos Juizados de Violência Doméstica e Familiar contra a mulher, altera o Código de Processo Penal, o Códio Penal e a Lei de Execução Pena e dá outras providências [Internet]. Brasília: Diário Oficial da União, 2006[cited 2017 Aug 28]. Available from: http://www.planalto.gov.br/ccivil_03/_ato2004-2006/2006/lei/l11340.htm
http://www.planalto.gov.br/ccivil_03/_at...
). However, a time series study, conducted to assess the impact of the Maria da Penha Law on the mortality of women due to assault, found that there was no impact, that is, there was no reduction in the annual mortality rates(1111 Garcia LP, Freitas LRS, Höfelmann DA. Avaliação do impacto da Lei Maria da Penha sobre a mortalidade de mulheres por agressões no Brasil, 2001-2011. Epidemiol Serv Saude. 2013;22(3):383-94. doi: 10.5123/S1679-49742013000300003
https://doi.org/10.5123/S1679-4974201300...
).

In a new attempt to reduce violence against women, the Brazilian government, in 2015, approved the bill to classify femicide as a heinous crime and qualify the murder of women due to gender reasons. Thus, murder motivated by gender becomes a homicide qualified with imprisonment for 12 to 30 years(1212 Presidência da República (BR). Lei nº.13.104, de 9 de março de 2015. Altera o art. 121 do Decreto-Lei no 2.848, de 7 de dezembro de 1940 - Código Penal, para prever o feminicídio como circunstância qualificadora do crime de homicídio, e o art. 1o da Lei no 8.072, de 25 de julho de 1990, para incluir o feminicídio no rol dos crimes hediondos. Brasília: Diário Oficial da União, 2015.).

Although gender violence is an important social and human rights problem, there is still little information about the magnitude of this phenomenon. A search was conducted using the PICO strategy (P: female/women; I: homicide/femicide; CO: Brazilian) in five databases (Virtual Health Library, PubMed, LILACS, BIREME and Scielo) identified 35 articles. Of these, four studied femicide in Brazil(1313 Souza ER, Meira KC, Ribeiro AP. Homicides among women in the different Brazilian regions in the last 35 years: an analysis of age-period-birth cohort effects. Cien Saude Colet. 2017;22(9):2949-62. doi: 10.1590/1413-81232017229.12392017
https://doi.org/10.1590/1413-81232017229...

14 Meneghel SN, Hirakata VN. Femicídios: homicídios femininos no Brasil. Rev Saude Publica. 2011;45:564-74. doi: 10.1590/S0034-89102011000300015
https://doi.org/10.1590/S0034-8910201100...

15 Martins-Filho PRS, Mendes MLT, Reinheimer DM. Femicide trends in Brazil: relationship between public interest and mortality rates. Arch Womens Ment Health. 2018;21(5):579-82. doi: 10.1007/s00737-018-0842-1
https://doi.org/10.1007/s00737-018-0842-...
-1616 Meneghel SN, Rosa B, Ceccon RF, Hirakata VN, Danilevicz IM. Femicides: a study in Brazilian state capital cities and large municipalities. Cien Saude Colet. 2017;22(9):2963-70. doi: 10.1590/1413-81232017229.22732015
https://doi.org/10.1590/1413-81232017229...
) and only one evaluated the city of Goiânia in order to analyze the relationship between femicides and various indicators(1616 Meneghel SN, Rosa B, Ceccon RF, Hirakata VN, Danilevicz IM. Femicides: a study in Brazilian state capital cities and large municipalities. Cien Saude Colet. 2017;22(9):2963-70. doi: 10.1590/1413-81232017229.22732015
https://doi.org/10.1590/1413-81232017229...
). In this setting, this is the first study that proposes to contribute to the visibility of this event by obtaining population data on the profile and distribution of female deaths from homicide in Goiânia’s health districts.

OBJECTIVES

To identify the female homicide profile in the city of Goiânia, State of Goiás.

METHODS

Ethical aspects

Although it used secondary data available for public consultation, the study was approved by the Ethics Committee of the Universidade Pontifícia Católica de Goiás - PUC Goiás (Opinion 1,616,347) on June 30, 2016. All ethical guidelines established by CNS (Conselho Nacional de Saúde - Brazilian National Health Board) Resolution 466, of December 12, 2012, which regulates research involving human beings, were followed.

Study design, period and location

This is a cross-sectional and descriptive study, guided by the STROBE tool, which analyzed the epidemiological profile of cases of deaths of women by homicide in Goiânia, based in the central region of Brazil between 2008 and 2015. The city is divided into seven health districts (North, South, East, West, Northwest, Southwest and Campinas-Center). The secondary database used to obtain the data was the SIM.

Population, inclusion and exclusion criteria

The study population was all women aged ten years or older, living in the city of Goiânia, who died during the study period.

The study inclusion criteria were homicide of women aged ten years and older who lived in Goiânia. All other causes of death in the city of Goiânia were excluded.

Study protocol

Death distribution was performed based on the variable of the victims’ place of residence, designated in the SIM databse as CODBAIRRORES (public domain variable).

The femicide category is not included in the SIM. Also, similar to other studies, the total number of female homicide was used as an “approximate indicator” of femicide, since 60% to 70% of these deaths are caused by gender inequalities(22 Campbell JC, Glass N, Sharps PW, Laughon K, Bloom T. Intimate partner homicide: review and implications of research and policy. Trauma Violence Abuse. 2007;8(3):246-69. doi: 10.1177/1524838007303505.
https://doi.org/10.1177/1524838007303505...
,1414 Meneghel SN, Hirakata VN. Femicídios: homicídios femininos no Brasil. Rev Saude Publica. 2011;45:564-74. doi: 10.1590/S0034-89102011000300015
https://doi.org/10.1590/S0034-8910201100...
). The use of total deaths as an approximation of cases of femicide does not overestimate the mortality from this event, in view of the compensation for underreporting or ill-defined diagnoses of assault in women, especially in the poorest regions of the country(1717 Instituto Brasileiro de Geografia e Estatística. Estatísticas do Registro Civil 2009[Internet]. 2010[cited 2018 Aug 28]. Available from: https://www.ibge.gov.br/estatisticas/sociais/populacao/9110-estatisticas-do-registro-civil.html
https://www.ibge.gov.br/estatisticas/soc...
).

Female homicide was considered according to the categories of the 10th edition of the International Classification of Diseases (ICD-10), from X85 to Y09. This classification covers homicide and injuries inflicted by another person, using any means with intention of injuring or killing, as shown in Chart 1.

Chart 1
Categories of the 10th edition of the International Classification of Diseases (ICD-10), from X85 to Y09

The variables were classified into: (i) sociodemographic characteristics - age group (in years); race (white, black, yellow, mixed-ethnicity); marital status (married, single, widow, separated); education (in years); (ii) characteristics of the occurrence of death - year of death (from 2008 to 2015); weekdays (Monday, Tuesday, Wednesday, Thursday, Friday, Saturday and Sunday); month of occurrence (January to December); means of assault (firearm, sharp object, hanging, suffocation or strangulation, fire, smoke and flames); place of death (hospital, public roads, home, others); neighborhood where the victims lived, grouped by health districts.

Analysis of results and statistics

A database was built using the Statistical Package for the Social Science (SPSS), version 20, on Windows platform. Typing was performed by researchers with experience in handling the DATASUS system, with the support of a statistician. A descriptive analysis was carried out to characterize the profile of the victims through tables of distribution of absolute and relative frequencies of the variables for all cases of deaths of women by homicide, declared by SIM.

RESULTS

In Goiânia, 376 women died from assault between 2008 and 2015. Table 1 presents sociodemographic characteristics and occurrences of female homicide in this period.

Table 1
Sociodemographic and occurrence characteristics of women victims of homicide living in the city of Goiânia, Goiás, Brazil, 2008-2015

Most of the victims were women aged 20 to 39 years (57.5%), single (78.8%), mixed-ethnicity (61.1%) and had low education (58.4%). Approximately 20% of female deaths occurred among adolescents.

Regarding the means of assault suffered by the victims, firearm use (64.0%) stands out, followed by sharp object (25.3%). The most frequent place of death was public roads (36.2%), followed by hospitals (24.5%) and home (23.9%) (Table 1).

As for the year in which femicide occurred, there was an increase in its proportion during the study period: 8.2% in 2008, reaching 20.7% in 2014, and a slight drop in 2015, as shown in Figure 1.

Figure 1
Percentage of deaths due to violence against women according to the year of occurrence, Goiânia, Goiás, Brazil, 2008-2015

The health districts where most female deaths from assault occurred were the Southwest (19.5%), followed by Campinas-Center (17.3%), Northwest (16.7%), East (13.5%), South (11.4%), West (11.1%) and North (10.5%). Among the records of female deaths due to assault, 9.3% had no records of the region where the victims lived.

The distribution of deaths that occurred during the study period, according to weekdays, shows that 141 deaths occurred during the weekends (37.5%). The percentage of the number of deaths was 18.9% on Sundays, 18.6% on Saturdays and 8.5% on Mondays (Figure 2).

Figure 2
Percentage of deaths due to violence against women according to the weekdays of occurrence, in victims from Goiânia, Goiás, Brazil, 2008-2015

Figure 3 lists the distribution of femicides, according to the month of the year. The highest percentages correspond to April, September, October and January, respectively.

Figure 3
Percentage of deaths due to violence against women according to the months of the year of occurrence, in victims from Goiânia, Goiás, Brazil, 2008-2015

DISCUSSION

The predominant profile of deaths observed was that of young, single, mixed-ethnicity, poorly educated victims and residents in less favored regions of the city. Other studies, international and national, have also identified the relationship between violence against women with these characteristics, also associating this type of violence with black and unemployed women(1111 Garcia LP, Freitas LRS, Höfelmann DA. Avaliação do impacto da Lei Maria da Penha sobre a mortalidade de mulheres por agressões no Brasil, 2001-2011. Epidemiol Serv Saude. 2013;22(3):383-94. doi: 10.5123/S1679-49742013000300003
https://doi.org/10.5123/S1679-4974201300...
,1818 Vyas S, Jansen H. Unequal power relations and partner violence against women in Tanzania: a cross-sectional analysis. BMC Womens Health. 2018;18(1):185. doi: 10.1186/s12905-018-0675-0
https://doi.org/10.1186/s12905-018-0675-...

19 Meneghel SN, Mueller B, Collaziol ME,Quadros MM. Repercussões da lei Maria da Penha no enfrentamento da violência de gênero. Cien Saude Colet. 2013;18(3):691-700. doi: 10.1590/s1413-81232013000300015
https://doi.org/10.1590/s1413-8123201300...

20 Memiah P, Ah Mu T, Prevot K. The prevalence of intimate partner violence, associated risk factors, and other moderating effects: findings from the Kenya National Health Demographic Survey. J Interpers Violence. 2018:886260518804177. doi: 10.1177/0886260518804177
https://doi.org/10.1177/0886260518804177...

21 Benebo FO, Schumann B, Vaezghasemi M. Intimate partner violence against women in Nigeria: a multilevel study investigating the effect of women's status and community norms. BMC Womens Health. 2018; 18(1): 136. doi: 10.1186/s12905-018-0628-7
https://doi.org/10.1186/s12905-018-0628-...
-2222 Margarites AF, Meneghel SN, Ceccon RF. Feminicides in Porto Alegre: how many? who are they? Rev Bras Epidemiol. 2017;20(2):225-36. doi: 10.1590/1980-5497201700020004.
https://doi.org/10.1590/1980-54972017000...
).

Similar to our findings, in the United States, relationships were found between rates of femicide and places of greatest poverty, instability, black population, unemployment and violent crime rates(22 Campbell JC, Glass N, Sharps PW, Laughon K, Bloom T. Intimate partner homicide: review and implications of research and policy. Trauma Violence Abuse. 2007;8(3):246-69. doi: 10.1177/1524838007303505.
https://doi.org/10.1177/1524838007303505...
). In Latin America, many murdered women are prostitutes, young people, with low purchasing power, from slum areas, who perform precarious jobs and are in a situation of high vulnerability(2323 Prieto-Carrón M, Thomson M, Macdonald M. No more killings! women respond to femicides in Central America. Gender Developm [Internet]. 2007 [cited 2017 Aug 28];15(1):25-40. Available from: www.jstor.org/stable/20461179
www.jstor.org/stable/20461179...
).

On the other hand, this study identified that 10% of deaths occurred among women with higher education, contradicting the literature(1111 Garcia LP, Freitas LRS, Höfelmann DA. Avaliação do impacto da Lei Maria da Penha sobre a mortalidade de mulheres por agressões no Brasil, 2001-2011. Epidemiol Serv Saude. 2013;22(3):383-94. doi: 10.5123/S1679-49742013000300003
https://doi.org/10.5123/S1679-4974201300...
,1414 Meneghel SN, Hirakata VN. Femicídios: homicídios femininos no Brasil. Rev Saude Publica. 2011;45:564-74. doi: 10.1590/S0034-89102011000300015
https://doi.org/10.1590/S0034-8910201100...
). This might happen due to change in traditional gender roles. Women entry into the formal workforce allows many to achieve their economic independence, which is potentially a source of conflict. Men, when lose the role of provider and head of the family, often react aggressively, and this can increase the number of situations of violence among genders, including femicides(1919 Meneghel SN, Mueller B, Collaziol ME,Quadros MM. Repercussões da lei Maria da Penha no enfrentamento da violência de gênero. Cien Saude Colet. 2013;18(3):691-700. doi: 10.1590/s1413-81232013000300015
https://doi.org/10.1590/s1413-8123201300...
).

Although the literature brings conflicting results in relation to the victim’s marital status, an American study, similar to our findings, found that single women had a higher risk of homicide than married women(22 Campbell JC, Glass N, Sharps PW, Laughon K, Bloom T. Intimate partner homicide: review and implications of research and policy. Trauma Violence Abuse. 2007;8(3):246-69. doi: 10.1177/1524838007303505.
https://doi.org/10.1177/1524838007303505...
). In Brazil, other researchers have also shown a higher risk of femicides among single women(1414 Meneghel SN, Hirakata VN. Femicídios: homicídios femininos no Brasil. Rev Saude Publica. 2011;45:564-74. doi: 10.1590/S0034-89102011000300015
https://doi.org/10.1590/S0034-8910201100...
). For married women, the period in which they are trying to achieve separation represents a risk situation for femicide(2424 Dobash RE, Dobash RP, Cavanagh K, Lewis R. Not an ordinary killer-Just an ordinary guy: when men murder an intimate woman partner. Violence Against Women. 2004;10(6):577-605. doi: https://doi.org/10.1177/1077801204265015
https://doi.org/10.1177/1077801204265015...
). However, it is not clear whether this danger is greater than staying in an abusive relationship. Therefore, is important that other studies are carried out to assess whether there is an association between marital status and femicide.

In this study, there was an increase in the proportion of homicide among women between 2008 (8.2%) and 2015 (12.5%). A study conducted with data from all over Brazil also identified an increase in the prevalence of femicide over the years. In other countries, the reality is no different, especially in homicide caused by an intimate partner. Intimate partner violence prevalence is variable(1111 Garcia LP, Freitas LRS, Höfelmann DA. Avaliação do impacto da Lei Maria da Penha sobre a mortalidade de mulheres por agressões no Brasil, 2001-2011. Epidemiol Serv Saude. 2013;22(3):383-94. doi: 10.5123/S1679-49742013000300003
https://doi.org/10.5123/S1679-4974201300...
), ranging from 13% to 71%. A systematic review with data obtained from 66 countries showed that overall, 13.5% of homicide were committed by an intimate partner, and this proportion was six times higher for female homicide than for male homicide. Percentages of homicide by intimate partners were higher in high-income countries and Southeast Asia(33 Stöckl H, Devries K, Rotstein A. The global prevalence of intimate partner homicide: a systematic review. Lancet. 2013;382(9895):859-65. doi: 10.1016/S0140-6736(13)61030-2
https://doi.org/10.1016/S0140-6736(13)61...
). However, high rates of femicide have also been found in developing countries, especially in Latin America and the Caribbean(2525 Organização Pan-Americana de Saúde. Violência contra a mulher. Estratégia e Plano de Ação para o reforço do sistema de saúde para abordar a violência contra a mulher[Internet]. 2015 [cited 2018 Nov 10]. Available from: http://iris.paho.org/xmlui/bitstream/handle/123456789/18386/CD549Rev2_por.pdf?sequence=9&isAllowed=y.
http://iris.paho.org/xmlui/bitstream/han...
). These results highlight the need for effective public policies to reduce female homicide rates.

In Goiânia, in 2014, there was a greater number of female homicide. This happens because of the figure of a serial killer that promoted an abrupt increase in female deaths in the city (20.7%), in this period. The serial killer was arrested in October 2014, when he confessed to murdering 39 people, mostly women, between 2011 and 2014. Of the women, two would be call girls. Among the men, some would be homeless and homosexuals. As of the end of 2013, he started to kill only women, mostly young men, chosen at random while he was riding a(2626 Lara R. Serial Killer de Goiânia é condenado a vinte anos de prisão. Veja [Internet]. Editora Abril, 16 Feb 2016[cited 2018 Nov 10]. Available from: https://veja.abril.com.br/brasil/serial-killer-de-goiania-e-condenado-a-20-anos-de-prisao/
https://veja.abril.com.br/brasil/serial-...
) motorcycle. The catastrophes could be prevented with active epidemiological surveillance to monitor the female homicide rate and act in a timely manner to prevent outbreaks like this.

Three regions stood out in relation to the frequency of female homicide in the city of Goiânia (Northeast, Southeast and Center), corresponding to more than half of femicides (53.5%), distributed in the seven health districts. This disparity in the distribution of female deaths identified emphasizes the great intra-urban spatial inequality, evidencing high concentrations of deaths in less favored regions of the city.

The literature also shows that economically disadvantaged regions have a higher homicide rate related to the gender(55 Abrahams N, Mathews S, Martin LJ, Lombard C, Jewkes R. Intimate partner femicide in South Africa in 1999 and 2009. PLoS Med [Internet]. 2013 [cited 2017 Aug 28];10(4):132-8 Available from: https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001412
https://journals.plos.org/plosmedicine/a...
,1111 Garcia LP, Freitas LRS, Höfelmann DA. Avaliação do impacto da Lei Maria da Penha sobre a mortalidade de mulheres por agressões no Brasil, 2001-2011. Epidemiol Serv Saude. 2013;22(3):383-94. doi: 10.5123/S1679-49742013000300003
https://doi.org/10.5123/S1679-4974201300...
,2727 Leites GT, Meneghel SN, Hirakata VN. Female homicide in Rio Grande do Sul, Brazil. Rev Bras Epidemiol [Internet]. 2014[cited 2017 Aug 28];17(3):642-53 Available from: http://www.scielo.br/pdf/rbepid/v17n3/1415-790X-rbepid-17-03-00642.pdf
http://www.scielo.br/pdf/rbepid/v17n3/14...
). In Brazil, a study designed to verify the main causes of death, identified an increase in the rates of femicide in the regions with the worst socioeconomic indicators(2828 Franca EB, Passos VMA, Malta DC. Cause-specific mortality for 249 causes in Brazil and states during 1990-2015: a systematic analysis for the global burden of disease study 2015. Popul Health Metr. 2017;15(1):39. doi: 10.1186/s12963-017-0156-y
https://doi.org/10.1186/s12963-017-0156-...
). Such regions are linked to areas of greater violence with a large number of male homicide, which increases homicide by gender, since aggressive and sexist behaviors prevail in these environments(2727 Leites GT, Meneghel SN, Hirakata VN. Female homicide in Rio Grande do Sul, Brazil. Rev Bras Epidemiol [Internet]. 2014[cited 2017 Aug 28];17(3):642-53 Available from: http://www.scielo.br/pdf/rbepid/v17n3/1415-790X-rbepid-17-03-00642.pdf
http://www.scielo.br/pdf/rbepid/v17n3/14...
). Therefore, where society is more violent, women are more penalized(1919 Meneghel SN, Mueller B, Collaziol ME,Quadros MM. Repercussões da lei Maria da Penha no enfrentamento da violência de gênero. Cien Saude Colet. 2013;18(3):691-700. doi: 10.1590/s1413-81232013000300015
https://doi.org/10.1590/s1413-8123201300...
,2727 Leites GT, Meneghel SN, Hirakata VN. Female homicide in Rio Grande do Sul, Brazil. Rev Bras Epidemiol [Internet]. 2014[cited 2017 Aug 28];17(3):642-53 Available from: http://www.scielo.br/pdf/rbepid/v17n3/1415-790X-rbepid-17-03-00642.pdf
http://www.scielo.br/pdf/rbepid/v17n3/14...
,2929 Munévar DI. Delito de feminicidio. Muerte violenta de mujeres por razones de género. Estud Soc Jur [Internet]. 2012[cited 2017 Aug 28];14(1):135-75 Available from: http://www.corteidh.or.cr/tablas/r28986.pdf
http://www.corteidh.or.cr/tablas/r28986....
).

Regarding the Center of Goiânia, despite being an economically more favored region, it is also marked by social destabilization, since it is a region characterized by places of prostitution. A study conducted in Goiânia, to characterize the profile of female sex workers, using the Respondent-Driven Sampling (RDS), a sampling methodology, identified the central region of Goiânia as one of the places of women prostitution. Goiânia is also considered an important route for prostitution and national and international sexual tourism(3030 Matos MA, Caetano KA, Franca DD, Pinheiro RS, Moraes LC, Teles SA. Vulnerability to sexually transmitted infections in women who sell sex on the route of prostitution and sex tourism in central Brazil. Rev Latino-Am Enfermagem. 2013;21(4):906-12. doi: 10.1590/s0104-11692013000400011
https://doi.org/10.1590/s0104-1169201300...
). Other investigators have shown femicides in stigmatized populations, whose victims belong to marginalized populations such as homeless people and sex workers(3131 Jovanovski N, Tyler M. "Bitch, You Got What You Deserved!": violation and violence in sex buyer reviews of legal brothels. Violence Against Women. 2018;24(16):1887-908. doi: 10.1177/1077801218757375
https://doi.org/10.1177/1077801218757375...
). On the other hand, there is a discourse that minimizes crimes when murdered women are addicted to drugs or prostitutes leading to the naturalization of violence. A study that looked at the behavior of men who pay to have sex, conducted in the United States, found that sex buyers were more likely to report sexual assault and rape(3232 Farley M, Golding JM, Matthews ES, Malamuth NM, Jarrett L. Comparing sex buyers with men who do not buy sex: new data on prostitution and trafficking. J Interpers Violence. 2017;32(23):3601-25. doi: 10.1177/0886260515600874
https://doi.org/10.1177/0886260515600874...
). For this population, geographical space appears as a potential threat for cases of femicide.

Regarding the type of occurrence, firearm was the most used means of assault (64.0%) in this research. Most deaths are committed by an intimate partner and involve firearms(3333 Geneva Declaration on Armed Violence and Development. Global burden of armed violence 2015: every body counts. Periodical Global burden of armed violence 2015: every body counts [Internet]. 2015[cited 2019 Jan 28]. Available from: http://www.genevadeclaration.org/measurability/global-burden-of-armed-violence/global-burden-of-armed-violence-2015.html
http://www.genevadeclaration.org/measura...
). Therefore, a weapon that may have been purchased for family defense can become a threat where there are cases of domestic violence.

The results of the present study identified that the majority of female homicide occurred on weekends and during vacation months. This finding is consistent with a Brazilian study, in which more than a third of female deaths occurred during weekends(1111 Garcia LP, Freitas LRS, Höfelmann DA. Avaliação do impacto da Lei Maria da Penha sobre a mortalidade de mulheres por agressões no Brasil, 2001-2011. Epidemiol Serv Saude. 2013;22(3):383-94. doi: 10.5123/S1679-49742013000300003
https://doi.org/10.5123/S1679-4974201300...
). A possible explanation for this is that this may be the period in which abusers spend more time with women, since in most cases, they are not working. Another factor may refer to the higher consumption of alcoholic beverages in this period of the week, which leads to an increase in domestic violence(3434 Naved RT, Mamun MA, Parvin K. Magnitude and correlates of intimate partner violence against female garment workers from selected factories in Bangladesh. PLoS One. 2018;13(11):e0204725. doi: 10.1371/journal.pone.0204725
https://doi.org/10.1371/journal.pone.020...
).

Public roads stood out as the most frequent place of death in the present study. However, most studies that correlate female homicide with the gender issue have a higher prevalence of home deaths(1919 Meneghel SN, Mueller B, Collaziol ME,Quadros MM. Repercussões da lei Maria da Penha no enfrentamento da violência de gênero. Cien Saude Colet. 2013;18(3):691-700. doi: 10.1590/s1413-81232013000300015
https://doi.org/10.1590/s1413-8123201300...
). However, no significant discrepancy was found in the literature between the variables public roads, home, and hospitals(1111 Garcia LP, Freitas LRS, Höfelmann DA. Avaliação do impacto da Lei Maria da Penha sobre a mortalidade de mulheres por agressões no Brasil, 2001-2011. Epidemiol Serv Saude. 2013;22(3):383-94. doi: 10.5123/S1679-49742013000300003
https://doi.org/10.5123/S1679-4974201300...
).

Study limitations

One of the limitations of this study is the use of secondary data for the study of homicide against women, since there may be problems in the diagnosis and in filling out death certificates, since many homicide are considered accidents or suicides(77 Waiselfisz JJ. Mapa da Violência 2015: homicídios de mulheres no Brasil[Internet]. 2015[cited 2017 Aug 28]. 79 p. Available from: https://www.mapadaviolencia.org.br/pdf2015/MapaViolencia_2015_mulheres.pdf.
https://www.mapadaviolencia.org.br/pdf20...
). Another limitation was the identification of ignored values or blank data in the database (“missing data”) in some variables, with emphasis on victims’ marital situation and education, impairing the knowledge of their characteristics.

Contributions to public policies

This study may contribute to expanding surveillance activities on registration quality of women deaths, thus allowing greater visibility in Brazil. It also helps to understand the profile of women who have suffered violence and died as a result of this fact, in order to know which population of women is most vulnerable to this fatality.

CONCLUSIONS

This study identified the profile of violent deaths of women in the city of Goiânia, distributed by health districts, based on the SIM database. The investigated population was formed predominantly by young, mixed-ethnicity, single women, with low level of education and living in peripheral regions. The highest percentages of femicides occurred on weekends and on vacation months. It is worth mentioning that it is still necessary to broad the understanding of gender violence in the city through new studies that obtain qualitative information to understand this complex reality in which ethnicity, social class and gender interact.

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Edited by

EDITOR IN CHIEF: Antonio José de Almeida Filho
ASSOCIATE EDITOR: Cristina Parada

Publication Dates

  • Publication in this collection
    31 July 2020
  • Date of issue
    2020

History

  • Received
    20 Feb 2019
  • Accepted
    09 Mar 2020
Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
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