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| Author(s): |
Marcelo Ryngelblum
Total Authors: 1
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| Document type: | Master's Dissertation |
| Press: | São Paulo. |
| Institution: | Universidade de São Paulo (USP). Faculdade de Medicina (FM/SBD) |
| Defense date: | 2021-01-26 |
| Examining board members: |
Maria Fernanda Tourinho Peres;
Sergio França Adorno de Abreu;
Rita de Cassia Barradas Barata;
Marcia Thereza Couto Falcão
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| Advisor: | Maria Fernanda Tourinho Peres |
| Abstract | |
INTRODUCTION: Lethal police violence (LPV) is a public health issue and should be monitored. Although the Mortality Information System (SIM) is the most reliable record of deaths from assault, the same is not the case when we analyze deaths committed by police officers. Despite increasing use, Legal Intervention (Y35), the category of the 10th revision of the International Classification of Diseases (ICD10), which specifies the deaths committed by police officers, continues to show a high degree of underreporting compared to the relative data of the Secretary of Public Security of São Paulo (SSP-SP). This work focuses on the production of health data on deaths committed by police officers, more specifically registered in the SIM, in the city of São Paulo (CSP), between 2014 and 2015, based on the analysis of completeness, scope and the spatial distribution of the phenomenon. METHODS: The present work has three complementary axes. The first axis consists of a descriptive epidemiological study to assess the quality of SIM information about deaths caused by police action. The second axis consists of the association of mortality data (SIM) with SSP-SP data, which allowed us to describe the use of the most frequent causes of deaths by firearms involving police officers in the city of São Paulo. The data linkage made it also possible to estimate the underreporting of lethal police violence, in the SIM data, in the SSP-SP data, as well as in estimating the mortality rate from police activity in the city of São Paulo. The third axis comprises an ecological study that aims to analyze the spatial distribution of deaths resulting from police activity. RESULTS: We saw that both the SIM and the SSP-SP underreport the deaths committed by police, however, in different magnitudes, when we use the estimates indicated via MSE (53.2% in the SIM and 7.9% in the SSP). The reclassification of deaths obtained from the data association generated a substantial gain on the part of SIM, which now has the same average mortality rate as the SSP (3.44 / 100 thousand), having reduced the underreporting compared to the initial scenario. From the association of the two databases, we saw that most deaths were incorrectly classified (53%), with the category Assault by arms Firing - Unspecified (X93-95) being the most frequently used (50 %). Although the SSP-SP reporting of more cases, its data are in general incomplete when we focus on the sociodemographic characteristics of the victims, with inferior completeness of the data, missing high percentages of information. SIM, on the other hand, despite reporting fewer cases of LPV, has excels in terms of completeness (> 95%) in the fields of our interest. Despite the differences in the total number of deaths, the sociodemographic information available from the two sources are coincident: most of the victims were young and black, almost all male, with low education levels, living in the periphery. With the spatial analysis, we performed a description of how LPV is targeted to specific territories in the city, either being directed at groups living and circulating in specific territories in the city, with the housing data (SIM) pointing to patterns of urban segregation, or being directed to places that concentrate violence, social inequalities and institutional violence (SSP-SP). Furthermore, we saw how there is a spatial pattern of underreporting for this type of event, focusing on the southern region of the municipality. CONCLUSIONS: The recognition of police violence as a public health problem is recent. We aim to contribute to bring the health field closer to the theme of police violence and we also note the still frail recognition of the problem. Although the social and health impact of police violence is recognized, its systematic study remains a challenge. The correct death registration is the first step towards the right to justice and truth. To register a death appropriately is a guarantee to the right of information, which is not a goal in itself, but only the beginning in the activity of violence prevention. We recommend the continuous sharing of data and the creation of an intersectoral working group with the objective of monitoring cases of police violence with the participation of several secretaries, especially that of Health and Public Security. Furthermore, the association of the databases must be carried out regularly at the secretarial level, ensuring that São Paulo is one of the first cities in the world to monitor this type of event with excellence, the first step towards actions to combat lethal police violence. (AU) | |
| FAPESP's process: | 18/11773-4 - Analysis of the quality of police lethality data in the City of São Paulo (2013 to 2015) |
| Grantee: | Marcelo Ryngelblum |
| Support Opportunities: | Scholarships in Brazil - Master |