[Mortality by firearms in the state of Rio de Janeiro, Brazil: a spatial analysis]

Mortality caused by firearms has been increasing at an alarming rate in the state of Rio de Janeiro, Brazil. This study analyzes the gradual evolution of firearm mortality rates in this Brazilian state from 1979 to 1992, according to sex, age, and area of residence (capital city, metropolitan area, or the state's interior), and uses spatial statistical techniques to describe the propagation of this firearm mortality epidemic in time and space. During the period analyzed, mortality due to firearms showed the greatest increase among 15- to 19-year-old male adolescents, with yearly rates ranging from 13 to 16%, according to area of residence. For children 10 to 14 years of age, mortality caused by firearms increased by 10% annually in the same period. The highest annual increase occurred in the state's interior. At the beginning of the period studied, dissemination of firearm mortality was observed to follow a definite direction parallel to the federal road that runs along the east coast of the state. Between 1990 and 1992, however, the increase in deaths by firearms spread out in practically every direction. Empirical confirmation of a general expansion of firearm wound mortality contradicts the usual claim that violence is concentrated in areas of extreme poverty within Brazil's largest cities. Programs for prevention and control of this epidemic should focus on its various aspects and take into consideration both collective issues (such as proliferation of firearms among persons involved with international firearm smuggling, increases in criminal activity, expansion of drug trafficking, and exclusion from social opportunities) and personal issues (relationships and interaction of young people with their families, schools, and social environment).