Homicides in the Region of the Americas: magnitude, distribution, and trends - 1999-2009

The scope of this analysis was to describe the magnitude and distribution of deaths by homicide in the Americas and to analyze the prevailing trends.

Deaths by homicide (X85 to Y09 and Y35) were analyzed in 32 countries of the Americas Region from 1999 to 2009, recorded in the Mortality Information System/Pan American Health Organization. A negative binomial model was used to study the trends.

Highlights of the results: There were around 121,297 homicides (89% men and 11% women) in the Americas annually, predominantly in the 15 to 24 and 25 to 39 year age brackets. In 2009, the age-adjusted mortality rate due to homicides was 15.5/100,000 in the region. Countries with lower rates were Canada (1.8), Argentina (4.4), Cuba (4.8), Chile (5.2), and the United States (5.8), whereas the highest rates were found in El Salvador (62.9), Guatemala (51.2), Colombia (42.5), Venezuela (33.2), and Puerto Rico (25.8). From 1999 to 2009, the homicide trend in the region was stable. They increased in nine countries including Venezuela (p<0.001), Panama (p<0.001), El Salvador (p<0.001), and Puerto Rico (p<0.001); decreased in four countries, particularly in Colombia (p<0.001); and were stable in Brazil, the United States, Ecuador and Chile. The increase in Mexico occurred in recent years.

The authors concluded that despite many efforts by the countries in the Region in the past years, various still face high homicide rates that are on the increase.

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Suicide among adolescents and young adults has increased in many countries of the Americas in the past decade  

There has been a significant increase in adolescent and young people's suicides in several countries of the Americas between 2001 and 2008, as shown in a recent PAHO/WHO study: Suicide among young people in the Americas.

Researchers used data collected by PAHO in 19 countries and one territory in the Region to measure rates, analyze trends and estimate the risk of suicide to create new prevention programs and more effective public health interventions and policies. The adolescent and young adult population is the largest cohort in the history of the Americas, representing almost 30% of the total population. The three most common causes of death in the young population are external causes, and suicide is one of them.

The results of the study show that the countries with highest suicide rates in the young population (defined as those between 10 and 24 years of age) include (per 100,000): Guyana (22.3), Suriname (15.3), Nicaragua (9.9), Chile (8.9), and Ecuador (8.5). The suicide rates from those countries are at least twice as high as the countries with the lowest rates. The mortality rate among adolescents and young adults, adjusted by age, was 5.7 per 100,000 people. Nevertheless, the study found statistically significant reductions in mortality rates due to suicide in all age groups in Canada, Colombia, Cuba, El Salvador, and Venezuela. Results also show that the most common means of suicide in the Americas is hanging, the use of firearms (especially in the United States), and poisoning.

The article found that among adolescents and young adults, men were more likely to commit suicide than women (less in El Salvador, Ecuador, Paraguay, and Suriname). The authors commented on possible factors that may be associated with this increase in rates, such as the change of gender roles, socioeconomic inequalities and increase in competency for work and resources. However, even though men between 15 and 24 years of age were more likely to commit suicide, women in the Region suffered from more thoughts of suicide.

Public health implications of the data

The study suggests that the wrong use of medicines and the lack of programs to prevent drug and alcohol abuse, as well as deficits in the treatment of mental health issues may be factors that are linked with an increased risk of suicides in adolescents in the Americas. Further, low income levels and slow economic growth may be linked with these increases in some countries of the Region.

The study found that the risk to commit suicide increases with age, and therefore suggests that prevention efforts should start at an early age to reduce those rates. The necessary measures to ensure the well-being of young people and future generations require coordinated multi-sectorial collaboration and strategic alliances. Further, the study concludes that there is great need for research in adolescent mental health in the Region.

Deaths in motorcyclists in the Americas tripled between 1998 and 2010

Injuries, handicap, and deaths due to motorcycle accidents increased disproportionally in the Americas in the last two decades, according to the study "Trends in fatal motorcycle injuries in the Americas, 1998-2010",  carried out by PAHO and the Cisalva Institute of the Universidad del Valle in Colombia. The study shows that deaths related to motorcycles in thr region increased 227% in 12 years, from 3,209 in 1998 to 10,505 in 2010.

Men are the main motorcycle users in Latin America, and those 25 to 34 were the main victims. Further, their relative risk of death is 7.8 times higher than women. Recent economic changes, the rapid increase of motorization rates, the affordability of motorcycles compared to public transportation, the lack of adequate public transportation policies and other measures to improve safety may explain the trends in mortality rates due to motorcycle incidents.

The study covers 17 nations in the Region (Argentina, Brazil, Canada, Chile, Colombia, Costa Rica, Cuba, Ecuador, United States, mexico, Nicaragua, Panama, Paraguay, Puerto Rico, Suriname, Trinidad and Tobago, and Venezuela). According to the results, the countries with the highest mortality rates were Colombia (3.6 per 100,000), Brazil (2.9), Paraguay (2.5), and Suriname (2.2). On the other hand, Chile and Ecuador showed the lowest rate (0.2 per 100,000). However, the highest increases in the Southern Cones were in Chile and Paraguay.

Motorcyclists represent 15% of all traffic-related deaths

In the Region, traffic-related injuries are the number one cause of deaths in children 5 to 14 years of age, and the second cause in the 15 to 44 years age group. In 2010, there were 149,992 traffic-related deaths in the Americas and it is estimated that 5 million people were injured. Motorcyclists represent 15% of those deaths. Motorcycle drivers are especially vulnerable to injuries because of high speeds, a small vehicular structure that offers little protection, and lack of visibility in traffic. As a result, drivers involved in collisions are at higher risk of dying or being severely injured because of the high frequency of head, chest, and leg injuries.

In the Americas and the Caribbean, the number of matriculated vehicles has been estimated to more than 422 millions, of which about 38 millions are motorcycles. The motorization rate varies from one country to the next from 55 per 1,000 in Peru to 779 per 1,000 in the United States, as does the type of vehicles.

The poorest countries show higher fatality rates by motorcycle

The results of the study suggest that the poorest countries tend to have higher fatality rates due to motorcycles accidents, as do those with higher inequalities. Less than half (40.6%) of the countries in the Region have an adequate helmet law, which means that helmets must be used by all passengers of all ages, using any type of motorized vehicle with two wheels, on any road, and must meet the specified security norms.

To slow down or inverse this fatal trend, a series of measures is required, such as the development and application of security standards for motorcycles, integral laws for use of helmets for all passengers, paths reserved for motorcycles, speed controls and quality and safety of those vehicles, as well as policies that promote the use of public transportation.

Additional information:

Global status report on road safety; 2013

Road Safety Fact in the Region of the Americas; 2013