South Africa's male homicide epidemic hiding in plain sight: exploring sex differences and patterns in homicide risk in a retrospective descriptive study of postmortem investigations.
South Africa's male homicide epidemic hiding in plain sight: exploring sex differences and patterns in homicide risk in a retrospective descriptive study of postmortem investigations.
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南非的男性凶杀流行病隐藏在人们的视线中：在尸检调查的回顾性描述性研究中探讨凶杀风险的性别差异和模式。
DOI：
10.1101/2023.02.02.23285093
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Abrahams,N
中科院分区：
文献类型：
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作者：
Matzopoulos,R;Prinsloo,M;Mhlongo,S;Marineau,L;Cornell,M;Bowman,B;Mamashela,TA;Gwebushe,N;Ketelo,A;Martin,LJ;Dekel,B;Lombard,C;Jewkes,R;Abrahams,N
南非的总体杀人率是全球平均水平的六倍。男性主要是受害者和肇事者，但对男性受害者知之甚少。对于该国有史以来第一次对男性凶杀案的研究，我们比较了2017年男性和女性受害者的选定协变量，与2009年的全球平均值和先前的估计值。我们对通过尸检调查收集的常规数据进行了回顾性描述性研究，计算了按年龄、性别和省份划分的死亡方式的年龄标准化死亡率，以及男性与女性的发病率比和95%置信区间。然后，我们使用广义线性模型和线性回归模型来评估性别和受害者特征之间的关联，包括年龄和伤害机制（枪支，锋利和钝力）年内和年间。在2017年的19，477起凶杀案中，87%是男性，相当于每名女性有7名男性死亡，其中锋利的武力和火器射击是最常见的死亡原因。在所有年龄段，男性的发病率都高于女性，15-44岁年龄组的发病率最高可达8倍。各省的发病率在总体上和性别上各不相同，西开普省的男性相对于女性的相对风险最高（11.4名男性对1名女性）。男性凶杀案在12月达到高峰，在周末达到最高水平，这突出表明酒精作为一个风险因素的突出作用。南非男子中存在着大规模、不成比例和持久的杀人风险，这突出表明他们在该国的预防和政策应对措施中相对受到忽视。只有通过挑战男性不可伤害的规范观念，我们才能开始处理影响男性的暴力的巨大负担。迫切需要解决这种社会规范的潜在影响，同时实施结构性干预措施，以消除贫穷、不平等的根源，并更好地控制酒精和枪支。
South Africa has an overall homicide rate six times the global average. Males are predominantly the victims and perpetrators, but little is known about the male victims. For the country’s first ever study on male homicide we compared 2017 male and female victim profiles for selected covariates, against global average and previous estimates for 2009. We conducted a retrospective descriptive study of routine data collected through postmortem investigations, calculating age-standardised mortality rates for manner of death by age, sex and province and male-to-female incidence rate ratios with 95% confidence intervals. We then used generalised linear models and linear regression models to assess the association between sex and victim characteristics including age and mechanism of injury (guns, sharp and blunt force) within and between years. 87% of 19,477 homicides in 2017 were males, equating to seven male deaths for every female, with sharp force and firearm discharge being the most common cause of death. Rates were higher among males than females at all ages, and up to eight times higher for the age group 15–44 years. Provincial rates varied overall and by sex, with the highest comparative risk for men vs. women in the Western Cape Province (11.4 males for every 1 female). Male homicides peaked during December and were highest during weekends, underscoring the prominent role of alcohol as a risk factor. There is a massive, disproportionate and enduring homicide risk among South African men which highlights their relative neglect in the country’s prevention and policy responses. Only through challenging the normative perception of male invulnerability do we begin to address the enormous burden of violence impacting men. There is an urgent need to address the insidious effect of such societal norms alongside implementing structural interventions to overcome the root causes of poverty, inequality and better control alcohol and firearms.