Spatial-temporal distribution of maxillofacial injuries resulting from intimate partner violence against women.

Abstract

Maxillofacial trauma resulting from intimate partner violence (IPV) represents an important oral health problem. In this sense, the aim of this study was to investigate the spatial-temporal distribution of maxillofacial trauma resulting from IPV against women, using a geostatistical approach. An ecological study was carried out including the analysis of confirmed IPV cases against women treated at a Center for Forensic Medicine and Dentistry over a four-year observation period, as well as the evaluation of population data from the victims' places of residence extracted from the last demographic census of the Brazilian Institute of Geography and Statistics. Statistical analysis included: (i) finite mixture modeling to establish incidence trajectory patterns; (ii) Getis-Ord indicator (Gi*) for spatial autocorrelation; (iii) spatial regression analysis (p < .05). Two distinct trajectory patterns (TP1 and TP2) related to IPV incidence were identified using finite mixture modeling, suggesting spatial-temporal disparities at theregional level. In TP1, it was observed that IPV incidence was relatively low and remained stable over time, covering almost two-thirds (62.0%) of investigated spatial units. TP2 was characterized by higher IPV incidence witha tendency to increase in the last year, including more than one-third of neighborhoods (38.0%). Autocorrelation analysis showeda predominance of hot areas (hotspots) in the Eastern zone (p < .05) and in the Western zone (p < .05); and cold areas (coldspots) in the Northern zone (p < .05). In addition, statistically significant association was observed among neighborhoods with higher percentage of households with family householder without income and higher incidence of maxillofacial trauma resulting from IPV against women (β=5.305; SE=1.741; p=.002). The findings indicate anassociation between higher IPV incidence against women, maxillofacial trauma, and socio-spatial vulnerability.