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The relationship between pay day and violent death in Guatemala: a time series analysis
  1. Dorian E Ramírez1,
  2. Charles C Branas2,
  3. Therese S Richmond3,
  4. Kent Bream4,
  5. Dawei Xie5,
  6. Magda Velásquez-Tohom1,
  7. Douglas J Wiebe5
  1. 1Facultad de Ciencias Médicas, Centro de Investigaciones de las Ciencias de la Salud, Universidad de San Carlos de Guatemala, Guatemala, Guatemala
  2. 2Penn Injury Science Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  3. 3School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  4. 4Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  5. 5Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr Dorian E Ramírez, Facultad de Ciencias Médicas, Centro de Investigaciones de las Ciencias de la Salud, Universidad de San Carlos de Guatemala, 9 av. 9-45 zona 11, Guatemala 01011, Guatemala; dorianramirez{at}gmail.com

Abstract

Objective To assess if violent deaths were associated with pay days in Guatemala.

Design Interrupted time series analysis.

Setting Guatemalan national autopsy databases.

Participants Daily violence-related autopsy data for 22 418 decedents from 2009 to 2012. Data were provided by the Guatemalan National Institute of Forensic Sciences. Multiple pay-day lags and other important days such as holidays were tested.

Outcome measures Absolute and relative estimates of excess violent deaths on pay days and holidays.

Results The occurrence of violent deaths was not associated with pay days. However, a significant association was observed for national holidays, and this association was more pronounced when national holidays and pay days occurred simultaneously. This effect was observed mainly in males, who constituted the vast majority of violent deaths in Guatemala. An estimated 112 (coefficient=3.12; 95% CI 2.15 to 4.08; p<0.01) more male violent deaths occurred on holidays than were expected. An estimated 121 (coefficient=4.64; 95% CI 3.41 to 5.88; p<0.01) more male violent deaths than expected occurred on holidays that coincided with the first 2 days following a pay day.

Conclusions Men in Guatemala experience violent deaths at an elevated rate when pay days coincide with national holidays. Efforts to be better prepared for violence during national holidays and to prevent violent deaths by rescheduling pay days when these days co-occur with national holidays should be considered.

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Footnotes

  • Contributors DER, DJW and CCB conceived and designed the study. DER and MV-T acquired the data. DJW and DER analysed the data. DER, DJW, TSR, KB and DX interpreted the data. KB, MV-T and DER drafted the manuscript. All authors critically revised the manuscript for important intellectual content; all approved the final version to be published and all agreed to be accountable for all aspects of the work. DER, DJW and CCB as guarantors accept full responsibility for the work and the conduct of the study, had access to all the data, and controlled the decision to publish. The manuscript's guarantors affirm that the manuscript is an honest, accurate and transparent account of the study being reported; that no important aspects of the study have been omitted and that any discrepancies from the study as planned (and, if relevant, registered) have been explained.

  • Funding This work was funded in part by US NIH Fogarty International Center under grant number D43TW008972, and US CDC under grant number R49CE002474. All researchers kept independent from funders and sponsors.

  • Competing interests DER, TSR and CCB had financial support from the US NIH (grant number D43TW008972) and TSR, DJW and CCB had financial support from the US CDC (grant number R49CE002474) for the submitted work.

  • Ethics approval The study protocol was approved by the Institutional Review Board of the School of Medicine at Universidad Francisco Marroquín, Guatemala, Central America.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data available. Data were provided by the National Institute of Forensic Sciences (INACIF), a governmental institution of Guatemala's justice system. The INACIF carries out all forensic medicolegal investigations throughout Guatemala, including for all violent deaths. The INACIF provides the Guatemalan justice system with forensic evidence from autopsies, so that the courts can assess the intentionality of each violent death (eg, intentional homicide, unintentional death). The data it collects are also available to interested researchers. Interested parties could contact the INACIF directly in Guatemala City to obtain the same data that were used for our study.

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