The negative impacts of community or domestic violence on individuals self-rated health are known, but there is little evidence of the combined effect of these two types of interpersonal violence.To analyze the association between exposure to community and domestic violence and negative self-rated health status, distinguishing the type of violence suffered and also considering its cumulative exposure.
Cross-sectional epidemiological study developed with the data from Brazilian ‘National Health Survey – 2013’. We used crude and adjusted multinominal logistic regression models to test the association of variables. All types of violence analyzed were associated with negative self-rated health. Exposure to community violence only was associated with regular (OR=1.39, 95% CI 1.14 to 1.70) and poor (OR=1.81, 95% CI, 1.30 to 2, 52) self-rated health. Exposure to domestic violence was associated with regular (OR=1.59, 95% CI 1.31 to 1.92) and poor (OR=2.93, 95% CI 2.23 to 3.84) self-rated health. Cumulative exposure to the two types of violence was associated with a regular (OR=3.97, 95% CI 2.32 to 6.78) and poor (OR=7.90, 95% CI 3.04 to 20, 56) self-rated health, being this association of greater magnitude.
The effect of domestic violence was stronger than that of community violence, and the combined exposure was greater than isolated type violence. When considering violence a psychosocial stressor it is possible to understand such findings, since the characteristics between the types of violence differ, being possible to consider each type of violence a new stressor. In Brazil, community violence is evaluated as endemic, there is an increase in state violence and a structural collapse of public policies, which reinforces the possibility of polivitimization. Therefore, health professionals should be aware of polivitimization and its impact on the health and, above all, public policies should be strengthen aimed at promoting a safer environment and prevention of exposure to violence.
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