Domestic violence, socio-spatial vulnerability and maxillofacial trauma: an ecological study to identify high-risk areas.

The aim of this study was to determine the incidence and spatial-temporal distribution of maxillofacial trauma caused by domestic violence using an innovative approach, through geostatistical techniques. For this purpose, an ecological study was carried out, involving the analysis of cases of maxillofacial trauma caused by domestic violence, using aggregated data from Brazilian victims attended at a Center of Forensic Medicine and Forensic Dentistry during a period of four years. Three types of spatial-temporal analysis techniques were performed: (i) analysis of the incidence of cases using finite mixture modeling; (ii) spatial autocorrelation analysis; and (iii) spatial regression analysis (p < 0.05). During the investigation period, 858 new cases of maxillofacial trauma caused by domestic violence were recorded. The results showed that the incidence was high and with tendency to increase in the last year of observation in about 30.0% of neighborhoods under study. The Getis-Ord indicator (Gi*) pointed to predominance of high-risk neighborhoods in the Eastern zone (p < 0.05) and in the Western zone (p < 0.05). Based on the final regression model, it was found that indicator 2 (proxy of socioeconomic status) remained significantly associated with the incidence of events (β = 8.403; SE = 2.738; p < 0.001). The association between socioeconomic status, domestic violence and maxillofacial trauma reinforces the role of social inequalities. The findings suggest an association between a higher number of cases and high socio-spatial vulnerability, highlighting the need for the development of public policies to prevent domestic violence and maxillofacial injuries.