Exposure to Community and Family violence and self-rated health in the Brazilian population

ABSTRACT: Introduction: The isolated negative impacts of community violence and family violence on individuals’ self-rated health (SRH) are known, but there is little evidence on the combined effect of these two types of interpersonal violence. Objective: To analyze the association between exposure to community violence/by strangers and family violence/by acquaintances and negative SRH, distinguishing the type of violence suffered and also considering its cumulative exposure. Methods: Epidemiological cross-sectional study developed with data from the National Health Survey (PNS) 2013. Crude multinominal logistic regression models were performed and adjusted to test the association of variables. Results: All types of violence analyzed were associated with negative SRH. Isolated community/unknown interpersonal violence was associated with SRH as regular (odds ratio - OR = 1.38) and bad (OR = 1.79). Exposure to family violence/by acquaintances was associated with regular (OR = 1.52) and bad (OR = 2.70) self-assessment. Concomitant exposure to the two types of violence was associated with regular (OR = 4.00) and bad (OR = 7.81) health assessments, with this association being of greater magnitude than those for isolated violence. Conclusion: The cumulative effect of exposure to family/known and community/unknown violence enhances the negative assessment of health status. Health professionals must be aware of the multivitaminization and its impact on the health of victims who access health services.