Análise comparativa da mortalidade entre os policiais militares e a população geral residentes no Ceará entre 2011 e 2021

Abstract

The study of mortality is an appropriate tool for assessing and evaluating the health situation, as well as for preparing and evaluating current health programs due to its level of data registration, availability, and the indisputability of the events. The mortality of military police officers in Brazil stands out when compared to other types of police, given that they are the largest contingent on duty and carry out activities on the front lines in the fight against crime. It is noteworthy that the number of deaths among military police officers due to violent causes is higher than in the general population. Therefore, this study aims to analyze the mortality indicators of military police officers by comparing them with those of the general population, in addition to characterizing their sociodemographic profile, identifying causes of death, comparing temporal trends and spatial distribution of mortality, and evaluating the potential years of life lost among military police officers and the general population, both residing in Ceará between 2011 and 2021. This is an analytical and ecological cross-sectional study with temporal and spatial trend analyses conducted through a situational analysis of the deaths of military police officers and the general population. The data used are secondary and were extracted from the Mortality Information System database. The study population comprises military police officers engaged in any type of policing activity and the general population residing in Ceará who died between 2011 and 2021, of both sexes. Data analysis was conducted in three stages. For qualitative variables, absolute and relative frequencies were calculated. The data were organized into univariate tables characterizing death cases among military police officers and the general population. Subsequently, relative risk calculations were carried out through the construction of contingency tables. Pearson’s chi-square test and Fisher’s exact test were used to compare the military police group with the general population. For quantitative variables, measures of central tendency and dispersion were calculated. These indicators were used to create thematic maps aimed at identifying which municipalities had the highest number of deaths and their causes, using ArcGIS 10.2 software. The analysis was carried out using Stata 15 software, and trend analysis was conducted using Joinpoint statistical software. As this study used public domain data, approval from an Ethics and Research Committee was deemed unnecessary. Between 2011 and 2021, 1,829 military police officers died in Ceará, with the highest prevalence in the soldier category (43.1%), followed by corporal (32.4%). Among officers, captains were the most affected (3.8%), followed by majors (2.4%). Regarding sociodemographic factors, it was observed that deaths among military police officers were more frequent in those aged 70 years or older (62.9%), male (99.18%), mixed race (65.10%), married (69.76%), and with incomplete higher education (53.16%). Similar data were found in the general population, differing only in the level of education, with elementary school I (39.71%) being more common. Regarding aspects related to mortality and information about the agents compared to other professions, it was found that most deaths were not related to work accidents (97.0%), more than half of the cases occurred in hospitals where medical assistance was provided (>80.0%), autopsies were largely unnecessary (>70.95%), and the primary source of information came from police reports (>88.48%). The causes of death were similar for the most part, differing only in order. However, it is noteworthy that being a military police officer in Ceará increases vulnerability to death from external causes, as external causes accounted for 21.30% of the top ten causes of mortality in the historical series studied for Ceará. During this period, more than 3 million years of potential life were lost, with military police officers accounting for 10,635 years (0.30%) of this total. When comparing age groups, higher proportions were observed among individuals aged 50 to 54 years (18.6%), followed by those aged 35 to 39 years (15.3%) for military police officers, and 25 to 29 years (14.6%), followed by those aged 30 to 34 years (14.1%) for the general population. When evaluating the historical series, it was observed that mortality trends do not follow the same pattern between the two populations when it comes to acute myocardial infarction (AMI). For both populations, there was a significant reduction in AMI cases, with a greater reduction among military police officers, showing a negative average annual variation of 13.52%. Regarding mortality due to aggression by firearms or unspecified weapons, the trend remained stable for both populations. Furthermore, municipalities with high mortality rates were identified in the metropolitan region of Fortaleza for both military police officers and the general population. The capital, Fortaleza, stands out, followed by the cities of Caucaia and Maracanaú. Additionally, the municipalities of Sobral (North Region) and Juazeiro do Norte (Cariri) stand out in terms of the number of deaths only among military police officers. When these numbers are stratified by gender and only the male sex is analyzed, it is observed that there were no variations among military police officers. However, in the general population, the cities of Juazeiro do Norte, Camocim, and Viçosa do Ceará stand out. The profile of military police deaths in the state of Ceará is similar to that of the general population, with a predominance of men, mixed race, elderly, and married individuals. The causes of death are similar for the most part, differing only in order, but it is worth noting that being a military police officer in Ceará increases vulnerability to death from external cause