A city under siege: Time-series analysis of shootouts and the association with health and living conditions in Rio de Janeiro, Brazil, 2017-2022

Abstract Armed violence is characterized by episodes of conflicts with the use of firearms and occasionally knives and other sharp objects. Ecological time series study applying the joinpoint model based on data on shootouts in the city of Rio de Janeiro, Brazil, from 2017 to 2022. We analyzed the possible association between shootouts and living conditions based on linear and polynomial regressions. Decreases were observed in the number of shootouts in the city of Rio de Janeiro from 2017 to 2022, although current levels of violence are still far above those defined by international agencies as desirable or even acceptable. The statistically significant associations between indicators of living and health conditions and episodes of shootouts were nonlinear (SPI: -2747.9 [(-4973.8; -522.0]; SDI: -2987.4 [(-537.1; -437.6)]). A decrease was observed in episodes of armed violence. The relationship with living conditions points to a complex association, not reducible to a possible linear relationship between violence and living conditions. The findings suggest that complex phenomena should be analyzed with state-of-the-art models, whether for diagnosis or to inform truly structural interventions.