In this month’sBulletin

Homicide accounts for nearly a third of deaths in young Brazilians between 15 and 19 years of age and is the leading cause of death in this age group. And the problem is escalating: between 1977 and 1994 the nationwide death rate due to homicide rose by 160%. Several predisposing factors have been postulated, among them use of narcotics, alcohol and tobacco, having an unmarried mother, exposure to violence on television, high-risk sexual behaviour, dropping out of school, and membership in a youth gang. In an attempt to identify risk factors that might be amenable to preventive action, Falbo et al. (pp. 2–7) conducted a case–control study in Recife, one of Brazil’s most violent cities. With a teenage homicide rate of 324 per 100 000 males — about 30% higher than that of Afro-American males in New York City — it may even be one of the most violent cities in the world. The study compared data on a range of personal and social variables in 255 homicide victims under 20 years of age with the same variables in 255 ageand sex-matched living neighbours of the victims. Data were obtained by questionnaire and personal interview. Of the victims, 95%were male and 97% had died of shot wounds, mostly to the head. The typical teenager at greatest risk of dying by homicide, the Recife study showed, has a police record and uses narcotic drugs. Teenagers who had completed their higher education, who had had a religious upbringing and whose father lived at home were at lowest risk. Social workers take note, the authors urge. They add that possession of firearms must also be a significant risk factor but was not picked up by the study because of gross underreporting by victims’ families fearful of legal repercussions.