Considerations on methodology used in the World Health Organization 2000 Report.

The article analyzes the World Health Organization Report for 2000, with emphasis placed on the methodology used to analyze the indicators utilized to compare and classify the performance of the health systems of the 191 member countries. The Report's contribution was the compromise of monitoring the performance of the health systems of member countries, but because of the inconsistent way it was elaborated, and the utilization of questionable scientific evaluation methodologies, the Report fails to give a clear picture. A criterion-based methodology revision is imposed. The main problems in evidence are the choice of individual indicators of disparity in health that discount the population profile, the inadequate control of the impact of social disparities over the performance of the systems, the evaluation of the responsibility of systems that are only partially articulated to the right of the citizens, the lack of data for a great number of countries, consequently having inconsistent estimations, and the lack of transparency in the methodological procedures in the calculation of some indicators. The article suggests a wide methodological revision of the Report.

Income inequality and homicide rates in Rio de Janeiro, Brazil.

OBJECTIVES: This study determined the effect of income inequality on homicide rates in the state of Rio de Janeiro, Brazil. METHODS: We conducted an ecological study at 2 geographical levels, municipalities in the state of Rio de Janeiro and administrative regions in the municipality of Rio de Janeiro. The association between homicide and income inequality was tested by multiple regression procedures, with adjustment for other socioeconomic indicators. RESULTS: For the municipalities of Rio de Janeiro State, no association between homicide and income concentration was found an outcome that can be explained by the municipalities' different degrees of urbanization. However, for the administrative regions in the city of Rio de Janeiro, the 2 income inequality indicators were strongly correlated with the outcome variable (P < .01). Higher homicide rates were found precisely in the sector of the city that has the greatest concentration of slum residents and the highest degree of income inequality. CONCLUSIONS: The findings suggest that social policies specifically aimed at low-income urban youth, particularly programs to reduce the harmful effects of relative deprivation, may have an important impact on the homicide rate.